The Role of Multislice Computed Angiography of the Bronchial Arteries before Arterial Embolization in Patients with Hemoptysis
Author(s)
Despina Savvidou*,
Katerina Malagari,
Matina Kampanarou,
Fotios Laspas,
Arkadios Rousakis,
Dimitrios Kelekis,
John Andreou
Affiliation(s)
CT-MRI Department, Hygeia Hospital, Athens, Greece. Research Unit of Radiology and Medical Imaging, Evgenidion Hospital, Athens, Greece. 2nd Department of Radiology, University of Athens, Athens, Greece.
CT-MRI Department, Hygeia Hospital, Athens, Greece. Research Unit of Radiology and Medical Imaging, Evgenidion Hospital, Athens, Greece. 2nd Department of Radiology, University of Athens, Athens, Greece.
ABSTRACT
Purpose: To evaluate the role of multislice computed angiography of the bronchial arteries and nonbronchial systemic arteries in patients with hemoptysis when performed before arterial embolization procedure. Materials and Methods: Twenty-eight patients with hemoptysis underwent multislice CT angiography of the bronchial arteries with dual-source 64 × 2 detector row scanner before embolization. The transverse CT images as well as the multiplanar reconstructions, the maximum intensity projections and the three-dimensional CT images were used for the depiction of bronchial arteries (the total number of the bronchial arteries, the abnormal bronchial arteries, their origin at the aorta and the diameter of the ostium). The presence of nonbronchial systemic arteries regarded as causing hemoptysis was also evaluated. Digital angiography and selective arteriograms of abnormal bronchial and nonbronchial systemic arteries were performed based on the findings of multislice computed tomography (MDCT). Results: Seventy-eight (40 right and 38 left) bronchial arteries were detected at computed angiography (CTA). Forty of the seventy-eight bronchial arteries that were detected at CTA, were considered abnormal. On selective angiography 38 of these bronchial arteries were regarded as causing hemoptysis. Two of these arteries could not be selectively catheterized and therefore could not be evaluated. All 38 bronchial arteries regarded as causing hemoptysis at selective angiography were detected prospectively at CTA as abnormal. Four bronchial arteries that were found to be responsible for hemoptysis had diameter <2 mm. Twelve nonbronchial systemic arteries were considered to be abnormal on CTA scans. Ten of these twelve nonbronchial systemic arteries were regarded on selective angiography as causing hemoptysis. Two of these arteries were found normal on angiography. All 10 nonbronchial arteries regarded as causing hemoptysis were detected at CTA scans. All bronchial and nonbronchial arteries causing hemoptysis were successfully embolized. Conclusion: MDCT angiography allows detailed identification of abnormal bronchial and nonbronchial systemic arteries using a variety of reformatted images, providing a precise road map for the interventional radiologist.
Purpose: To evaluate the role of multislice computed angiography of the bronchial arteries and nonbronchial systemic arteries in patients with hemoptysis when performed before arterial embolization procedure. Materials and Methods: Twenty-eight patients with hemoptysis underwent multislice CT angiography of the bronchial arteries with dual-source 64 × 2 detector row scanner before embolization. The transverse CT images as well as the multiplanar reconstructions, the maximum intensity projections and the three-dimensional CT images were used for the depiction of bronchial arteries (the total number of the bronchial arteries, the abnormal bronchial arteries, their origin at the aorta and the diameter of the ostium). The presence of nonbronchial systemic arteries regarded as causing hemoptysis was also evaluated. Digital angiography and selective arteriograms of abnormal bronchial and nonbronchial systemic arteries were performed based on the findings of multislice computed tomography (MDCT). Results: Seventy-eight (40 right and 38 left) bronchial arteries were detected at computed angiography (CTA). Forty of the seventy-eight bronchial arteries that were detected at CTA, were considered abnormal. On selective angiography 38 of these bronchial arteries were regarded as causing hemoptysis. Two of these arteries could not be selectively catheterized and therefore could not be evaluated. All 38 bronchial arteries regarded as causing hemoptysis at selective angiography were detected prospectively at CTA as abnormal. Four bronchial arteries that were found to be responsible for hemoptysis had diameter <2 mm. Twelve nonbronchial systemic arteries were considered to be abnormal on CTA scans. Ten of these twelve nonbronchial systemic arteries were regarded on selective angiography as causing hemoptysis. Two of these arteries were found normal on angiography. All 10 nonbronchial arteries regarded as causing hemoptysis were detected at CTA scans. All bronchial and nonbronchial arteries causing hemoptysis were successfully embolized. Conclusion: MDCT angiography allows detailed identification of abnormal bronchial and nonbronchial systemic arteries using a variety of reformatted images, providing a precise road map for the interventional radiologist.
Cite this paper
Savvidou, D. , Malagari, K. , Kampanarou, M. , Laspas, F. , Rousakis, A. , Kelekis, D. and Andreou, J. (2014) The Role of Multislice Computed Angiography of the Bronchial Arteries before Arterial Embolization in Patients with Hemoptysis. Open Journal of Medical Imaging, 4, 133-141. doi: 10.4236/ojmi.2014.43019.
