The Guidance Effect Of Pulmonary Arterial CT Angiography In Interventional Therapy For Hemoptysis

[Objective] To investigate the significance and clinical application value of the preoperative pulmonary circulation artery CT angiography to find the target vessel in interventional treatment of hemoptysis.[materials and methods] 40 cases of hemoptysis patients, preoperative whether pulmonary artery CT angiography (CTA) divided into two groups, namely, preoperative pulmonary artery CTA,underwent DSA and embolization in the 20 cases of patients for the CTA group.20 patients direct underwent DSA and embolization treatment for patients with DSA group. Patients CTA group preoperative pulmonary artery CTA examination, the reconstructed images were transmitted to the workstation for postprocessing, using multi planar reconstruction (MPR), maximum intensity projection (MIP) and volume rendering (VR) processing to display all may play a role in the lesion area of blood supply arteries, however,according to the CTA images after DSA and interventional treatment. DSA group of 20 patients direct DSA and interventional treatment.[results] CTA group 20 cases of preoperative patients with hemoptysis of pulmonary artery CTA, a total of detection of bronchial artery of 49, interventional operation in a total of detection of bronchial artery is 52, with DSA as the standard, the preoperative CTA detected rate was 94.23%. Right BA clear display 26, average 1.3/cases, left BA clear display,23, average 1.15/cases, showing 1 right bronchial artery in 14 patients,2 with 6 patients, left bronchial artery in 1 of 15 patients,2 of 4 patients, were not detected in 1 patient; in this group of patients, a total of found five BA distribution types. DSA group 20 cases underwent digital subtraction angiography (DSA) in the treatment of patients, right BA clear display of 25, the average 1.25/ cases, left BA clear display of 25, the average 1.25 per case. Display right bronchial artery 1 in 15 patients,2 had 5 patients showed a left bronchial artery in 16 patients,2 with 3 patients,3 in 1 patient, the cases of this group of the Communist Party of China found five BA distribution types. A total of 40 patients were found 6 kinds of BA type distribution. The R1L1 type is the largest, accounting for 55%(22/40), followed by R1L2 22.5%. Operation time by intraoperative radiation time were compared, DSA alone group average (40.55±10.01) min, the preoperative CTA group an average of (28.33±7.68) min.Through the statistical analysis(t=4.03, p=0.001<0.05), DSA group and preoperative CTA group was statistically significant. After one year follow-up. Preoperative CT angiography (CTA) in 20 patients,4 cases of hemoptysis again, the recurrence rate was 20%, but not short-term recurrence of patients, with DSA group 20 patients,8 cases of hemoptysis again, the recurrence rate was 40%.5 patients with short-term recurrence, the recurrence rate was 25%. By statistical processing. CTA and DSA group short-term recurrence rate compared with statistical significance (x2=5.714, p=0.017<0.05). CTA group short-term recurrence rate was lower than that of DSA group. CTA group and DSA group compared with the long-term recurrence rate was not statistically significant (x2=0.173, p=0.677>0.05). All 40 patients were embolized successfully, immediate hemostasis rate of 95%. Serious complications of paraplegia, local skin necrosis, ectopic embolism were not seen in all cases.[Conclusion] The results of this study showed that pulmonary artery CTA of pulmonary artery imaging with high sensitivity and sensitivity and specificity, it can accurately display the bleeding of the target vessel origin, number, course, can be the origin of ectopic Ba were accurate positioning, and better displayed on lesion blood supply of non bronchial systemic artery involvement, improve the interventional therapy of intubation success rate, shorten the duration of intubation, reduce the patient and the operator of the exposure dose, reducing the leakage probability of bolt. In the interventional treatment of preoperative formulation of treatment and catheter selection and approach, selection of embolic material provides important information and guidance.