Tc-99m-MAA scintigraphy was performed in a patient with pulmonary hypertension to
confirm the presence of a Right-to-LEFT (R-L) shunt due to the pulmonary Arteriovenous (AV)
fistula. Both planar imaging and SPECT/CT showed multiple decreased or increased RI accumulation
in both lung fields, and the R-L shunt ratio was high, indicating the presence of an R-L shunt.
We considered that the decreased RI accumulated lesions were caused by pulmonary hypertension
due to the pulmonary AV fistula. Osler-Weber-Rendu syndrome was proposed and genetic diagnosis
was done. However, we speculated that the increased RI accumulated lesions were attributable
to localized bleeding or a venous telangiectasia around the pulmonary AV fistula.
Keywords: Osler-Weber-Rendu syndrome, pulmonary arteriovenous fistula, single-photon emission computed tomography/
computed tomography (SPECT/CT), Tc-99m-macroaggregated albumin (Tc-99m-MAA) scintigraphy, vascular malformations.
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