Role of multi detector computed tomography (MDCT) angiography in the management of patients with haemoptysis

Abstract

Haemoptysis is one of the deadliest symptoms of respiratory illness. Identifying the etiology and source of haemoptysis plays a crucial role in early diagnosis and planning for appropriate management. The aim of the study was to evaluate the role of MDCT angiography in identifying the site, cause and source of haemoptysis along with determining the normal variants of bronchial arteries. A prospective study was performed on 50 patients with complaints of haemoptysis for a period of 18 months. MDCT angiography was performed to interpret site and source of bleed. Tuberculosis (44%) was the most common underlying cause of haemoptysis in a cohort of 50 patients. In most patients, bronchial artery was adjudged to the source of haemoptysis (72%), followed by the pulmonary artery. Non bronchial systemic arteries contributed to haemoptysis in 12% of patients. A total of 145 bronchial arteries were detected, out of which 75 were right bronchial arteries (51%) and 71 left bronchial arteries (49%). The combination of 2 right bronchial arteries and 1 left bronchial artery was the most common (18%) branching pattern in this study. MDCT angiography is a robust diagnostic tool that permits visualisation of pulmonary vasculature involved in haemoptysis, thereby effectuating suitable treatment in time, and possibly reduce associated mortality rates.