Savvidou, D. , Malagari, K. , Kampanarou, M. , Laspas, F. , Rousakis, A. , Kelekis, D. and Andreou, J. (2014) The Role of Multislice Computed Angiography of the Bronchial Arteries before Arterial Embolization in Patients with Hemoptysis. Open Journal of Medical Imaging, 4, 133-141. doi: 10.4236/ojmi.2014.43019.
References
[1] Khalil, A., Fartoukh, M., Tassart, M., Parrot, A., Marsault, C. and Carette, M.F. (2007) Role of MDCT in Identification of the Bleeding Site and the Vessels Causing Hemoptysis. AJR, 188, 117-125.
http://dx.doi.org/10.2214/AJR.05.1578 [2] Chung, M.J., Lee, J.H., Lee, K.S., Yoon, Y.C., Kwon, O.J. and Kim, T.S. (2006) Bronchial and Nonbronchial Systemic Arteries in Patients with Hemoptysis: Depiction on MDCT Angiography. AJR, 186, 649-655.
http://dx.doi.org/10.2214/AJR.04.1961 [3] Remy-Jardin, M., Bouaziz, N., Dumont, P., Brillet, P.Y. Bruzzi, J. and Remy, J. (2004) Bronchial and Nonbronchial Systemic Arteries at Multidetector Row CT Angiography: Comparison with Conventional Angiography. Radiology, 233, 741-749.
http://dx.doi.org/10.1148/radiol.2333040031 [4] Yoon, Y.C., Lee, K.S., Jeong, Y.J., Shin, S.W., Chung, M.J. and Kwon, O.J. (2005) Hemoptysis: Bronchial and Nonbronchial Systemic Arteries at 16-Detector Row CT. Radiology, 234, 292-298.
http://dx.doi.org/10.1148/radiol.2341032079 [5] Gupta, M., Srivastava, D.N., Seith, A., Sharma, S., Thulkar, S. and Gupta, R. (2013) Clinical Impact of Multidetector Row Computed Tomography before Bronchial Artery Embolization in Patients With Hemoptysis: A Prospective Study. Canadian Association of Radiologists Journal, 64, 61-73.
http://dx.doi.org/10.1016/j.carj.2011.08.002 [6] Bruzzi, J.F., Remy-Jardin, M., Delhaye, D., Teisseire, A., Khalil, C. and Remy, J. (2006) Multi-Detector Row CT of Hemoptysis. Radiographics, 26, 3-22.
http://dx.doi.org/10.1148/rg.261045726 [7] Ponnuswamy, I., Sankaravadivelu, S.T., Maduraimuthu, P., Natarajan, K., Sathyanathan, B.P. and Sadras, S. (2012) 64-Detector Row CT Evaluation of Bronchial and Non-Bronchial Systemic Arteries in Life-Threatening Haemoptysis. BJR, 85, 666-672.
http://dx.doi.org/10.1259/bjr/24730002 [8] Yildiz, A.E., Ariyurek, O.M., Akpinar, E., Peynircioglu, B. and Cil, B.E. (2011) Multidetector CT of Bronchial and Non-Bronchial Systemic Arteries. Diagnostic Interventional Radiology, 17, 10-17. [9] Noe, G.D., Jaffe, S.M. and Molan M.P. (2011) CT and CT Angiography in Massive Haemoptysis with Emphasis on Pre-Embolization Assessment. Clinical Radiology, 66, 869-875.
http://dx.doi.org/10.1016/j.crad.2011.03.001 [10] Cauldwell, E.W., Siekert, R.G., Lininger, R.E. and Anson, B.J. (1948) The Bronchial Arteries: An Anatomic Study in 150 Human Cadavers. Surgery, Gynecology and Obstetrics, 86, 395-412. [11] Mori, H., Ohno, Y., Tsuge, Y., Kawasaki, M., Ito, F., Endo, J., Funaguchi, N., La, B. L.B., Kanematsu, M. and Minatoguchi, S. (2010) Use of Multidetector Row CT to Evaluate the Need for Bronchial Arterial Embolization in Hemoptysis Patients. Respiration, 80, 24-31.
http://dx.doi.org/10.1159/000253882 [12] Botenga A.S. (1970) Selective Bronchial and Intercostals Arteriography. Stenfert Kroese, Leiden, 53-65.
http://dx.doi.org/10.1007/978-94-010-3156-1 [13] Hartmann, I.J.C., Remy-Jardin, M., Menchini, L., Teisseire, A., Khalil, C. and Remy, J. (2007) Ectopic Origin of Bronchial Arteries: Assessment with Multidetector Helical CT Angiography. European Radiology, 17, 1943-1953.
