Posterior mediastinal arteriovenous malformation with atypical color Doppler sonographic findings

An arteriovenous malformation (AVM) is an anomaly of capillary development that results in a direct connection between branches of an artery and veins, with no intervening capillary network. A definite diagnosis of AVM is usually made with angiography. We report the case of a posterior mediastinal AVM found on routine sonography in a 64‐year‐old woman with neglected hypertension and severe back pain. Color Doppler imaging showed 2 adjoined vascular structures without a typical mosaic‐like flow pattern, and spectral Doppler analysis showed low‐resistance flow and arteriovenous shunting in 2 adjoined vascular structures. The diagnosis was subsequently confirmed by angiography. Because disastrous bleeding could result if needle biopsy were performed inadvertently in the case of a suspected mediastinal AVM, we suggest that color Doppler sonography be attempted if there is an adequate acoustic window. © 2002 Wiley Periodicals, Inc. J Clin Ultrasound 31:44–47, 2003