Posttreatment Monitoring of Pulmonary Arteriovenous Malformations: Challenges and Approaches.

Although initial treatment guidelines are well established, posttreatment surveillance practices remain heterogeneous, with no standardized approach for monitoring treated lesions or detecting PAVM persistence.

尽管初始治疗指南已经很好地建立，但治疗后的监测实践仍然多样化，没有标准化的方法来监测治疗后的病变或检测PAVM的持续存在。

This variability in follow-up care may affect patient outcomes, particularly in high-risk populations such as those with hereditary hemorrhagic telangiectasia (HHT).

随访护理的这种变异性可能会影响患者的结果，特别是在高风险人群中，例如那些患有遗传性出血性毛细血管扩张症（HHT）的患者。

review_findings

Post-embolization PAVM persistence occurs in up to 25% of treated cases through mechanisms that include recanalization and reperfusion., Current follow-up relies primarily on CT imaging, although radiation exposure remains a concern with repeated studies.

在治疗的病例中，高达25%的患者在栓塞后仍存在肺动静脉畸形（PAVM）的持续，其机制包括再通和再灌注。目前的随访主要依赖于CT成像，尽管重复研究中辐射暴露仍然是一个令人关注的问题。

Transthoracic contrast echocardiography shows promise for surveillance but requires validation against CT findings.

经胸对比超声心动图在监测方面显示出希望，但需要与CT发现进行验证。

Time-resolved magnetic resonance angiography exhibits 89% sensitivity and 95% specificity for detecting PAVM patency compared with 82% and 81% for CT images, respectively.

时间分辨磁共振血管造影对于检测PAVM通畅性的敏感性为89%，特异性为95%，与CT图像的82%和81%相比。

The newly established multicenter PAVM registry may help standardize surveillance protocols and improve outcome tracking.

新建立的多中心肺动静脉畸形(PAVM)登记系统有助于标准化监测方案并改善结果追踪。

Special consideration is needed for monitoring during high-risk periods such as pregnancy and adolescence when growth rates may accelerate.

特别是在高风险时期，如怀孕和青春期，需要特别注意监测，因为此时生长速度可能会加快。

summary

Long-term surveillance is essential following PAVM embolization, particularly in patients with HHT.

在肺动静脉畸形栓塞后，特别是对于遗传性出血性毛细血管扩张症患者，长期监测是必不可少的。

Although multiple imaging modalities are available, optimal surveillance protocols balancing detection sensitivity with radiation exposure remain undefined.

尽管有多种成像方式可供选择，但最佳的监测方案，即在检测灵敏度与辐射暴露之间取得平衡，仍然不明确。

Implementation of standardized follow-up guidelines through multicenter collaboration and registry data may improve risk detection and allow for more timely intervention.

通过多中心合作和登记数据实施标准化随访指南，可能提高风险检测的准确性，并允许更及时的干预。