http://dx.doi.org/10.1007/s00330-006-0576-8 [14] Yoon, W., Kim, Y.H., Kim, J.K., Kim, Y.C., Park, J.G. and Kang, H.K. (2003) Massive Hemoptysis: Prediction of Nonbronchial Systemic Arterial Supply with Chest CT. Radiology, 227, 232-238.
http://dx.doi.org/10.1148/radiol.2271020324
[1] Khalil, A., Fartoukh, M., Tassart, M., Parrot, A., Marsault, C. and Carette, M.F. (2007) Role of MDCT in Identification of the Bleeding Site and the Vessels Causing Hemoptysis. AJR, 188, 117-125.
http://dx.doi.org/10.2214/AJR.05.1578 [2] Chung, M.J., Lee, J.H., Lee, K.S., Yoon, Y.C., Kwon, O.J. and Kim, T.S. (2006) Bronchial and Nonbronchial Systemic Arteries in Patients with Hemoptysis: Depiction on MDCT Angiography. AJR, 186, 649-655.
http://dx.doi.org/10.2214/AJR.04.1961 [3] Remy-Jardin, M., Bouaziz, N., Dumont, P., Brillet, P.Y. Bruzzi, J. and Remy, J. (2004) Bronchial and Nonbronchial Systemic Arteries at Multidetector Row CT Angiography: Comparison with Conventional Angiography. Radiology, 233, 741-749.
http://dx.doi.org/10.1148/radiol.2333040031 [4] Yoon, Y.C., Lee, K.S., Jeong, Y.J., Shin, S.W., Chung, M.J. and Kwon, O.J. (2005) Hemoptysis: Bronchial and Nonbronchial Systemic Arteries at 16-Detector Row CT. Radiology, 234, 292-298.
http://dx.doi.org/10.1148/radiol.2341032079 [5] Gupta, M., Srivastava, D.N., Seith, A., Sharma, S., Thulkar, S. and Gupta, R. (2013) Clinical Impact of Multidetector Row Computed Tomography before Bronchial Artery Embolization in Patients With Hemoptysis: A Prospective Study. Canadian Association of Radiologists Journal, 64, 61-73.
http://dx.doi.org/10.1016/j.carj.2011.08.002 [6] Bruzzi, J.F., Remy-Jardin, M., Delhaye, D., Teisseire, A., Khalil, C. and Remy, J. (2006) Multi-Detector Row CT of Hemoptysis. Radiographics, 26, 3-22.
http://dx.doi.org/10.1148/rg.261045726 [7] Ponnuswamy, I., Sankaravadivelu, S.T., Maduraimuthu, P., Natarajan, K., Sathyanathan, B.P. and Sadras, S. (2012) 64-Detector Row CT Evaluation of Bronchial and Non-Bronchial Systemic Arteries in Life-Threatening Haemoptysis. BJR, 85, 666-672.
http://dx.doi.org/10.1259/bjr/24730002 [8] Yildiz, A.E., Ariyurek, O.M., Akpinar, E., Peynircioglu, B. and Cil, B.E. (2011) Multidetector CT of Bronchial and Non-Bronchial Systemic Arteries. Diagnostic Interventional Radiology, 17, 10-17. [9] Noe, G.D., Jaffe, S.M. and Molan M.P. (2011) CT and CT Angiography in Massive Haemoptysis with Emphasis on Pre-Embolization Assessment. Clinical Radiology, 66, 869-875.
http://dx.doi.org/10.1016/j.crad.2011.03.001 [10] Cauldwell, E.W., Siekert, R.G., Lininger, R.E. and Anson, B.J. (1948) The Bronchial Arteries: An Anatomic Study in 150 Human Cadavers. Surgery, Gynecology and Obstetrics, 86, 395-412. [11] Mori, H., Ohno, Y., Tsuge, Y., Kawasaki, M., Ito, F., Endo, J., Funaguchi, N., La, B. L.B., Kanematsu, M. and Minatoguchi, S. (2010) Use of Multidetector Row CT to Evaluate the Need for Bronchial Arterial Embolization in Hemoptysis Patients. Respiration, 80, 24-31.
http://dx.doi.org/10.1159/000253882 [12] Botenga A.S. (1970) Selective Bronchial and Intercostals Arteriography. Stenfert Kroese, Leiden, 53-65.
http://dx.doi.org/10.1007/978-94-010-3156-1 [13] Hartmann, I.J.C., Remy-Jardin, M., Menchini, L., Teisseire, A., Khalil, C. and Remy, J. (2007) Ectopic Origin of Bronchial Arteries: Assessment with Multidetector Helical CT Angiography. European Radiology, 17, 1943-1953.
http://dx.doi.org/10.1007/s00330-006-0576-8 [14] Yoon, W., Kim, Y.H., Kim, J.K., Kim, Y.C., Park, J.G. and Kang, H.K. (2003) Massive Hemoptysis: Prediction of Nonbronchial Systemic Arterial Supply with Chest CT. Radiology, 227, 232-238.
http://dx.doi.org/10.1148/radiol.2271020324