背景:本研究的目的是评估多探测器CT血管造影(CTA)在显示咯血患者支气管和非支气管全身动脉方面的诊断性能,并评估这种模式是否有助于确定血管造影栓塞的可行性。
方法:在2010年1月至2011年7月期间,52例咯血患者接受了术前多探测器CTA和数字减影血管造影(DSA)成像。在每个患者和每个动脉的基础上评估CTA在描绘引起咯血的动脉方面的诊断性能。分析了CTA评估的血管内治疗的可行性。灵敏度,特异性,并确定了这些分析的阳性和阴性预测值。
结果:50例患者被纳入动脉-存在-数量分析。在每个患者的分析中,CTA(P=0.25)和DSA(P=1.00)在检测引起咯血的动脉方面均无统计学差异。敏感性,特异性,阳性和阴性预测值为94%,100%,100%,40%,分别,对于CTA评估的病理性动脉的存在,98%,100%,100%,67%,分别,DSA。在每动脉的基础上,CTA正确识别97%(107/110)。52例患者纳入可行性分析。CTA在预测血管造影栓塞可行性方面的表现与所进行的治疗没有统计学差异(P=1.00)。敏感性,特异性,阳性和阴性预测值为96%,80%,98%和67%,分别,CTA.
结论:多探测器CTA是一种准确的成像方法,可以描述引起咯血的动脉的存在和数量。这种方式也可用于确定血管造影栓塞治疗咯血的可行性。
BACKGROUND: The aim of this study is to evaluate the diagnostic performance of multidetector CT angiography (CTA) in depicting bronchial and non-bronchial systemic arteries in patients with
haemoptysis and to assess whether this modality helps determine the feasibility of angiographic embolisation.
METHODS: Fifty-two patients with
haemoptysis between January 2010 and July 2011 underwent both preoperative multidetector CTA and digital subtraction angiography (DSA) imaging. Diagnostic performance of CTA in depicting arteries causing
haemoptysis was assessed on a per-patient and a per-artery basis. The feasibility of the endovascular treatment evaluated by CTA was analysed. Sensitivity, specificity, and positive and negative predictive values for those analyses were determined.
RESULTS: Fifty patients were included in the artery-presence-number analysis. In the per-patient analysis, neither CTA (P = 0.25) nor DSA (P = 1.00) showed statistical difference in the detection of arteries causing
haemoptysis. The sensitivity, specificity, and positive and negative predictive values were 94%, 100%, 100%, and 40%, respectively, for the presence of pathologic arteries evaluated by CTA, and 98%, 100%, 100%, and 67%, respectively, for DSA. On the per-artery basis, CTA correctly identified 97% (107/110). Fifty-two patients were included in the feasibility analysis. The performance of CTA in predicting the feasibility of angiographic embolisation was not statistically different from the treatment performed (P = 1.00). The sensitivity, specificity, and positive and negative predictive values were 96%, 80%, 98% and 67%, respectively, for CTA.
CONCLUSIONS: Multidetector CTA is an accurate imaging method in depicting the presence and number of arteries causing haemoptysis. This modality is also useful for determining the feasibility of angiographic embolisation for
haemoptysis.