CTICasesLarge Pulmonary Arteriovenous Malformation
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Imaging findings
Chest CT angiogram reveals a massive pulmonary arteriovenous malformation in the left lower lobe, characterized by a dilated feeding segment of the pulmonary artery directly communicating with an aneurysmal draining vein that empties into the left atrium. Opacification dynamics show unpacified blood mixing in the left atrium and left ventricle due to the high-flow right-to-left shunt.
Key takeaways
Pulmonary arteriovenous malformations (AVMs) are abnormal direct connections between pulmonary arteries and veins that bypass the capillary bed, most commonly associated with Hereditary Hemorrhagic Telangiectasia (HHT). Due to the lack of a filtering capillary bed, patients are at high risk for paradoxical emboli, presenting as transient ischemic attacks (TIAs), stroke, or brain abscesses, making transcatheter embolization the treatment of choice for larger lesions.
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