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Master Thesis

Évaluation de la stratégie diagnostique et du suivi des malformations artério-veineuses pulmonaires, chez les patients suspects d’être atteints, ou atteints de la maladie de Rendu-Osler : état des lieux au CHU de Caen

Abstract : There are several methods for screening and monitoring pulmonary arteriovenous malformation (PAVMs) in patients with Rendu-Osler disease (ROD). The chest computerized tomography (CT scan) with or without contrast product injection is the first line examination performed in our center in the initial management. It can be supplemented by functional tests such as trans-thoracic contrast echocardiography (TTCE) or hyperoxia test (100% oxygen method). Our study assesses the contribution of these two functional examinations in the management of patients followed at the Caen University Hospital. We included 74 patients who underwent chest CT and close TTCE and/or hyperoxia test. The calculated Sensitivity and Specificity were 84% and 74,19% for TTCE, and 61,54% and 70% for the 100% oxygen method test respectively, using an arteriovenoux difference (AVD) of 4.4 and a shunt tresholds values of 5%. There are several sources of error in these two exams, such as the operator dependant character for the TTCE, or the variability of the calculated shunt according to the assumed AVD or the arterial blood gases sampling conditions. TTCA seems to be the most efficient test for screening for PAVM, especially in the event of non-contributory chest CT and hyperoxia appears relevant in pre and post-embolisation follow up, thanks to its objective quantitative evaluation of the shunt. Quantitative follow-up of the PAVM through these two functional examinations has a relevant clinical implication in the long-term follow-up.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03524792
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Submitted on : Thursday, January 13, 2022 - 2:25:45 PM
Last modification on : Saturday, January 15, 2022 - 3:32:42 AM
Long-term archiving on: : Thursday, April 14, 2022 - 6:52:36 PM

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  • HAL Id : dumas-03524792, version 1

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André Wu. Évaluation de la stratégie diagnostique et du suivi des malformations artério-veineuses pulmonaires, chez les patients suspects d’être atteints, ou atteints de la maladie de Rendu-Osler : état des lieux au CHU de Caen. Médecine humaine et pathologie. 2021. ⟨dumas-03524792⟩

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