Edwards Jared, Keller Frederick S, Chesnutt Mark S, Coates Stephanie, Jahangiri Younes
School of Medicine, Oregon Health & Science University, Portland, OR, USA.
Dotter Department of Interventional Radiology, Oregon Health & Science University, Portland, OR, USA.
Clin Imaging. 2020 Oct;66:23-25. doi: 10.1016/j.clinimag.2020.04.019. Epub 2020 May 3.
A 50-year-old female with a 20-year history of multifocal pulmonary benign metastasizing leiomyoma (BML), and asthma presented with subacute worsening of chronic dyspnea. A contrast-enhanced computerized tomography of the chest showed a single 1.4 × 1.5-cm contrast-enhancing mass in the right lower lobe among numerous non-enhancing bilateral pulmonary BML lesions. Pulmonary angiogram was not performed at that time due to clinical improvement. Four years later, the patient presented with refractory subacute worsening of her chronic dyspnea and was referred for embolization of the pulmonary arteriovenous malformation (PAVM). Two feeder arteries to the PAVM were embolized; each with a 6-mm Amplatzer-IV vascular plug and a 4-mm Nester coil. Follow-up angiograms demonstrated no flow through the PAVM. The patient's dyspnea resolved and she remained asymptomatic at one-year follow-up.
一名50岁女性，有20年多灶性肺良性转移性平滑肌瘤（BML）病史，合并哮喘，出现慢性呼吸困难亚急性加重。胸部增强计算机断层扫描显示，在众多双侧肺部无强化的BML病变中，右下叶有一个1.4×1.5厘米的强化肿块。由于临床症状改善，当时未进行肺血管造影。四年后，患者出现慢性呼吸困难难治性亚急性加重，被转诊进行肺动静脉畸形（PAVM）栓塞治疗。PAVM的两条供血动脉进行了栓塞；每条动脉使用一个6毫米的Amplatzer-IV血管封堵器和一个4毫米的Nester线圈。随访血管造影显示PAVM无血流通过。患者的呼吸困难得到缓解，一年随访时仍无症状。
