Steal phenomenon-induced lung perfusion defects in pulmonary arteriovenous fistulas: assessment with automated perfusion SPECT-CT fusion images

Abstract

In addition to the right-to-left shunt, 'steal phenomenon'-induced perfusion defects are common in the surrounding lung of pulmonary nodular AVF and cause hypoxemia. DIBrH SPECT-CT fusion images contribute to the objective evaluation of 'steal phenomenon'-induced lung perfusion impairment in AVF and the detection of tiny, subtle AVFs that may be missed by other radiological imaging techniques.

Images of the month 1: Ischaemic stroke due to pulmonary arteriovenous fistula

“…Multi-detector row CT enhancement can not only reveal the lesion itself and corresponding blood vessels but also detect smaller lesions, and can be used to interpret peripheral and complex PAVF more accurately. 4 In this case, the patient had abnormal coagulation and pulmonary angiography showed PAVF in the left bronchial artery. Therefore, the patient had cerebral infarction due to an RLS formed by PAVF.…”

Artifacts and Anatomical Variants Affecting Ventilation and Perfusion Lung Imaging

“…Perfusion defects have also been reported in cases on anomalous systemic arterial supply to normal basal segments of the left lower lobe of the lung 54 and with the arterio-venous malformation producing a "region steal" phenomenon-induced perfusion defects. 55 …”