Hereditary hemorrhagic telangiectasia [I78.0] / Arteriovenous malformation, site unspecified [Q27.30], Reason for Study: ^Reason: 3T Scanner, please evaluate for brain AVMs History: HHT Brain MRI:No evidence of acute ischemic or hemorrhagic lesion on this scan.There is focal linear and slightly nodular enhancement on the right frontal lobe pre central gyrus and middle frontal gyrus junction area (series 1101, image 24/32, series 1201, 24/31). Considering the patient's history of HHT, this could represent a very small arteriovenous shunt. Follow up MR examination needs to be considered.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.Brain MRA:3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate enlarged left PCA which is communicating with the left ICA branch likely representing inferolateral trunk.The right Pcom artery is patent and the Acom artery is also patent.There is no evidence of intracranial arterial aneurysm or significant luminal stenosis.
1. Focal enhancing lesion on the right frontal lobe as described above which may indicate tiny arteriovenous shunt. Follow up MRI with and without contrast enhancement can be considered.2. No intracranial arterial aneurysm. No intracranial arterial luminal stenosis. No evidence of intracranial arterio-venous malformation. 