Clinical application of multi-slice spiral CT angiography in diagnosing bronchial-pulmonary shunts / 介入放射学杂志

ABSTRACT

Objective To evaluate multi- slice spiral CT angiography (MSCTA) in diagnosing bronchial-pulmonary shunts (BPS). Methods The materials of MSCTA images in 31 patients with DSA-confirmed BPS were retrospectively analyzed. Taking DSA imaging as the reference standard, the consistency in diagnosing BPS at different levels between MSCTA and DSA was compared. Results On MSCTA using aorta-density trigger scanning technique BPS was manifested as wrong-time enhancement of pulmonary artery branches. Wilcoxon test indicated that MSCTA had a high concordance with DSA in detecting BPS occurring at sub-segmental (or above) pulmonary artery branches (Z = -1.854, P > 0.05), but MSCTA detection of BPS occurring at peripheral pulmonary arteries was obviously poorer than DSA (Z = -3.923, P < 0.05). MSCTA confirmed the diagnosis of BPS in 11 cases with a sensitive rate of 35.5% (11/31), and no differences in revealing the number and the shunt levels of BPS existed between DSA and MSCTA. The number of abnormal systemic arteries demonstrated by MSCTA was quite the same as the number detected by DSA. No false positive case was seen. Conclusion MSCTA is very effective in diagnosing high-flow BPS locating at sub-segmental (or above) pulmonary artery branches as well as in revealing abnormal bronchus-related systemic arteries, which is very helpful in preoperatively evaluating the severity of the BP shunting and the supplying arteries to be obstructed.