Utility of contrast echocardiography for pulmonary arteriovenous malformation screening in pediatric hereditary hemorrhagic telangiectasia

J Pediatr. 2012 Jun;160(6):1039-43.e1. doi: 10.1016/j.jpeds.2011.11.038. Epub 2011 Dec 21.


Objective: To evaluate the utility of transthoracic contrast echocardiography (TTCE) as a screening tool for pulmonary arteriovenous malformations (PAVMs) in children with hereditary hemorrhagic telangiectasia (HHT).

Study design: This was a single-center study of children who underwent baseline screening for PAVMs using both TTCE and chest computed tomography (CT) for evaluation of HHT. The CT and TTCE results were prospectively reviewed independently by 2 radiologists and 2 cardiologists blinded to the study results.

Results: Both intraobserver and interobserver agreement for interpreting TTCE results were excellent (κ = 0.97 and 0.92, respectively) and higher than the interobserver agreement for CT interpretation (κ = 0.75). The sensitivity and specificity of TTCE to predict PAVMs were 1 and 0.82, respectively, and the positive predictive and negative predictive values were 0.39 and 1, respectively.

Conclusion: TTCE is a sensitive test for PAVMs in children with suspected HHT and can be a useful initial screening tool in pediatric HHT.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Arteriovenous Malformations / diagnostic imaging*
  • Child
  • Child, Preschool
  • Contrast Media*
  • Diagnosis, Differential
  • Echocardiography / methods
  • Echocardiography / statistics & numerical data*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Mass Screening / methods*
  • Predictive Value of Tests
  • Pulmonary Artery / abnormalities*
  • Pulmonary Artery / diagnostic imaging
  • Pulmonary Veins / abnormalities*
  • Pulmonary Veins / diagnostic imaging
  • Reproducibility of Results
  • Retrospective Studies
  • Severity of Illness Index
  • Telangiectasia, Hereditary Hemorrhagic / diagnostic imaging*


  • Contrast Media