多层螺旋CT支气管动脉造影与数字减影下经股动脉支气管动脉造影在咯血诊治中的对比

Multidetector-Row CT Angiography and Digital Subtraction Angiography of Bronchial Artery in Diagnosis of Hemoptysis:A Comparative Study

目的比较咯血患者行多层螺旋CT支气管动脉造影成像与数字减影(DSA)下选择性支气管动脉造影成像的差异,评价多层螺旋CT支气管动脉造影在咯血患者临床诊治中的应用。方法对133例咯血患者先后行螺旋CT支气管动脉造影成像及DSA下经股动脉支气管动脉造影,比较两者图像符合程度。结果 DSA下经股动脉支气管动脉造影检出129例患者存在血管异常,其中多层螺旋CT支气管动脉造影检出117例,检出率为90.7%(117/129)。多层螺旋CT支气管动脉造影与DSA下经股动脉支气管动脉造影同时检出117例异常,同时检出4例未见支气管动脉异常,符合率为91.0%(121/133);术前多层螺旋CT支气管动脉造影证实的异常血管的起源情况与DSA下经股动脉支气管动脉造影发现的血管起源情况基本相同,符合率为100%。结论多层螺旋CT支气管动脉造影成像与DSA下经股动脉支气管动脉造影成像符合率高,多层螺旋CT支气管动脉造影能清晰显示异常血管的起源以提供给血管介入医生做术前评估及准备,可作为咯血患者术前首选的常规检查方法。

Objective To compare the bronchial arteriography through multidetector-row CT （MDCT） with the digital subtraction angiography （DSA） via femoral artery, and evaluate the application value of bronchial arteriography through MDCT in the diagnosis and treatment of hemoptysis. Methods 133 cases complained of hemoptysis were examined by MDCT and DSA via femoral artery respectively to perform bronchial arteriography,and the differences of image results by two methods were compared. Results 129 cases with abnormal bronchial arteries were confirmed by DSA via femoral artery, 117 cases were checked by MDCT [ the positive rate was 90.7% （117/129）]. 117 cases with abnormal bronchial arteries were confirmed by both MDCT and DSA via femoral artery and 4 cases did not detected any abnormal arteries by both methods. The coincidence rate of two methods was 91.0% （ 121/133 ）. MDCT and DSA via femoral artery showed the similar origins of abnormal bronchial arteries. The coincidence rate of two methods was 100%. Conclusions There is a high coincidence rate between MDCT and DSA in detecting bronchial artery abnormalities. MDCT shows the origins of abnormal vessels clearly which could be a fist-choice of routine imagination for interventive operation.