Mudit Gupta MD, Presenter: Nothing to Disclose

Deep Narayan Srivastava MD, Abstract Co-Author: Nothing to Disclose

Ashu Seith, Abstract Co-Author: Nothing to Disclose

Sanjay Thulkar MD, Abstract Co-Author: Nothing to Disclose

Sanjay Sharma MD, Abstract Co-Author: Nothing to Disclose

Rashmi Gupta MD, Abstract Co-Author: Nothing to Disclose

To evaluate prospectively the role and impact of multi detector row CT (MDCT) prior to bronchial artery embolization (BAE) in patients with hemoptysis.

MDCT of the thorax was performed in 27 patients (21 men, six women; age range, 22–70 years; mean age, 39 years) with hemoptysis who were referred for BAE. Transverse images, multiplanar reconstruction and three-dimensional reconstruction (maximum intensity projection MIP and volume rendered VR) images were analyzed to identify the abnormal hypertrophied bronchial and non bronchial systemic arteries causing hemoptysis, their origin and course was noted. Selective arteriogram of these arteries was performed with knowledge of findings of MDCT. Embolization was done in 25 (92.6%) of these patients using PVA or embospheres (400-700um). Follow up was done for a mean period of 10.5 months.

Based on findings of MDCT, 2 out of 27 patients were found unsuitable for BAE. On CT, 36 arteries (29 bronchial and 9 non bronchial systemic arteries) were identified as abnormal hypertrophied vessels. On angiography, 33 of these arteries (26 bronchial and 7 non bronchial systemic arteries) were found to be responsible for hemoptysis. Two of these arteries couldn’t be evaluated during angiography and one artery which was found to be abnormal on CT, was found to be normal on angiography. All 26 bronchial and 7 non bronchial systemic arteries causing hemoptysis were detected at MDCT. Embolization was successful in 23 out of 25 patients.

MDCT changed the management in 2 (7.4%) of patients. It enables detection and depiction of all bronchial and non bronchial systemic arteries causing hemoptysis. Moreover, it guides successful and focused catheterization of these abnormal vessels. Embolization of these vessels is an effective method to control hemoptysis.

MDCT has the potential to reduce procedure time, radiation dose and hence the complications related to BAE procedure.

Gupta, M, Srivastava, D, Seith, A, Thulkar, S, Sharma, S, Gupta, R, Clinical Impact of MDCT Prior to Bronchial Artery Embolization (BAE) in Patients with Hemoptysis: A Prospective Study.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5007071.html