Two resected cases of pulmonary arteriovenous fistula following visualization and evaluation by 3D-CT and perfusion scintigraphy

Abstract

Here we report two resected cases of pulmonary arteriovenous fistula. Case 1: A 57-year-old man was admitted to a hospital because of cerebral infarction. Chest X-ray revealed an abnormal shadow in the left lung field. The patient was symptomatic and cyanosis, hypoxemia and polycythemia were recognized. Case 2: A 33-year-old, healthy man was referred to our hospital because of an abnormal shadow with enlarged pulmonary vessels in the left lung field incidentally detected in a medical checkup. In both cases, 3D-CT showed an excellent image of pulmonary arteriovenous fistula, a feeding artery and a drainage vein. Perfusion scintigraphy revealed extrapulmonary activity due to the right-to-left shunt. The postoperative course of the two patients was uneventful. When surgical intervention is considered for pulmonary arteriovenous fistula, anatomical assessment by 3D-CT and functional evaluation by pulmonary perfusion scintigraphy are non-invasive, useful modalities for preoperative study.