Evaluation of effects of bronchiectasis on bronchial artery diameter with multidetector computed tomography

Abstract

Background:

Among patients with increased bronchial artery diameter there is a significant association between hemoptysis and bronchiectasis score. The higher score of bronchiectasis, the higher risk of hemoptysis development.

Purpose:

To investigate the association of stages of bronchiectasis based on a computed tomography (CT) grading system, with bronchial artery diameter and hemoptysis in patients with bronchiectasis.

Material and Methods:

Patients with lung pathologies other than bronchiectasis, which may cause hemoptysis, were excluded from the study. One hundred and forty-five patients who underwent contrast-enhanced thorax CT by a 64-detector CT for various indications, and who were diagnosed with bronchiectasis, were evaluated retrospectively. CT examinations were carried out by two radiologists with 9 and 4 years of experience with chest radiology, respectively. The diameters of the right and left bronchial arteries were measured 1 cm from the aortic origin and perpendicular to the vessel axis. Cases were assessed based on the Bhalla CT scoring system. The hemoptysis history of every patient was taken.

Results:

The diameters of the right and left bronchial arteries were significantly greater in patients with scores of 2 and 3 bronchiectasis than in patients with a score of 1. This was significantly greater in patients with a score of 3 than in patients with a score of 2 (P < 0.05). In patients with a score of 1, the right bronchial artery diameter was significantly greater than that of the left bronchial artery (P < 0.05). Right bronchial artery diameters were significantly greater than left bronchial artery diameters in score 3 patients (P < 0.05). A significant association was observed between hemoptysis and bronchiectasis in patients with increased bronchial artery diameter (P < 0.05).

Conclusion:

In patients with bronchiectasis, as the stage of bronchiectasis increases, the bronchial artery diameters and the risk of hemoptysis increase. We think that in patients who are diagnosed with bronchiectasis via multidetector CT (MDCT), based on scoring with bronchial artery diameters, the risk of hemoptysis can be estimated, and early management plans can be implemented.

Keywords

Bronchiectasis bronchial artery multidetector computed tomography hemoptysis

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References

Barker

. Bronchiectasis. N Engl J Med 2002; 346: 1383–1393.

Morrissey

Evans

. Severe bronchiectasis. Clin Rev Allergy Immunol 2003; 25: 233–247.

Rosen

. Chronic cough due to bronchiectasis: ACCP evidence-based clinical practice guidelines. Chest 2006; 129: 122–131.

Tasker

Flower

. Imaging the airways. Hemoptysis, bronchiectasis, and small airways disease. Clin Chest Med 1999; 20: 761–773.

Hirshberg

Biran

Glazer

. Hemoptysis: etiology, evaluation, and outcome in a tertiary referral hospital. Chest 1997; 112: 440–444.

Dodd

Souza

Müller

. Conventional high-resolution CT versus helical high-resolution MDCT in the detection of bronchiectasis. Am J Roentgenol 2006; 187: 414–420.

Cauldwell

Siekert

. The bronchial arteries: an anatomic study of 150 human cadavers. Surg Gynecol Obstet 1948; 86: 395–412.

Kım

Müller

Park

. Cylindrical bronchiectasis: diagnostic findings on thin-section CT. Am J Roentgenol 1997; 168: 751–754.

Hansell

Armstrong

Lynch

. Imaging of diseases of the chest , 4th edn. London: Elsevier, 2005.

10.

Song

Shim

. Hypertrophied bronchial artery at thin-section CT in patients with bronchiectasis: correlation with CT angiographic findings. Radiology 1998; 208: 187–191.

11.

Deffebach

Charan

Lakshminarayan

. The bronchial circulation. Small, but a vital attribute of the lung. Am Rev Respir Dis 1987; 135: 463–481.

12.

Furuse

Saito

Kunieda

. Bronchial arteries: CT demonstration with arteriographic correlation. Radiology 1987; 162: 393–398.

13.

Cudkowicz

Armstrong

. Observations on the normal anatomy of the bronchial arteries. Thorax 1951; 6: 343–358.

14.

Hansell

Bankier

MacMahon

. Fleischner Society: glossary of terms for thoracic imaging. Radiology 2008; 246: 697–722.

15.

Bhalla

Turcios

Aponte

. Cystic fibrosis: scoring system with thin-section CT. Radiology 1991; 179: 783–798.

16.

Roberts

Wells

Milne

. Airflow obstruction in bronchiectasis: correlation between computed tomography features and pulmonary function tests. Thorax 2000; 55: 198–204.

17.

Murayama

Hashiguchi

Murakami

. Helical CT imaging of bronchial arteries with curved reformation technique in comparison with selective bronchial arteriography: preliminary report. J Comput Assist Tomogr 1996; 20: 749–755.

18.

Kauczor

Schwickert

Mayer

. Spiral CT of bronchial arteries in chronic thromboembolism. J Comput Assist Tomogr 1994; 18: 855–861.

19.

Schwickert

Kauczor

Schweden

. The anatomy of the bronchial arteries—their imaging with spiral CT. Rofo 1994; 160: 506–512.

20.

Kauczor

Fischer

Cagil

. Computerized tomography of bronchial arteries before and after embolization. Pneumologie 1994; 48: 395–399.

21.

Kim

Choi

Lee

. CT of the bronchus intermedius: frequency and cause of a nodule in the posterior wall on normal scans. Am J Roentgenol 1995; 165: 1349–1352.

22.

Naidich

Funt

Ettenger

. Hemoptysis: CT-bronchoscopic correlations in 58 cases. Radiology 1990; 177: 357–362.

23.

Khalil

Fartoukh

Tassart

. Role of MDCT in identification of the bleeding site and the vessels causing hemoptysis. Am J Roentgenol 2007; 188: 117–125.

24.

Yoon

Lee

Jeong

. Hemoptysis: bronchial and nonbronchial systemic arteries at 16-detector row CT. Radiology 2005; 234: 292–298.

25.

Remy-Jardin

Bouaziz

Dumont

. Bronchial and nonbronchial systemic arteries at multi-detector row CT angiography: comparison with conventional angiography. Radiology 2004; 233: 741–749.

26.

Lucidarme

Grenier

Coche

. Bronchiectasis: comparative assessment with thin-section CT and helical CT. Radiology 1996; 200: 673–679.