Extended-Thoracic Imaging of Multi-slice Computed Tomography Technique in the Evaluation of Hemoptysis Resulting from Neoplastic Lesions: Two Cases Study

Abstract

Objective: This study aimed to evaluate the role of multi-detectors computed tomography in patients suffering from hemoptysis, resulting from neoplastic lesions, and aiming to reach proper diagnosis and subsequent proper management. Methods: This study was carried out on consecutive 13 patients suffering from hemoptysis resulting from malignant thoracic lesions. All patients were subject to complete clinical assessment, laboratory study, roentgen graphic study including Plain chest X-Ray and Multidetector Computed Tomography (MDCT), Multidetector Computed Tomography Angiography (MDCTA), Minimum intensity projection (MIP), 3D volume –rendering images and Virtual Bronchoscopy (VB). VB was also compared with the report of Fiber-optic Bronchoscopy (FOB). Conventional Angiography was performed in selected indicated patients with a digital subtraction technique (DSA). (2 patients only). Results: 9 male (70%), and 4 female (30%). Based on clinical chest X-RAY, MDCT, DSA , FOB and Histopathology , a source and etiology for bleeding could be identified applying a diagnostic work up in 12 /13 (92%). Plain radiography was considered successfully contributing in the identification of the cause of hemoptysis in only 38.5% of patients. CT angiography showed enlarged tortuous bronchial feeding vessels in 42% of patients. Bleeding from pulmonary artery was identified in 20%. DSA was performed in 2 patients 15%, indicated for embolization. Fibrooptic bronchoscopy findings were evaluated in 13/13 patients with histopathological confirmation in 12 patients. Conclusion: The study concluded that MDCT using VB is considered a primary non-invasive imaging modality in the evaluation of patients with hemoptysis resulting from neoplastic lesions.