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Transpleural ultrasound diagnosis of a pulmonary arteriovenous malformation

¹ Department of Radiology, Addenbrooke's Hospital, Cambridge University Teaching Hospitals Trust, Hills Road, Cambridge CB2 2QQ and ² Department of Medicine, Papworth Hospital, Papworth Everard, Cambridge CB3 8RE, UK

View larger version (76K): [in a new window]   Figure 1. Transverse ultrasound image of the right chest demonstrating: (a) a low echogenicity tubular structure, containing a high echogenic focus in its periphery, presumed to represent vessel with calcification in its wall. An echogenic pleural effusion is present in (b) spectral Doppler trace from the vessel, confirming arterial blood flow.

View larger version (169K): [in a new window]   Figure 2. Coronal maximal intensity projection (MIP) 4-detector multislice CT image demonstrating an enhancing lesion (arrow) arising from the middle lobe and clearly identifying the feeding and draining vessels.

View larger version (139K): [in a new window]   Figure 3. Selective digitally subtracted right pulmonary artery angiogram (predominantly arterial phase) demonstrating the right middle lobe arteriovenous malformation.

View larger version (131K): [in a new window]   Figure 4. Post-embolisation image demonstrating the employed vaso-occlusive coils.