支气管动脉CTA检查在咯血介入治疗中的临床价值  

The value of bronchial artery CT angiography in embolotherapy for hemoptysis

作　　者：李继军[1,2] 尚建强[2] 唐军[2] 赵斌[1,2] 

机构地区：[1]山东大学医学院,山东济南250012 [2]山东省医学影像学研究所,山东济南250021

出　　处：《医学影像学杂志》2015年第2期230-233,共4页Journal of Medical Imaging

摘　　要：目的探讨CTA检查在咯血介入治疗中的价值、局限及应用策略。方法 53例咯血患者行支气管动脉CTA检查,随后行支气管动脉栓塞术。统计CTA与栓塞术中DSA检查显示支气管动脉、异常支气管动脉、侧支供血动脉的数量。所有病例术后随访1年。结果 CTA检查与术中DSA检查分别显示支气管动脉152支、123支。以DSA检查结果为标准,CTA检出的支气管动脉、异常支气管动脉、侧支供血动脉符合率分别为100%(123/123),82.3%(79/96),53.8%(21/39)。51例患者成功行支气管动脉栓塞治疗,术后1年内复发6例。结论 CTA检查发现支气管动脉敏感度高,有助于介入术中快速查找出血动脉和优化介入治疗方案。CTA显示异常支气管动脉及侧支供血动脉效果不够理想,介入术中应充分利用CTA提供的信息,但确认出血血管仍需要DSA检查。Objective To explore the value,limitation and application strategy of bronchial artery CT angiography（CTA）in embolotherapy for hemoptysis.Methods Fifty three patients with hemoptysis underwent bronchial artery CT angiography and bronchial artery embolization（BAE）.Bronchial artertes,abnormal bronchial arteries and non-bronchial systemic arteries detected by CTA and DSA before embolotherapy were statistically analyzed.All the patients were followed up for 12 months after embolotherapy.Results 152 and 123 bronchial arteries were detected by CTA and DSA separately,taking result of DSA as the criteria.The coincident rate of CTA in detecting bronchial arteries,abnormal bronchial arteries and non-bronchial systemic arteries were 100%（123/123）,82.3%（79/96）and 53.8%（21/39）.BAE was successfully performed in 51 patients and hemoptysis recurrence occurred in 6 cases within 12 months after operation.Conclusion CT angiography is proved to be an accurate means in finding bronchial arteries.And it is helpful in locating bleeding arteries and optimizing the operation.While,CTA is not an effective way in detecting abnormal bronchial arteries and nonbronchial systemic arteries and DSA is indispensable in confirming bleeding arteries.

关 键 词：咯血 支气管动脉栓塞 体层摄影术 X线计算机 

分 类 号：R563.6[医药卫生—呼吸系统] R814.42[医药卫生—内科学]