Learning objectives
To evaluate the value of CT angiography for patients with hemoptysis,
in: (1) identifying vascular abnormalities,
(2) predicting the site of bleeding,
and (3) identifying the underlying etiology.
Background
Hemoptysis is a potentially life-threatening complication of an underlying disease,
most often in patients suffering from cancer or long-lasting inflammations of the lung or bronchi.
CT angiography is a well established method for evaluating pulmonary arteries and the aorta and its branches.
With recent advances in the CT technology,
mainly related to the high spatial resolution and the fast acquisition time,
the CT is regarded as valuable tool not only to establish diagnosis of the underlying diseases but also to localize the site of bleeding...
Imaging findings OR Procedure details
25 consecutive patients (12 women,
13 men) with a mean age of 50±39 years (min 15,
max 89) presenting with submassive or massive hemoptysis who had CT angiography were included in the study.
We analyzed vascular abnormalities including bronchial (BA),
systemic non-bronchial (SNBA) and pulmonary arteries (PA),
and parenchymal changes.
The CT findings were compared to those obtained from transcatheter angiography (TCA).
According to the TCA,
BA were responsible for hemoptysis in 25 cases and the SNBA in 4 cases and no patient had PA...
Conclusion
CT is a useful tool to identify vascular abnormalities and a help for making therapeutic decisions.
However,
the site of bleeding cannot be predicted in all cases.
References
Khalil et al,
Impact of MDTC Angiography on the Management of Patients With Hemoptysis,
AJR 2010; 195:772-778
Khalil et al,
Severe Hemoptysis of Pulmonary Arterial Origin: Signs and Role of Multidetector Row CT Angiography,
Chest 2008;133;212-219
Remy-Jardin et al,
Bronchial and Nonbronchial Systemic Arteries at Multi-Detector Row CT Angiography: Comparison with Conventional Angiography,
Radiology 2004; 233:741-749
Young Cheol Yoon et al,
Hemoptysis: Bronchial and Nonbronchial Systemic Arteries at 16-Detector Row CT,
Radiology 2005; 234:292-298
Woong Yoon et al,
Massive Hemoptysis: Prediction of Nonbronchial Systemic Arterial...