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Objective To depict imaging anatomy of bronchial artery (BA) using multidetector CT-angiography (MDCTA) and evaluate the value of MDCTA for management of hemoptysis patients requiring admission to emergency room. Methods We retrospectively studied the clinical and radiological data of patients with severe hemoptysis (≥100 ml of expectorated blood in a 24-hour period) requiring admission to emergency room from Jan 1, 2013 to Dec 31, 2015. Patients' images of MDCTA, treatment modalities, and outcome were discussed. Results A total of 108 patients underwent MDCTA scans. Etiology of hemoptysis was mainly bronchiectasis (44%), tuberculosis sequelae (26%) and tumor (18%). MDCTA visualized 197 traceable BAs and also suggested the involvement of 35 nonbronchial systemic arteries. The mean diameter of BAs, measured at the level of the bronchial bifurcation in the mediastinum, was 2.8±1.2 mm. The mean diameter of BAs, for 52 patients who only received conservative treatment, was 2.9±1.1 mm, and was not significantly larger than that of BAs for 56 patients who underwent bronchial artery embolization (BAE) for continued bleeding which did not resolve after conservative treatment (2.7±1.1 mm, = 0.94). The technical success rate of embolization was 95% (53/56). Clinical success rate during follow-up was achieved in 50 (94%) of 53 patients who had undergone embolization. Conclusions MDCTA provides useful information for identifying the anatomical characteristics of bleeding-related BAs and nonbronchial systemic arteries for the management of patients with severe hemoptysis. However, MDCTA could not determine the individuals who need BAE through measuring diameter of BAs.
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Objective To study the dynamic changes of pulmonary lesions of severe acute respiratory syndrome(SARS)treated by non-invasive positive pressure ventilation(NIPPV)on CT. Methods Serial chest CT images in 18 patients with SARS were retrospectively analyzed before and after NIPPV(4—12 days),and a long-term follow-up(3—36 months)examination by CT was carried out.And 27 SARS cases without NIPPV were enrolled as the control group.Results(1)There were dynamic changes in 15 cases of 18 cases:partial multilobar consolidations of bilateral lungs changed into ground-glass opacities in 7 of 18 cases,a circular pulmonary emphysema around bronchial vascular strains of the lower lobes was seen in 5 of 18,subpleural pulmonary emphysema was seen in 8 of 18,pulmonary barotraumas were showed in 2 of 18.Residual of subpleural curvilinear shadow related to NIPPV was found in 2 cases on the follow-up scan.(2)Above changes on CT were not found in 27 cases without NIPPV.Conclusion There were changes of pulmonary lesions of SARS on CT related to NIPPV treatment,It is beneficial to assess the CT images in the NIPPV treatment of the related pneumonia in SARS.