Comparison of the Role of CT and Fiberoptic Bronchoscopy in the Diagnosis of Hemoptysis / 결핵

ABSTRACT

BACKGROUNDS To investigate the role of CT as a screening tool and to compare the diagnostic accuracy with that of the fiberoptic bronchoscopy (FOB) in evaluating the causes of hemoptysis. METHODS: The retrospective review of plain chest radiograph, CT and FOB was done in 72 patients with hemoptysis. The diagnosis were confirmed by histology (n=33), bacterial culture (n=6), cytology (n=3), serology (n=2), skin test (n=1), clinical response (n=5), and airway disease mainly by HRCT (n=22). RESULTS: The causes of hemoptysis were shown to be lung cancer (n=29), bronchiectasis (n=19), tuberculosis (n=12), aspergilloma (n=5), invasive aspergillosis (n=1), COPD (n=3) and others (n=3). The sensitivity was 100% and 91,7% by CT and FOB respectively. The diagnostic compatibility was 95.8% and 59.7% by CT and FOB respectively. The diagnostic compatibility in cases with central airway disease was 96.3% and 100% in CT and FOB. In parenchymal disease, CT and FOB showed 91.3% and 43.5% of compatibility, respectively. In airway disease, CT and FOB showed 100% and 31.8% compatibility, respectively. That is to say, CT has higher sensitivity and diagnostic compatibility than FOB for identifying the causes of hemoptysis, and is more helpful for patients with hemoptysis from parenchymal or airway disease. FOB had the advantage in obtaining histologic, cytologic and bacteriologic diagnosis with biopsy or washing. CONCLUSION: CT should be used as the screening method before performing FOB for patients with hemoptysis who have normal or nonspecific findings or 3 peripheral airway disease in plain chest radiograph.