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British Journal of Radiology (2004) 77, 445-448
© 2004 British Institute of Radiology
doi: 10.1259/bjr/80737867
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Small pulmonary arteriovenous fistulae revealed by scintigraphy during selective injection of 99Tcm-macroaggregated albumin

T Hirota, MD T Yamagami, MD, PhD T Nakamura, MD, PhD C Okuyama, MD Y Ushijima, MD, PhD and T Nishimura, MD, PhD

Department of Radiology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602-8566, Japan



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  		Figure 1. 99Tcm-macroaggregated albumin posterior imaging showed radioactive accumulation in the kidneys (arrows) and spleen (arrowheads).

 


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  		Figure 2. Pulmonary arteriography showed abnormal vessels at the medial site of the left descending branch (arrow).

 


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  		Figure 3. Selective pulmonary arteriography via the left A6 branch showed abnormal subtle vessels (arrows) after contrast medium filled the arterial branch, but prompt venous return through pulmonary arteriovenous fistulae remained unclear.

 


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  		Figure 4. (a) Anterior and (b) left lateral views of dynamic images (five frames, every 2 s) obtained immediately after the injection of 99Tcm-macroaggregated albumin via the left A6. Schema of the images is also shown. The left S6 pulmonary parenchyma was initially visualized (arrow heads), followed by the left ventricle (thick arrows). Note that the infused 99Tcm-macroaggregated albumin is visible within the microcatheter in the first frame (thin arrow); in the later phases, the compound is visible in the descending aorta, spleen and kidneys.

 




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