Prediction of recurrent hemoptysis with MDCT angiography.
OBJECTIVE
To identify the computed tomography (CT) findings to predict recurrent bleeding in patients with massive hemoptysis.


METHODS
Fifty-eight patients with massive hemoptysis underwent both CT and conventional bronchial angiography for bronchial artery embolization. Retrospective analysis was done to analyze the statistical differences in the initial CT findings between the nonrecurrent and recurrent hemoptysis groups using the Mann-Whitney U test and the chi or Fisher exact test. Stepwise logistic regression analysis was used to find predictive variables for the recurrence of hemoptysis.


RESULTS
After embolization, recurrence of hemoptysis was observed in 15 of 58 patients (26%). The diameter of bronchial (P = 0.001) and nonbronchial systemic arteries (P < 0.05), total number of dilated bronchial and nonbronchial systemic arteries (P = 0.001), pleural thickening (P = 0.01), extrapleural fat thickening (P = 0.004), and enhancing vascular structures within the extrapleural fat layer (P = 0.04) were significantly different in the nonrecurrent and recurrent hemoptysis groups. Stepwise logistic regression analysis showed that the total number of dilated bronchial and nonbronchial systemic arteries (odds ratio, 3.540; 95% confidence interval: 1.175, 10.662; P = 0.025) was a significant CT variable associated with the recurrence of hemoptysis.


CONCLUSIONS
CT bronchial angiography may help in the prediction of recurrent bleeding in patients with massive hemoptysis.
Jeong
Yeon Joo
YJ
Department of Diagnostic Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Pusan, Korea.
Kim
Chang Won
CW
Kim
Kun-Il
KI
Shin
Su Mi
SM
Seo
Im Jeong
IJ
Lee
In Sook
IS
Lee
Min Ki
MK
D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods*; D001981:Bronchial Arteries; D016009:Chi-Square Distribution; D003287:Contrast Media; D004621:Embolization, Therapeutic; D005260:Female; D006469:Hemoptysis / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012008:Recurrence; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide