DOI:10.2214/AJR.05.1578
AJR 2007; 188:W117-W125
© American Roentgen Ray Society
Role of MDCT in Identification of the Bleeding Site and the Vessels Causing Hemoptysis
Antoine Khalil1,
Muriel Fartoukh2,
Marc Tassart1,
Antoine Parrot2,
Claude Marsault1 and
Marie-France Carette1
1 Department of Radiology, AP-HP Tenon Hospital, 4 Rue de la Chine, 75020 Paris,
France.
2 Respiratory Intensive Care Unit, AP-HP Tenon Hospital, Paris, France.
Received September 6, 2005;
accepted after revision December 7, 2005.
Address correspondence to A. Khalil
(antoine_khalil{at}yahoo.fr).
WEB This is a Web exclusive article.
Abstract
OBJECTIVE. MDCT has improved the management of hemoptysis by
providing more precise depiction of bronchial and nonbronchial systemic
arteries than conventional CT. The purpose of this article is to review the
role of MDCT in the identification of the bleeding site and the vessels
causing hemoptysis.
CONCLUSION. Identification of the origin of the involved systemic
arteries (bronchial and nonbronchial) or involved pulmonary artery on MDCT
enables the interventional radiologist to treat them, especially in elderly
patients with a tortuous aorta and atheroma.
Keywords: bronchial arteries • chest imaging • hemoptysis • lung disease • MDCT • pulmonary artery
Introduction
Hemoptysis usually results from systemic hypervascularization of the
lung by bronchial and nonbronchial systemic arteries in contact with the
pleura [1]. Hemoptysis is
related to pulmonary artery injury in up to 11% of cases
[2]. Before starting the
examination, the interventional radiologist needs information about the
bleeding side, the underlying disease, and the vascular origin of the bleeding
causing hemoptysis (bronchial artery, nonbronchial systemic artery, pulmonary
artery, or a combination of these arteries).
During the past decade, the use of CT has focused on locating the bleeding
site and determining the cause of hemoptysis
[3]. Recently, Yoon et al.
[4] evaluated the accuracy of
single-detector helical CT in predicting the presence of a nonbronchial
systemic arterial supply in patients with massive hemoptysis. Yoon et al.
[5] and Remy-Jardin et al.
[6] suggested that MDCT
angiography provides a more precise depiction of the bronchial arteries than
conventional angiography. This article illustrates the role of MDCT in the
identification of the bleeding site and the vessels causing hemoptysis.
MDCT Protocol
MDCT evaluation of systemic vascularization (bronchial and nonbronchial)
was performed using a 16-MDCT scanner (Sensation 16, Siemens Medical
Solutions). The imaging parameters were as follows: beam width, 12 mm; beam
pitch, 1; and reconstruction thickness, 0.75 mm every 0.5 mm at 120 kV and 180
mA. Eighty milliliters (25.6 g I) of nonionic contrast agent (iodixanol 652
[Visipaque 320, Amersham Health]) was administered IV at a rate of 3.5 mL/s
via an automated injector device (Injectron CT2, Medtron) through an 18-gauge
IV catheter.
A region of interest was placed on the descending aorta. When the density
reached 120 H, craniocaudal scanning started 6 seconds later from the lung
apex to the lung base; imaging was performed with the patient in the supine
position at maximal inspiration during a single breath-hold. We used real-time
axial scrolling, interactive maximum intensity projection, and volume-rendered
techniques to evaluate the origin and course of the bronchial and nonbronchial
arteries.
Identification of the Bleeding Site
Hemoptysis can generate two major signs in the lung
parenchyma—namely, ground-glass opacities, alveolar condensation, or
both (Fig. 1A,
1B,
1C). Sometimes atelectasis can
be caused by clots obstructing the bronchi. These abnormalities may help
identify the bleeding site when they are unilateral or located in one lobe.
When they are bilateral, CT is less accurate for locating the bleeding site.
