肺动脉联合支气管动脉双期CTA在咯血患者介入诊疗中的应用价值OA

Objective To investigate the application value of pulmonary artery combined with bronchial artery dual-phase computed tomography angiography(CTA)in the interventional diagnosis and treatment of hemoptysis patients.Methods A total of 138 hemoptysis patients admitted to our hospital from June 2023 to June 2025 were selected and divided into the study group(68 cases)and the control group(70 cases)according to different preoperative examination methods.The control group received conventional enhanced CT examination before surgery,while the study group received pulmonary artery combined with bronchial artery dual-phase CTA examination before surgery.On the premise of identifying the responsible bleeding vessels by imaging,further digital subtraction angiography(DSA)interventional diagnosis and bronchial artery embolization(BAE)were performed.The number of visualized blood vessels,diagnostic coincidence rate,surgical conditions(interventional treatment time,intraoperative contrast agent dosage),postoperative 72-hour hemoptysis recurrence rate and postoperative complication rate were compared between the two groups,and the vascular imaging characteristics displayed by dual-phase CTA were also analyzed.Results DSA detected 98 BAs and 109 NBSAs in the study group;dual-phase CTA detected 74 BAs and 84 NBSAs.DSA detected 102 BAs and 120 NBSAs in the control group;conventional CT detected 61 BAs and 78 NBSAs.The diagnostic coincidence rates for BAs(75.51%)and NBSAs(77.06%)in the study group were higher than 9.80%,65.00%in the control group(χ2=5.620,4.017,P<0.05).Dual-phase CTA could clearly visualize the origin of BAs,with the diameter ranging from 1.2 to 2.8 mm and showing homogeneous enhancement after contrast administration.NBSAs included intercostal artery,subclavian artery,internal thoracic artery,inferior phrenic artery,costocervical trunk,etc.,all of which featured relatively small diameters.Characteristics of responsible blood vessels:tuberculous lesions were mostly accompanied by tortuous and dilated BAs;in aspergillus pneumonia,the feeding arteries were thickened and extended to the lesion margin;bronchiectasis was often complicated with blood supply from NBSAs.The interventional therapy time of the study group was shorter than that of the control group,and the intraoperative contrast agent dosage was also less than that of the control group(P<0.05).Additionally,the recurrence rate of hemoptysis at 72 hours postoperatively and the overall incidence of complications in the study group were lower than those in the control group(P<0.05).Conclusions Pulmonary artery combined with bronchial artery dual-phase CTA can accurately localize the responsible blood vessels in hemoptysis patients,facilitating subsequent interventional treatment.Moreover,it also helps expedite the surgical process,reduce the use of contrast agents,and lower the risks of recurrence and complications,thereby providing reliable imaging evidence for the interventional diagnosis and treatment of hemoptysis patients.