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Acad Radiol. 2018 Aug;25(8):1018-1024. doi: 10.1016/j.acra.2017.12.013. Epub 2018 Jan 19.

Diagnostic Value of Dual-input Computed Tomography Perfusion on Detecting Bronchial-Pulmonary Artery Fistula in Tuberculosis Patients with Massive Hemoptysis.

Author information

1
Department of Interventional Radiology, The Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China.
2
Department of Interventional Radiology, The Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. Electronic address: 15652769102@163.com.
3
Department of Radiology, The Chinese PLA 309 Hospital, Beijing, China.

Abstract

RATIONALE AND OBJECTIVES:

This prospective study aimed to evaluate the diagnostic performance of dual-input computed tomography perfusion technique (DI-CTP) in identifying the bronchial-pulmonary artery fistula in patients tuberculosis with massive hemoptysis.

MATERIAL AND METHODS:

Twenty patients with tuberculosis with massive hemoptysis were enrolled from January 2015 to December 2015. The association between DI-CTP parameters and the diagnostic outcomes of digital subtraction angiography was assessed. Diagnostic efficacy of DI-CTP was evaluated by receiver operating curve (ROC) analyses using the diagnostic outcomes of digital subtraction angiography, which is the gold standard for identifying bronchial-pulmonary artery fistula.

RESULTS:

Compared to lung segments with normal blood flow (n = 304), those with bronchial-pulmonary artery fistula (n = 164) had a reduced pulmonary flow value, perfusion index (PI) value, and an elevated bronchial artery (BF) value in the DI-CTP scan, which was further confirmed by multivariate logistic regression. ROC analysis showed that PI and bronchial artery has an excellent diagnostic performance (both area under the ROC curve > 0.9, P < .001) and high sensitivity and specificity (from 0.79 to 0.95 at the optimal cutoff). PI has the best diagnostic performance, with an overall diagnostic accuracy of 0.91.

CONCLUSIONS:

DI-CTP scan possesses the diagnostic value for detecting bronchial-pulmonary artery fistula in patients with tuberculosis with massive hemoptysis, providing an alternative diagnostic method.

KEYWORDS:

Tuberculosis; bronchial circulation; dual-input computed tomography perfusion; hemoptysis; pulmonary circulation

PMID:
29371122
DOI:
10.1016/j.acra.2017.12.013
[Indexed for MEDLINE]

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