In rare cases, MDCT can show extravasation of contrast medium into a bronchus
(Fig. 2A,
2B) or intrapulmonary shunting
(Fig. 3A,
3B,
3C).
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Fig. 1A —45-year-old man with hemoptysis. Axial (A), sagittal
(B), and coronal (C) MDCT reconstructions with 1-mm-thick slice
viewed at lung window settings show ground-glass opacities on anterior segment
of left upper lobe. Multiplanar MDCT reconstructions (not shown) did not add
information about location of bleeding site to findings shown on axial
image.
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Fig. 1B —45-year-old man with hemoptysis. Axial (A), sagittal
(B), and coronal (C) MDCT reconstructions with 1-mm-thick slice
viewed at lung window settings show ground-glass opacities on anterior segment
of left upper lobe. Multiplanar MDCT reconstructions (not shown) did not add
information about location of bleeding site to findings shown on axial
image.
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Fig. 1C —45-year-old man with hemoptysis. Axial (A), sagittal
(B), and coronal (C) MDCT reconstructions with 1-mm-thick slice
viewed at lung window settings show ground-glass opacities on anterior segment
of left upper lobe. Multiplanar MDCT reconstructions (not shown) did not add
information about location of bleeding site to findings shown on axial
image.
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Fig. 2A —Iodine extravasation into bronchi of 57-year-old woman with
hemoptysis. Bronchoscopy (not shown) had revealed active bleeding on left side
without identifying precise lobe, whereas MDCT depicts bleeding site on left
upper lobe. Sagittal multiplanar reconstruction image on lung window setting
shows contrast medium (arrow) in bronchi of left upper lobe with air
bubbles (arrowheads).
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Fig. 2B —Iodine extravasation into bronchi of 57-year-old woman with
hemoptysis. Bronchoscopy (not shown) had revealed active bleeding on left side
without identifying precise lobe, whereas MDCT depicts bleeding site on left
upper lobe. Sagittal multiplanar reconstruction image on mediastinal window
setting shows same density in bronchi (arrows) and left pulmonary
artery (asterisk) as that shown in A.
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Fig. 3A —45-year-old man with right upper lobe atelectasis due to tubercular
sequelae complicated by aspergilloma was admitted for mild hemoptysis. Shunt
was placed in pulmonary artery. Coronal thin-slab maximum-intensity-projection
(MIP) image shows enhancement of pulmonary arteries (arrows) with
reflux into right main pulmonary artery (arrowhead).
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Fig. 3B —45-year-old man with right upper lobe atelectasis due to tubercular
sequelae complicated by aspergilloma was admitted for mild hemoptysis. Shunt
was placed in pulmonary artery. Coronal oblique thin-slab MIP shows
enlargement of right bronchointercostal trunk (black arrow),
bronchial artery (white arrows), and intercostal arteries. Note
enlargement of intercostal arteries (black arrowheads) in comparison
with other normal-sized intercostal arteries (white arrowheads).
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Fig. 3C —45-year-old man with right upper lobe atelectasis due to tubercular
sequelae complicated by aspergilloma was admitted for mild hemoptysis. Shunt
was placed in pulmonary artery. Right bronchointercostal trunk angiogram shows
pulmonary artery shunt, with reflux from right superior pulmonary artery
(arrows) into right main pulmonary artery (arrowhead). This
pulmonary system shunting is related to systemic hypervascularization and is
not major CT sign for bleeding site.
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Visualization of the Bleeding Vessels
The bronchial circulation is the most frequent source of hemoptysis, but
various nonbronchial systemic arteries and pulmonary arteries may also
contribute, depending on the underlying disorder
[7]. Anatomically, a bronchial
artery is defined as a vessel coursing along a major bronchus. Nonbronchial
systemic vessels enter the pulmonary parenchyma through the adherent pleura or
the pulmonary ligament, and their course is not parallel to that of the major
bronchi.
