Pan F, Wang F, Liu Z, Yuan F, Sun K K, Gao Z C, Sun Y
Department of Radiology, Peking University People's Hospital, Beijing 100044, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2018 Dec 12;41(12):949-953. doi: 10.3760/cma.j.issn.1001-0939.2018.12.010.
To summarize the computed tomography angiography(CTA) features of Dieulafoy disease of the bronchus. The clinical, imaging and pathological data of Dieulafoy disease of the bronchus diagnosed in our hospital from July 4, 2010 to June 20, 2016 were retrospectively analyzed, and the CTA imaging features of the abnormal bronchial arteries were summarized. There were 6 cases of bronchial Dieulafoy disease, 5 males and 1 female, with an average age of (55±15) years. Three cases had smoking history, and 2 cases had underlying diseases such as tuberculosis and acute myeloid leukemia. The common manifestations were hemoptysis, fever and pneumonia. Three patients got CTA examination, and bronchial arteries of Dieulafoy disease of the bronchus were circuitous and dilated, with the vascular diameter lager than 2 mm, no gradual narrowing but sudden truncation. Some circuitous vessels went into bronchial lumen as nodules. The bronchoscopy biopsy of 2 cases of bronchial nodules led to severe hemorrhage, with one death and one survival by successful management. Bronchial arteries of Dieulafoy disease of the bronchus were circuitous and dilated, and some circuitous vessels went into bronchial lumen as nodules, this demonstration can be used to diagnose Dieulafoy disease of the bronchus. For patients with hemoptysis, bronchial biopsy should only be performed after CTA examination if this disease is suspected.
总结支气管Dieulafoy病的计算机断层扫描血管造影(CTA)特征。回顾性分析2010年7月4日至2016年6月20日在我院诊断的支气管Dieulafoy病的临床、影像及病理资料,总结异常支气管动脉的CTA影像特征。支气管Dieulafoy病6例,男5例,女1例,平均年龄(55±15)岁。3例有吸烟史,2例有结核病、急性髓系白血病等基础疾病。常见表现为咯血、发热及肺炎。3例患者行CTA检查,支气管Dieulafoy病的支气管动脉迂曲扩张,血管直径大于2mm,无逐渐变窄而是突然截断。部分迂曲血管呈结节状进入支气管腔内。2例支气管结节行支气管镜活检导致严重出血,1例死亡,1例经成功处理存活。支气管Dieulafoy病的支气管动脉迂曲扩张,部分迂曲血管呈结节状进入支气管腔内,此表现可用于诊断支气管Dieulafoy病。对于咯血患者,若怀疑本病,应仅在CTA检查后进行支气管活检。