Bronchial and nonbronchial systemic arteries at multi-detector row CT angiography: comparison with conventional angiography.
OBJECTIVE
To retrospectively evaluate bronchial and nonbronchial systemic arteries at multi-detector row helical computed tomography (CT) compared with conventional angiography in patients undergoing endovascular treatment of hemoptysis.


METHODS
Neither institutional board approval nor informed consent was required. Forty-eight consecutive patients (39 men, nine women; mean age, 55.7 years; range, 20-82 years) with hemoptysis of bronchial and nonbronchial systemic artery origin underwent multi-detector row helical CT angiography of the thorax with use of a four-detector row (n = 31) or 16-detector row (n = 17) scanner prior to embolization. Findings on CT angiograms, including CT scans, maximum intensity projections, and three-dimensional volume-rendered images, were used to evaluate the depiction of bronchial and nonbronchial systemic arteries. Retrospective analysis of the ostium and the course of bronchial and/or nonbronchial systemic arteries on CT angiograms enabled evaluation of the accuracy of this technique in identification of the relevant vasculature.


RESULTS
Among the 46 patients initially treated with bronchial artery embolization, 58 bronchial arteries were identified at CT and/or angiography. In 50 (86%) cases, concordant findings were observed with both modalities. In five (9%) cases, CT could not be used to identify the ostia of bronchial arteries. In three (5%) cases, CT depicted bronchial arteries that could not be selectively catheterized. Three-dimensional images were found to be superior to transverse CT scans in depicting the ectopic origin of the bronchial arteries, which enabled the interventional radiologists to perform successful embolization after direct catherization of the ectopic vessel in every case. In five (11%) patients, the nonbronchial systemic origin of bronchial bleeding was identified on CT angiograms.


CONCLUSIONS
Multi-detector row helical CT angiography provides more precise depiction of bronchial and nonbronchial systemic arteries than does conventional angiography.
Department of Radiology, Hôpital Calmette, University Center of Lille, Blvd Jules Leclerc, 59037 Lille, France. mremy-jardin@chru-lille.fr
Martine
M
Remy-Jardin
Nebil
N
Bouaziz
Philippe
P
Dumont
Pierre-Yves
PY
Brillet
John
J
Bruzzi
Jacques
J
Remy
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D001981:Bronchial Arteries / Q000000981:diagnostic imaging*; D004621:Embolization, Therapeutic; D005260:Female; D006469:Hemoptysis / Q000209:etiology / Q000628:therapy; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008168:Lung / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012189:Retrospective Studies; D013895:Thoracic Arteries / Q000002:abnormalities; D015898:Tomography Scanners, X-Ray Computed; D036542:Tomography, Spiral Computed / Q000379:methods*