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Fig. 4A —Normal anatomy of bronchial arteries on MDCT in 45-year-old man
admitted for treatment of mild hemoptysis. Thin-slab
maximum-intensity-projection (MIP) MDCT images of superior left bronchial
artery (arrow, A), common lower bronchial trunk
(arrow, B), and right bronchointercostal trunk
(arrow, C). Note good visualization of bronchial artery
divisions of right bronchointercostal trunk (arrowheads,
C).
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Fig. 4B —Normal anatomy of bronchial arteries on MDCT in 45-year-old man
admitted for treatment of mild hemoptysis. Thin-slab
maximum-intensity-projection (MIP) MDCT images of superior left bronchial
artery (arrow, A), common lower bronchial trunk
(arrow, B), and right bronchointercostal trunk
(arrow, C). Note good visualization of bronchial artery
divisions of right bronchointercostal trunk (arrowheads,
C).
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Fig. 4C —Normal anatomy of bronchial arteries on MDCT in 45-year-old man
admitted for treatment of mild hemoptysis. Thin-slab
maximum-intensity-projection (MIP) MDCT images of superior left bronchial
artery (arrow, A), common lower bronchial trunk
(arrow, B), and right bronchointercostal trunk
(arrow, C). Note good visualization of bronchial artery
divisions of right bronchointercostal trunk (arrowheads,
C).
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Fig. 4D —Normal anatomy of bronchial arteries on MDCT in 45-year-old man
admitted for treatment of mild hemoptysis. Right bronchointercostal trunk
angiogram corresponding to C shows normal branching of bronchial
arteries is from right intercostal trunk (arrowheads) or from
descending thoracic aorta (arrow) between levels of T5 and T6
vertebrae.
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Bronchial Artery Origin
Bronchial arteries are the main source of the systemic arterial supply to
the lungs and also are the major type of vessel involved in hemoptysis. It is
helpful to identify the origin of bronchial arteries before treatment (Fig.
4A,
4B,
4C,
4D). More than 30% of
bronchial arteries have an anomalous origin, which is a cause of endovascular
treatment failure. Bronchial arteries that originate inside the area between
the T5 and T6 vertebrae at the level of the left main bronchus are considered
to be normal [1]. Aberrant
bronchial arteries may originate from the aortic arch (Fig.
5A,
5B,
5C,
5D,
5E), internal mammary artery,
thyrocervical trunk (Fig. 6A,
6B,
6C,
6D,
6E), subclavian artery (Fig.
7A,
7B,
7C), costocervical trunk,
brachiocephalic artery, pericardiacophrenic artery, inferior phrenic artery,
or abdominal aorta.
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Fig. 5A —Anomalous origin of upper left bronchial artery from aortic arch in
65-year-old man. Four consecutive 3-mm thin-slab maximum-intensity-projection
(MIP) images in axial plane show anomalous origin of upper left bronchial
artery from right aspect of aortic arch (arrow, A) and
trajectory under aortic arch (arrowheads, B-D).
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Fig. 5B —Anomalous origin of upper left bronchial artery from aortic arch in
65-year-old man. Four consecutive 3-mm thin-slab maximum-intensity-projection
(MIP) images in axial plane show anomalous origin of upper left bronchial
artery from right aspect of aortic arch (arrow, A) and
trajectory under aortic arch (arrowheads, B-D).
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Fig. 5C —Anomalous origin of upper left bronchial artery from aortic arch in
65-year-old man. Four consecutive 3-mm thin-slab maximum-intensity-projection
(MIP) images in axial plane show anomalous origin of upper left bronchial
artery from right aspect of aortic arch (arrow, A) and
trajectory under aortic arch (arrowheads, B-D).
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Fig. 5D —Anomalous origin of upper left bronchial artery from aortic arch in
65-year-old man. Four consecutive 3-mm thin-slab maximum-intensity-projection
(MIP) images in axial plane show anomalous origin of upper left bronchial
artery from right aspect of aortic arch (arrow, A) and
trajectory under aortic arch (arrowheads, B-D).
