• Clinical and Experimental Pediatrics
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• 제52권1호
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• pp.124-128
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• 2009

폐동정맥루는 폐동맥과 폐정맥이 모세혈관 없이 바로 연결된 것으로서 우좌 단락을 형성하여 청색증, 호흡곤란과 곤봉지를 일으키는 질환이다. 또한 뇌혈전에 의하여 뇌출혈이나 뇌농양 등의 신경학적인 합병증을 일으킬 수 있다. 대부분의 경우 청소년기 후기까지 증상이 나타나지 않는 경우가 많다. 본 증례는 입주위의 청색증과 곤봉지 및 호흡곤란을 보인 6세된 남아였다. 흉부 엑스레이에서 우측하엽에 국소적인 결절의 음영이 발견되었고 흉부 단층 촬영을 통해 우측 하엽의 큰 폐동정맥루를 확진하였다. 우측 하엽의 폐절제술로 합병증 없이 성공적으로 치료하였다. 영유아시기에 폐동정맥루의 발생 빈도는 드물긴 하지만, 심혈관계 질환 없이 청색증과 호흡곤란을 보이는 드문 원인으로 폐동정맥루의 가능성을 염두에 두고 일찍 진단하고 치료함으로써 신경학적인 합병증의 발생을 예방하여야 한다.

• Korean Journal of Radiology
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• 제23권8호
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• pp.794-802
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• 2022

Objective: To evaluate the feasibility of single-shot whole thoracic time-resolved MR angiography (TR-MRA) to identify the feeding arteries of pulmonary arteriovenous malformations (PAVMs) and reperfusion of the lesion after embolization in patients with multiple PAVMs. Materials and Methods: Nine patients (8 females and 1 male; age range, 23-65 years) with a total of 62 PAVMs who underwent percutaneous embolization for multiple PAVMs and were subsequently followed up using TR-MRA and CT obtained within 6 months from each other were retrospectively reviewed. All imaging analyses were performed by two independent readers blinded to clinical information. The visibility of the feeding arteries on maximum intensity projection (MIP) reconstruction and multiplanar reconstruction (MPR) TR-MRA images was evaluated by comparing them to CT as a reference. The accuracy of TR-MRA for diagnosing reperfusion of the PAVM after embolization was assessed in a subgroup with angiographic confirmation. The reliability between the readers in interpreting the TR-MRA results was analyzed using kappa (κ) statistics. Results: Feeding arteries were visible on the original MIP images of TR-MRA in 82.3% (51/62) and 85.5% (53/62) of readers 1 and 2, respectively. Using the MPR, the rates increased to 93.5% (58/62) and 95.2% (59/62), respectively (κ = 0.760 and 0.792, respectively). Factors for invisibility were the course of feeding arteries in the anteroposterior plane, proximity to large enhancing vessels, adjacency to the chest wall, pulsation of the heart, and small feeding arteries. Thirty-seven PAVMs in five patients had angiographic confirmation of reperfusion status after embolization (32 occlusions and 5 reperfusions). TR-MRA showed 100% (5/5) sensitivity and 100% (32/32, including three cases in which the feeding arteries were not visible on TR-MRA) specificity for both readers. Conclusion: Single-shot whole thoracic TR-MRA with MPR showed good visibility of the feeding arteries of PAVMs and high accuracy in diagnosing reperfusion after embolization. Single-shot whole thoracic TR-MRA may be a feasible method for the follow-up of patients with multiple PAVMs.