64-detector row CT evaluation of bronchial and non-bronchial systemic arteries in life-threatening haemoptysis

I Ponnuswamy, S T Sankaravadivelu, P Maduraimuthu, K Natarajan, B P Sathyanathan, S Sadras
British Journal of Radiology 2012, 85 (1017): e666-72

OBJECTIVE: To retrospectively evaluate the depiction of bronchial and non-bronchial systemic arteries with 64-detector row CT in patients undergoing endovascular treatment for life-threatening haemoptysis.

METHODS: 64-detector row helical CT and conventional angiography of the thorax were performed in 28 patients (25 males, 3 females; age range, 18-65 years; mean age, 40 years) with life-threatening haemoptysis. CT images were analysed to identify abnormal bronchial and non-bronchial systemic arteries and also to localise them in two planes.

RESULTS: Using multidetector CT (MDCT), 43 bronchial arteries were identified on the right side and 46 on the left side. 89% of the right bronchial arteries originated from the right intercostobronchial arteries. A common trunk of origin of the right and left bronchial artery was noted in 46% of cases. 23 non-bronchial systemic arteries were noted on the right side and 41 on the left side. Pleural thickening >3 mm was confirmed to be a good predictor of non-bronchial systemic supply. An internal mammary artery diameter of >3 mm and an inferior phrenic artery diameter of >2 mm were sensitive indicators for non-bronchial systemic supply.

CONCLUSION: MDCT is a good investigation tool for evaluating life-threatening haemoptysis as it confirms the disease process, identifies the origin and ostial position of bronchial arteries, detects non-bronchial systemic arteries and acts as a roadmap for percutaneous transcatheter embolisation.

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