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Fig. 5E —Anomalous origin of upper left bronchial artery from aortic arch in
65-year-old man. Coronal 8-mm thin-slab MIP image shows ectopic bronchial
artery and its trajectory (arrowheads). Ostium of ectopic bronchial
arteries is branching from descending thoracic aorta other than expected
origin (i.e., outside level T5-T6), such as from level of aortic arch or from
any aortic collateral vessel.
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Fig. 6A —Anomalous origin of upper left bronchial artery from thyrocervical
trunk in 72-year-old man. Serial axial 1-mm slices show origin
(arrow, A) and course (arrowheads) of left bronchial
artery.
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Fig. 6B —Anomalous origin of upper left bronchial artery from thyrocervical
trunk in 72-year-old man. Serial axial 1-mm slices show origin
(arrow, A) and course (arrowheads) of left bronchial
artery.
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Fig. 6C —Anomalous origin of upper left bronchial artery from thyrocervical
trunk in 72-year-old man. Serial axial 1-mm slices show origin
(arrow, A) and course (arrowheads) of left bronchial
artery.
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Fig. 6D —Anomalous origin of upper left bronchial artery from thyrocervical
trunk in 72-year-old man. Three-dimensional volume-rendered image (D)
and angiogram (E) show ectopic bronchial artery
(arrowheads).
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Fig. 6E —Anomalous origin of upper left bronchial artery from thyrocervical
trunk in 72-year-old man. Three-dimensional volume-rendered image (D)
and angiogram (E) show ectopic bronchial artery
(arrowheads).
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Fig. 7A —Anomalous origin of right lower lobe bronchial artery from right
subclavian artery in 64-year-old man with massive hemoptysis. Chest
radiography examination (not shown) depicted hilar necrotic mass with
disseminated bronchiectasis. Bronchoscopy (not shown) did not locate bleeding
site but showed infiltration of left upper lobe bronchus. Axial 3-mm thin-slab
maximum-intensity-projection (MIP) slice shows anomalous origin
(arrow) of right lower lobe bronchial artery.
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Fig. 7B —Anomalous origin of right lower lobe bronchial artery from right
subclavian artery in 64-year-old man with massive hemoptysis. Chest
radiography examination (not shown) depicted hilar necrotic mass with
disseminated bronchiectasis. Bronchoscopy (not shown) did not locate bleeding
site but showed infiltration of left upper lobe bronchus. Coronal 5-mm
thin-slab MIP slice shows anomalous trajectory of lower lobe bronchial artery
(arrows).
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Fig. 7C —Anomalous origin of right lower lobe bronchial artery from right
subclavian artery in 64-year-old man with massive hemoptysis. Chest
radiography examination (not shown) depicted hilar necrotic mass with
disseminated bronchiectasis. Bronchoscopy (not shown) did not locate bleeding
site but showed infiltration of left upper lobe bronchus. Right subclavian
artery angiogram obtained using humeral approach shows anomalous right
bronchial artery (arrows) with anomalous trajectory.
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In patients with hemoptysis, 16-MDCT can depict and trace the bronchial
arteries (Fig. 8A,
8B) and, in most cases, can be
used to detect the bronchial arteries causing hemoptysis
[5]. Yoon et al.
[5], in a retrospective study
comparing MDCT and angiography in 22 patients with hemoptysis, found that MDCT
depicted all bronchial arteries causing hemoptysis that were identified on
angiography. Five bronchial arteries had aberrant origins in that series
[5]. Furthermore, Yoon et al.
[5] showed a significant
difference of the traceability from the origin to the hilum between bronchial
arteries causing hemoptysis and those not causing it (Fig.
8A,
8B). Remy-Jardin et al.
[6] reported that MDCT provided
a more precise depiction of bronchial arteries than did conventional
angiography. Those researchers found that 3D images were more accurate than
transverse CT scans for detecting bronchial arteries with aberrant
origins.
