[Evaluations of bronchial and nonbronchial systemic arteries in patients with hemoptysis at dual-source computed tomograph: comparison with conventional angiography]

Zhaoping Cheng, Jianqiang Shang, Jun Tang, Zengtao Sun, Jie Chen, Lei Zhang, Jijun Li, Ximing Wang
Zhonghua Yi Xue za Zhi [Chinese medical journal] 2014 November 25, 94 (43): 3370-3

OBJECTIVE: To retrospectively evaluate the depiction of bronchial and nonbronchial systemic arteries with dual-source computed tomography (DSCT) versus conventional angiography in patients with hemoptysis.

METHODS: DSCT and conventional angiography of thorax were performed in 66 patients with hemoptysis. There were 46 males and 20 females with a mean age of 45 (22-72) years. Findings on DSCT, including CT scans, maximal intensity projections and three-dimensional volume-rendered images were used to evaluate the visibility and traceability of bronchial and/or nonbronchial systemic arteries. CT scans were evaluated by two radiologists in consensus. The CT findings were compared with those of conventional angiography.

RESULTS: A total of 171 (87 right, 84 left) bronchial arteries and 18 nonbronchial systemic arteries were visible on DSCT. The right bronchial arteries arose from intercostal-bronchial trunk thoracic aorta (n = 46), common trunk of both bronchial arteries (CBT) (n = 32) and thoracic aorta (n = 9) whereas left bronchial arteries arose from thoracic aorta (n = 50), CBT (n = 32) and left subclavian artery (n = 2). Compared with angiography, the accuracy of DSCT in the diagnosis of hemoptysis responsible vessels (i.e. dilatation BA) was approximately 88.7% (133/150). DSCT correctly diagnosed 18 nonbronchial systemic arteries, but missed 7; DSCT correctly diagnosed 5 bronchial-pulmonary vascular fistulas, but missed 15.

CONCLUSION: Excellent for evaluating hemoptysis, DSCT may identify the origin and ostial position of bronchial arteries, detect non-bronchial systemic arteries and act as a roadmap for percutaneous transcatheter embolisation.

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