Yoon Young Cheol, Lee Kyung Soo, Jeong Yeon Joo, Shin Sung Wook, Chung Myung Jin, Kwon O Jung
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea.
Radiology. 2005 Jan;234(1):292-8. doi: 10.1148/radiol.2341032079. Epub 2004 Nov 18.
To retrospectively evaluate 16-detector row computed tomography (CT) compared with conventional angiography in depiction of bronchial and nonbronchial systemic arteries in patients with hemoptysis.
Institutional review board approval was obtained, and informed consent was not required. Sixteen-detector row helical CT and conventional angiography of the thorax were performed in 22 patients (16 men, six women; age range, 18-75 years; mean age, 50 years) with hemoptysis. Three observers in consensus analyzed retrospectively transverse, multiplanar reconstruction, or three-dimensional CT images for visibility, traceability of bronchial arteries from their origin at the aorta or aortic branches to the hilum, and presence of nonbronchial systemic arteries. CT and angiographic findings of bronchial and nonbronchial systemic arteries causing hemoptysis were compared by two radiologists in consensus. Differences in visibility, traceability, and diameter of bronchial arteries causing and those not causing hemoptysis were tested by using generalized estimating equation method or the mixed model.
Fifty-two (30 right and 22 left) bronchial arteries and 33 nonbronchial systemic arteries were visible at CT. Thirty-four (20 right and 14 left) of 52 bronchial arteries were traceable from their origins to the hilum. Thirty-one (16 right and 15 left) of 46 (27 right and 19 left) bronchial arteries and 26 of 64 nonbronchial systemic arteries evaluated at angiography were causing hemoptysis. Forty (87%, 23 right and 17 left) of 46 bronchial arteries seen at angiography were also detected at CT. All 31 bronchial arteries and sixteen (62%) of 26 nonbronchial systemic arteries causing hemoptysis were detected at CT. Twenty-three (74%) of 31 bronchial arteries causing hemoptysis were traceable from their origins to the hilum, and one (11%) of nine bronchial arteries not causing hemoptysis was traceable (P = .002).
Sixteen-detector row CT provides depiction and traceability of the bronchial arteries in patients with hemoptysis, and in most patients it enables detection of the bronchial and nonbronchial arteries causing hemoptysis.
回顾性评估16排螺旋计算机断层扫描（CT）与传统血管造影术在咯血患者支气管和非支气管体动脉显示方面的差异。
研究获得机构审查委员会批准，无需患者签署知情同意书。对22例咯血患者（16例男性，6例女性；年龄范围18 - 75岁，平均年龄50岁）进行了16排螺旋CT胸部扫描及传统血管造影检查。三名观察者共同回顾性分析横断位、多平面重建或三维CT图像，观察支气管动脉从主动脉或主动脉分支起源至肺门的显示情况、可追溯性以及非支气管体动脉的存在情况。两名放射科医生共同比较导致咯血的支气管和非支气管体动脉的CT及血管造影表现。采用广义估计方程法或混合模型检验导致咯血与未导致咯血的支气管动脉在显示、可追溯性及直径方面的差异。
CT显示52条（30条右侧，22条左侧）支气管动脉及33条非支气管体动脉。52条支气管动脉中34条（20条右侧，14条左侧）可从起源追溯至肺门。血管造影评估的46条（27条右侧，19条左侧）支气管动脉中31条（16条右侧，15条左侧）及64条非支气管体动脉中26条导致咯血。血管造影显示的46条支气管动脉中40条（87%，23条右侧，17条左侧）在CT上也可显示。CT检出所有31条导致咯血的支气管动脉及26条非支气管体动脉中的16条（62%）。31条导致咯血的支气管动脉中23条（74%）可从起源追溯至肺门，9条未导致咯血的支气管动脉中1条（11%）可追溯（P = 0.002）。
16排CT能够显示咯血患者的支气管动脉并追溯其起源，在大多数患者中可检测到导致咯血的支气管和非支气管动脉。
