Contrast-enhanced MR perfusion imaging and MR angiography: utility for management of pulmonary arteriovenous malformations for embolotherapy

Objective: The purpose of this study was to assess the capability of MR perfusion imaging and angiography (MRA) for management of pulmonary arteriovenous malformation (PAVM). Methods and patients: Eight patients, having 15 PAVMs underwent pulmonary angiography (PAG), CT, MR perfusion imaging and MRA. For the pretherapeutic management, MRA was compared with PAG and CT regarding detectability and diameter of vasculature. For post-therapeutic management, the change in size of aneurysmal sac, any residual contrast-enhancement and the blood supply within the sac were evaluated. Results: All PAVMs with aneurysmal sac, feeding artery and draining vein diameters of equal to or more than 3 mm, were identified and measured with similar results by all modalities. On follow-up studies, 7 (58.4%) out of 12 treated PAVMs showed a decrease in size and residual contrast-enhancement. The residual contrast-enhancement was considered as bronchial artery-to-pulmonary artery collateral flow by MR perfusion imaging. Conclusion: MR perfusion imaging and MRangiography are useful for management of PAVMs over 3 mm in diameter.