Systemic Artery to Pulmonary Vein Fistula After Right Upper Lobectomy Demonstrated by 4-Dimensional Flow Magnetic Resonance Imaging Antoine Legras, MD,

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Systemic Artery to Pulmonary Vein Fistula After Right Upper Lobectomy Demonstrated by 4-Dimensional Flow Magnetic Resonance Imaging Antoine Legras, MD, MS, Arshid Azarine, MD, MS, Bastien Poitier, MD, Emmanuel Messas, MD, PhD, Françoise Le Pimpec-Barthes, MD, PhD The Annals of Thoracic Surgery Volume 104, Issue 2, Pages e169-e171 (August 2017) DOI: 10.1016/j.athoracsur.2017.02.061 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Three-dimensional reconstruction of computed tomographic angiography, anterior view, showing: (a, b, c) collateral branches of axillary artery, (d) intercostal arteries (maximum intensity projection [MIP], frontal section) (e) right internal mammary artery, (f) left internal mammary artery, (g) right diaphragmatic artery. The Annals of Thoracic Surgery 2017 104, e169-e171DOI: (10.1016/j.athoracsur.2017.02.061) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Computed tomographic angiography, with maximum intensity projection (MIP) reconstruction, axial section, showing intrapulmonary arteriovenous fistulas in the middle lobe (A) and in the anterobasal segment of the right inferior lobe (B) (arrows). The Annals of Thoracic Surgery 2017 104, e169-e171DOI: (10.1016/j.athoracsur.2017.02.061) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Four-dimensional flow magnetic resonance image with color representation of the flows, frontal view, showing the intrapulmonary fistula of the middle lobe (a) and evidence of parietal systemic hyperflow: from axillary branch (b), from the right internal mammary artery (c), compared with the left (d), but also diffuse parietal flow (e). The main pulmonary artery (f) is also seen. Arrows show the flow direction. Flow stream lines can be observed in the Video. The Annals of Thoracic Surgery 2017 104, e169-e171DOI: (10.1016/j.athoracsur.2017.02.061) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions