July 2016

This 14 year old male was found to have an enhancing tangle of abnormal vessels on the medial aspect of the right upper chest. This is also know as an AVM (ArterioVenous Malformation). An AVM is defined (by brainavm.uhnres.utoronto.ca) as: A tangle of abnormal and poorly formed blood vessels (arteries and veins). They can occur anywhere in the body and is considered a congenital disorder (MedicineNet).  The concern for AVM is that the vessels are poorly formed and have a higher rate of bleeding at the area of interest and into surrounding areas. This particular AVM is feeding from the right pulmonary artery and draining into 2 venous branches which exit via the 2 right pulmonary veins into the left atrium.

Treatment for this case is a catheter based embolization. Catheter embolization defined (by RadiologyInfo.org), places medications or synthetic materials called embolic agents through a catheter into a blood vessel to block blood flow to an area of the body. Embolization is a highly effective way to control bleeding and is much less invasive than open surgery.

The color images below show a virtual rendition of the vessels feeding into the AVM. The grayscale images below are CPRs (Curved Planar Reformations), which enables visualization of curved pathways by unwrapping and flattening them. One image shows the vein and the other demonstrates the artery.

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Demonstrates the anatomy location in relation to each other.

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Blue demonstrates the venous return system into the Lt Atrium. Orange demonstrates the arterial flow in the AVM.

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CPR of right pulmonary artery to AVM.

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CPR of right pulmonary vein to AVM.

Stanford 3DQ Lab provides specially trained technologists which use specialized post processing software to display anatomical features.

 

Nancy Ware

Nancy Ware – 3DQ Technologist