Chinese Medical Sciences Journal ›› 2019, Vol. 34 ›› Issue (3): 194-198.doi: 10.24920/003482

• Original Article • Previous Articles     Next Articles

Value of CT-Angiography in the Emergency Management of Severe Hemoptysis

Chen Ying1, Wang Kefei2, Wang Zhiwei2, *(), Liu Changzhu1, Jin Zhengyu2   

  1. 1 Department of Radiology, Peking the 6th Hospital, Beijing 100007, China
    2 Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
  • Received:2018-09-30 Online:2019-07-02 Published:2019-10-11
  • Contact: Wang Zhiwei E-mail:zhiweiwang1981@sina.com
  • Supported by:
    Supported by the National Public Welfare Basic Scientific Research Program of Chinese Academy of Medical Sciences(2018PT32003);Supported by the National Public Welfare Basic Scientific Research Program of Chinese Academy of Medical Sciences(2017PT32004)

Abstract:

Objective To depict imaging anatomy of bronchial artery (BA) using multidetector CT-angiography (MDCTA) and evaluate the value of MDCTA for management of hemoptysis patients requiring admission to emergency room.

Methods We retrospectively studied the clinical and radiological data of patients with severe hemoptysis (≥100 ml of expectorated blood in a 24-hour period) requiring admission to emergency room from Jan 1, 2013 to Dec 31, 2015. Patients’ images of MDCTA, treatment modalities, and outcome were discussed.

Results A total of 108 patients underwent MDCTA scans. Etiology of hemoptysis was mainly bronchiectasis (44%), tuberculosis sequelae (26%) and tumor (18%). MDCTA visualized 197 traceable BAs and also suggested the involvement of 35 nonbronchial systemic arteries. The mean diameter of BAs, measured at the level of the bronchial bifurcation in the mediastinum, was 2.8±1.2 mm. The mean diameter of BAs, for 52 patients who only received conservative treatment, was 2.9±1.1 mm, and was not significantly larger than that of BAs for 56 patients who underwent bronchial artery embolization (BAE) for continued bleeding which did not resolve after conservative treatment (2.7±1.1 mm, P = 0.94). The technical success rate of embolization was 95% (53/56). Clinical success rate during follow-up was achieved in 50 (94%) of 53 patients who had undergone embolization.

Conclusions MDCTA provides useful information for identifying the anatomical characteristics of bleeding-related BAs and nonbronchial systemic arteries for the management of patients with severe hemoptysis. However, MDCTA could not determine the individuals who need BAE through measuring diameter of BAs.

Key words: hemoptysis, multidetector CT-angiography, endovascular embolization

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