MDCT angiography mapping of abnormal bronchopulmonary vasculature in patients with haemoptysis

Abstract

Background: The systematic use of MDCT angiography in patients with haemoptysis is especially helpful to identify ectopic bronchial arteries, non-bronchial systemic arteries and pulmonary artery pseudoaneurysms. Aim of this study: Aim of this study is to assess the role of MDCT angiography in the evaluation of abnormal bronchopulmonary vasculature in patients with haemoptysis. Results: The study was performed on 36 patients presented with haemoptysis and showing vascular abnormalities on CT angiography. Tuberculosis was the most common underlying disease. Dilated bronchial arteries (BAs) were detected in 86% of patients; they originate between D4 and D6 vertebral levels. About 95% of right BAs have their ostia between 9 and 10o’clock positions, while 75% of left BAs originated between 11 and 1o’clock positions. This study included 8 non bronchial systemic arteries with the inferior phrenic arteries were the most common. Significant pleural thickening (>3 mm) may predict non-bronchial arterial supply. Pulmonary arteries had a role in haemoptysis in only 2 patients. Conclusion: This study has shown that MDCT angiography is a valuable non invasive diagnostic tool in the evaluation of haemoptysis. It provides a roadmap of the vascular abnormalities and aids in the diagnosis of the underlying disease.

Keywords

• Haemopytsis
• MDCT angiography
• Bronchial arteries