CTA与DSA对支气管动脉性咯血临床应用价值的比较

【目的】探讨支气管动脉CT血管造影（CTA）在支气管动脉性咯血临床诊治中的应用价值。【方法】48例大咯血患者利用16层螺旋CT进行CTA检查，并分别在DSA对照下对支气管动脉CTA影像结果进行对比分析。【结果】40例支气管扩张或慢性炎症以及8例肺癌的咯血患者均显示有支气管动脉的异常，表现为支气管动脉的主干及其分支的扩张、迂曲以及远端血管网的形成，部分有肺外体循环参与供血。2例CTA阴性表现中，经DSA血管造影证实均有不同程度的支气管动脉扩张并移位。【结论】CTA能显示咯血患者扩张的支气管动脉、其所在位置以及数量等信息有助于对再次咯血的预测和指导介入治疗，其无创、方便值得大咯血病例临床常规应用。

Comparison of Clinical Value of CTA vs DSA Used in Hemoptysis of Bronchial Artery

Objective]To comparatively assess the sensitivity, accuracy and safety of CT angiography （CTA） vs digital subtraction angiography（DSA） of bronchial artery for the patients with hemoptysis, and to explore the value of CTA used in the diagnosis and treatment of great hemoptysis. Methods] CTA examina- tion by 16-siice spiral CT was performed for 48 patients with hemoptysis. The imaging results were compared between CTA and DSA. Results]Bronchial arteries of 40 cases of bronchiectasis or chronic inflammation and 8 cases of lung cancer with hemoptysis were abnormal. The manifestations were the dilation and circuity of the stem and branches of bronchial arteries, the formation of distal vascular net and blood supply partly provided by extrapulmonary circulation. DSA angiography confirmed that 2 cases with negative manifestation had bron- chial artery dilation and translocation at different degree. Conclusion]CTA can show the site and number of dilated bronchial artery, which are helpful for predicting re-hemoptysis and guiding the interventional therapy. It is non-invasive and convenience, and worthy of clinical routine application in great hemoptysis.