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Fig. 8A —Mediastinal and hilar trajectory of normotopic right bronchial
artery in 61-year-old man with massive hemoptysis. Axial 3-mm thin-slab
maximum-intensity-projection (MIP) image shows tubular and punctiform enhanced
vascular lesion through mediastinum and hilum (arrowheads).
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Fig. 8B —Mediastinal and hilar trajectory of normotopic right bronchial
artery in 61-year-old man with massive hemoptysis. Coronal 10-mm thin-slab MIP
image shows enlarged right bronchial artery (arrow) from aorta to
hilum (arrowheads). Note good visualization of bronchial arteries in
right hilum.
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Fig. 9A —Systemic nonbronchial artery hypervascularization in 29-year-old
pregnant woman with massive hemoptysis. Axial (A) and coronal
(B) 1-mm slices show lingular and right middle lobe atelectasis
(arrow, A) secondary to bronchiectasis. Lingular ground-glass
opacities (asterisk) reveal bleeding site.
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Fig. 9B —Systemic nonbronchial artery hypervascularization in 29-year-old
pregnant woman with massive hemoptysis. Axial (A) and coronal
(B) 1-mm slices show lingular and right middle lobe atelectasis
(arrow, A) secondary to bronchiectasis. Lingular ground-glass
opacities (asterisk) reveal bleeding site.
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Fig. 9C —Systemic nonbronchial artery hypervascularization in 29-year-old
pregnant woman with massive hemoptysis. Coronal 10-mm thin-slab
maximum-intensity-projection image shows transpleural hypervascularization
(arrows) from left inferior phrenic artery.
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Fig. 9D —Systemic nonbronchial artery hypervascularization in 29-year-old
pregnant woman with massive hemoptysis. Left inferior phrenic artery angiogram
confirms systemic nonbronchial artery hypervascularization
(arrow).
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Nonbronchial Systemic Arteries
In some patients, bronchial bleeding arises from nonbronchial systemic
arteries. When enlarged vascular structures are found in extrapleural fat with
pleural thickening (3 mm), they can be considered as nonbronchial systemic
arteries that are potentially responsible for hemoptysis
[1]. The nonbronchial systemic
arteries involved in hemoptysis are usually the intercostal arteries
(Fig. 3B), inferior phrenic
arteries (Fig. 9A,
9B,
9C,
9D), pulmonary ligament
arteries, internal mammary arteries (Fig.
10A,
10B), and other collaterals
from the subclavian arteries
[1].
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Fig. 10A —Systemic nonbronchial artery hypervascularization in 55-year-old
woman with hemoptysis related to tubercular sequelae. Axial 2-mm thick-slab
image shows right internal mammary artery (arrow) is enlarged in
comparison with left internal mammary artery (arrowhead) and reveals
right middle lobe atelectasis (asterisk).
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Fig. 10B —Systemic nonbronchial artery hypervascularization in 55-year-old
woman with hemoptysis related to tubercular sequelae. Coronal 5-mm thin-slab
maximum-intensity-projection image shows right internal mammary artery
hypertrophy with hypertrophic collateral (arrows) to right middle
lobe atelectasis.
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Fig. 11A —Pulmonary artery false aneurysm in patient described in Figure 7
(64-year-old man with massive hemoptysis) who was readmitted to ICU for
hemoptysis recurrence (400 mL) 1 week after bronchial artery embolization with
microparticles and microcoils. Repeat MDCT angiography depicted pulmonary
artery false aneurysm. Axial 3-mm thick-slab maximum-intensity-projection
(MIP) image shows irregularity with enlargement of right upper lobe
subsegmental pulmonary artery (arrow).
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Fig. 11B —Pulmonary artery false aneurysm in patient described in Figure
7A,
7B,
7C (64-year-old man with
massive hemoptysis) who was readmitted to ICU for hemoptysis recurrence (400
mL) 1 week after bronchial artery embolization with microparticles and
microcoils. Repeat MDCT angiography depicted pulmonary artery false aneurysm.
