Value of bronchial artery CTA in the diagnosis and treatment of elderly patients with pulmonary hemoptysis

Zhang Zhigang; Zhang Yue; Zhou Wei; Zhang Xianhu; Li Fan; Liu Chong

doi:10.3969/j.issn.1674-3245.2024.06.011

Abstract：Objective To analyze the value of bronchial artery CT angiography(CTA)in the diagnosis and treatment of elderly patients with pulmonary hemoptysis.Methods Sixty elderly patients with pulmonary hemoptysis treated with bronchial artery embolization(BAE)were enrolled in this study.They were divided into group A(patients receiving CTA)and group B(patients not receiving CTA)according to whether they received CTA before operation.The dosage of contrast agent used for digital subtraction angiography(DSA),operation time,the success rate of hemostasis on day 30 after operation,and 1-year recurrence rate were compared between the two groups.CTA and DSA results of group A were compared.Results The dosage of contrast agent used during operation in group A was significantly lower than that in group B,and operation time was significantly shorter than that of group B,the success rate of hemostasis was significantly higher in than that in group B(t=5.665,7.721,χ2=5.192,P<0.05).One-year recurrence rates in the two groups were close(P>0.05).DSA showed 113 responsible blood vessels,CTA showed 108 responsible blood vessels,Both DSA and CTA showed 107 responsible blood vessels.The detection rate of responsible blood vessels by CTA was 94.74%(108/114).The coincidence rate of preoperative CTA for detecting bronchial artery(BA)was 96.15%.The sensitivity,specificity and accuracy of CTA for detecting ectopic BA were 95.00%,96.88%and 96.15%.The sensitivity,specificity and accuracy for detecting normal BA were 96.88%,95.00%and 96.15%(Kappa=0.92).The coincidence rates of CTA for detecting intercostal artery,subclavian artery,coeliac artery and inferior phrenic artery were 80.00%,100.00%,100.00%and 100.00%,respectively.Conclusion Preoperative bronchial artery CTA can provide accurate guidance for finding responsible vessels in BAE for elderly patients with pulmonary hemoptysis,reduce the dosage of contrast agent,shorten operation time and increase the success rate of hemostasis.