What is the role of ultrasonography and contrast echocardiography in the diagnosis of Osler-Weber-Rendu disease (OWRD) (hereditary hemorrhagic telangiectasia [HHT])?

Updated: Oct 06, 2020
  • Author: Klaus-Dieter Lessnau, MD, FCCP; Chief Editor: Vincent Lopez Rowe, MD  more...
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Doppler ultrasonography of the liver may be used for screening and first-line imaging in patients with OWRD who have hepatic AVM or other associated sequelae.

Contrast echocardiography has been shown to reveal pulmonary AVM when pulse oximetry examination or even pulmonary angiography findings were negative. Agitated saline, with its small air bubbles, creates visible contrast that can be observed in the left atrium on echocardiography. The presence of contrast in the left atrium indicates right-to-left shunt.

The ability to detect intracardiac shunts is an advantage that contrast echocardiography has over other shunt studies. [82] Higher-grade shunts (>20-30 microbubbles/frame) have higher positive predictive value. [92]

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