객혈 환자에서 기관지경술이나 기관지동맥색전술 시행 전의 다중절편 전산화 단층촬영의 유용성

• Published in: Tuberculosis and respiratory diseases Vol. 68; no. 2; pp. 80 - 86
• Main Authors: 이신재, Shin Jae Lee, 노지영, Ji Young Rho, 유승민, Seung Min Yoo, 김만득, Man Deuk Kim, 이지현, Ji Hyun Lee, 김은경, Eun Kyung Kim, 조영아, Young Ah Cho, 이상민, Sang Min Lee
• Format: Journal Article
• Language: Korean
• Published: 대한결핵 및 호흡기학회 28-02-2010
• Subjects: Bronchial Arteries; Bronchoscopy; Hemoptysis; Tomography; X-Ray Computed; Bronchoscopy; Bronchial Arteries; Tomography, X-Ray Computed; Hemoptysis
• ISSN: 1738-3536; 2005-6184

Background: Recently, many institutions have acquired multi-detector computed tomography (MDCT) systems. This made it easier and more convenient to use MDCT as a initial diagnostic modality for hemoptysis. The purpose of this study was to evaluate the usefulness of MDCT before bronchoscopy and/or bronchial arterial embolization (BAE) for hemoptysis. Methods: We studied a total of 125 patients with hemoptysis who underwent, between 2006 and 2008, MDCT in a routine protocol before bronchoscopy and/or BAE. One hundred two patients underwent bronchoscopy and 29 patients underwent BAE. We compared the usefulness of MDCT and bronchoscopy for detecting the bleeding site and identifying the cause. We also evaluated our ability, using MDCT, to detect instances where the bronchial artery caused hemoptysis. Results: The rate of detection of a bleeding site was 75.5% on MDCT and 50.9% on bronchoscopy. MDCT and bronchoscopy detected the bleeding site in agreement in 62.7% of patients. MDCT alone found the bleeding site in 27.5% of cases. MDCT identified the cause of hemoptysis in 77.5% and bronchoscopy in 11.8%. In 29 patients who underwent BAE, we detected a total of 37 hypertrophied bronchial arteries that were causing hemoptysis. Of 37 bronchial arteries, 23 (62.2%) were depicted on MDCT. Conclusion: MDCT is superior to bronchoscopy for detecting the bleeding site and identifying the cause of hemoptysis. MDCT can also predict the side of affected bronchial artery with depiction of hypertrophied bronchial artery and localizing the bleeding site. Doing MDCT before bronchoscopy and BAE can provide a guideline for the next step.