Oblique coronal 3-mm thick-slab MIP image clearly shows false aneurysm
(arrow) and microcoil (arrowhead) from previous treatment
session.
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Fig. 11C —Pulmonary artery false aneurysm in patient described in Figure
7A,
7B,
7C (64-year-old man with
massive hemoptysis) who was readmitted to ICU for hemoptysis recurrence (400
mL) 1 week after bronchial artery embolization with microparticles and
microcoils. Repeat MDCT angiography depicted pulmonary artery false aneurysm.
Subsegmental pulmonary artery angiogram confirms false aneurysm
(arrow). This subsegmental artery was occluded with coils. Hemoptysis
did not recur during 1 year of follow-up.
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MDCT depicted 16 (62%) of 26 nonbronchial systemic arteries seen on
angiograms in the study by Yoon et al.
[5] and all five nonbronchial
arteries in the series reported by Remy-Jardin et al.
[6]. Once the bleeding site has
been located on CT, vascularization of the nonbronchial systemic arteries
should be systematically attempted, especially for nonbronchial systemic
arteries that potentially vascularize the region involved, such as the
inferior phrenic artery (lower lobes and inferior segment of the lingula), the
intercostal arteries (posterior thickening), and the internal mammary artery
(anterior segment of the upper lobes, right middle lobe, and lingula)
[1,
4].
Pulmonary Artery Origin
Several clinical and MDCT signs suggest the origin of bronchial bleeding is
a pulmonary artery, such as the persistence of hemoptysis despite appropriate
systemic artery embolization (Fig.
11A,
11B,
11C), the presence of a
proximal cavity, and visualization of a pulmonary artery bordering a cavity
(especially in a necrotic tumor). Other causes of hemoptysis of pulmonary
artery origin can be visualized on MDCT, such as Rasmussen aneurysm
[8], aneurysm due to vasculitis
(e.g., Behçet's syndrome), and trauma (especially due to a Swan-Ganz
balloon catheter).
References
- Yoon W, Kim JK, Kim YH, Chung TW, Kang HK. Bronchial and
nonbronchial systemic artery embolization for life-threatening hemoptysis: a
comprehensive review. RadioGraphics 2002;22
: 1395-1409[Abstract/Free Full Text]
- Sbano H, Mitchell AW, Ind PW, Jackson JE. Peripheral pulmonary
artery pseudoaneurysms and massive hemoptysis. AJR2005; 184:1253
-1259[Abstract/Free Full Text]
- Revel MP, Fournier LS, Hennebicque AS, et al. Can CT replace
bronchoscopy in the detection of the site and cause of bleeding in patients
with large or massive hemoptysis? AJR2002; 179:1217
-1224[Abstract/Free Full Text]
- Yoon W, Kim YH, Kim JK, Kim YC, Park JG, Kang HK. Massive
hemoptysis: prediction of nonbronchial systemic arterial supply with chest CT.
Radiology 2003;227
: 232-238[Abstract/Free Full Text]
- Yoon YC, Lee KS, Jeong YJ, Shin SW, Chung MJ, Kwon OJ. Hemoptysis:
bronchial and nonbronchial systemic arteries at 16-detector row CT.
Radiology 2005;234
: 292-298[Abstract/Free Full Text]
- Remy-Jardin M, Bouaziz N, Dumont P, Brillet PY, Bruzzi J, Remy J.
Bronchial and nonbronchial systemic arteries at multi-detector row CT
angiography: comparison with conventional angiography.
Radiology 2004;233
: 741-749[Abstract/Free Full Text]
- Carette MF, Khalil A, Parrot A. Haemoptysis: aetiology and
management [in French]. EMC-Pneumologie2004; 1:99
-128
- Picard C, Parrot A, Boussaud V, et al. Massive hemoptysis due to
Rasmussen aneurysm: detection with helicoidal CT angiography and successful
steel coil embolization. Intensive Care Med2003; 29:1837
-1839[CrossRef][Medline]
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Abstract
Introduction
