RESUMEN
The disease caused by Sars-Cov-2 (Covid-19) has become a worldwide pandemic and consequently a public health problem. Multiple complications associated with Covid-19 have been described, including coagulation abnormalities. Although the infection is known to induce a prothrombotic state, hemorrhagic complications have also been reported in patients with Covid-19, especially in anticoagulated patients. We present two cases of spontaneous pulmonary hematoma in patients with Covid-19 undergoing anticoagulant treatment. We aim to describe this complication, which although uncommon, should be taken into account in anticoagulated patients with Covid-19.
RESUMEN
Life-threatening hemoptysis is a severe condition that requires rapid diagnosis and treatment. One of the treatments of choice is embolization. The initial assessment aims to locate the origin and cause of bleeding. The technological advance of the development of multidetector computed tomography (MDCT) has changed the management of patients with life-threatening hemoptysis. MDCT angiography makes it possible to evaluate the cause of bleeding and locate the vessels involved both rapidly and noninvasively; it is particularly useful for detecting ectopic bronchial arteries, nonbronchial systemic arteries, and pulmonary pseudoaneurysms. Performing MDCT angiography systematically before embolization enables better treatment planning. In this article, we review the pathophysiology and causes of life-threatening hemoptysis (including cryptogenic hemoptysis) and the MDCT angiography technique, and we review how to systematically evaluate the images (lung parenchyma, airways, and vascular structures).
Asunto(s)
Hemoptisis/diagnóstico por imagen , Tomografía Computarizada Multidetector , Urgencias Médicas , Hemoptisis/etiología , Hemoptisis/fisiopatología , Humanos , Pulmón/irrigación sanguínea , Enfermedades Pulmonares/complicaciones , Enfermedades Pulmonares/diagnóstico por imagenRESUMEN
The disease caused by Sars-Cov-2 (Covid-19) has become a worldwide pandemic and consequently a public health problem. Multiple complications associated with Covid-19 have been described, including coagulation abnormalities. Although the infection is known to induce a prothrombotic state, hemorrhagic complications have also been reported in patients with Covid-19, especially in anticoagulated patients. We present two cases of spontaneous pulmonary hematoma in patients with Covid-19 undergoing anticoagulant treatment. We aim to describe this complication, which although uncommon, should be taken into account in anticoagulated patients with Covid-19.
Asunto(s)
COVID-19 , Humanos , COVID-19/complicaciones , SARS-CoV-2 , Anticoagulantes/uso terapéutico , Hematoma/diagnóstico por imagen , Hematoma/etiología , PandemiasRESUMEN
OBJECTIVES: Immunotherapy is a new treatment in advanced lung cancer that works by modulating the immune response against malignant cells. One aspect that is challenging for radiologists in the evaluation of the response to immunotherapy is the phenomenon of pseudoprogression, in which the infiltration of inflammatory cells causes lesions to increase in size or new lesions to appear and then decrease in size or disappear. Pseudoprogression actually represents a response to treatment. We aimed to determine the frequency of pseudoprogression in patients with advanced stages of lung cancer treated with nivolumab. PATIENTS AND METHODS: We included 56 patients with advanced stages of lung cancer treated with nivolumab as a second-line or later treatment. We analyzed CT studies done while patients were undergoing nivolumab treatment. Tumor pseudoprogression was defined as an increase in the size of lesions or appearance of new lesions followed by a decrease in size or disappearance of these lesions on follow-up CT studies 4 to 8 weeks later. We did a descriptive analysis. RESULTS: In 15 patients, it was impossible to evaluate possible pseudoprogression because a second CT study was unavailable due to change of treatment or death. Tumor pseudoprogression was observed in 5 (12.2%) of the 41 patients, in most cases within 12 weeks of treatment initiation (in the fourth cycle). A second episode of pseudoprogression occurred in 2 (40%) of the 5 patients with an initial episode; the second episode occurred more than 12 weeks after treatment initiation. CONCLUSION: Tumor pseudoprogression occurred in 12.2% of patients with advanced stage lung cancer treated with nivolumab. An increase in lesion size or the appearance of new lesions must be assessed over time to avoid mistaking pseudoprogression for true progression of disease.
Asunto(s)
Antineoplásicos Inmunológicos/uso terapéutico , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico por imagen , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/tratamiento farmacológico , Nivolumab/uso terapéutico , Tomografía Computarizada por Rayos X , Anciano , Carcinoma de Pulmón de Células no Pequeñas/patología , Progresión de la Enfermedad , Femenino , Humanos , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
Primary non-Hodgkin's lymphoma (NHL) of the breast are rare and represent less than 0.6% of all mammary malignancies. Secondary involvement of the breast in patients with diffuse disease occurs more frequently. The radiologic features of breast lymphoma are nonspecific, and the diagnosis is based on histologic criteria. We present the MR-imaging features of a case of primary NHL of the breast.
Asunto(s)
Neoplasias de la Mama/diagnóstico , Linfoma de Células B/diagnóstico , Linfoma de Células B Grandes Difuso/diagnóstico , Linfoma no Hodgkin/diagnóstico , Imagen por Resonancia Magnética , Biopsia con Aguja , Mama/patología , Neoplasias de la Mama/patología , Femenino , Humanos , Aumento de la Imagen , Procesamiento de Imagen Asistido por Computador , Linfoma de Células B/patología , Linfoma de Células B Grandes Difuso/patología , Linfoma no Hodgkin/patología , Persona de Mediana Edad , Sensibilidad y EspecificidadRESUMEN
The pleural space is a potential space under normal physiologic circumstances. It envelops the lung, the mediastinum, the diaphragm and the chest wall. A thin film of pleural fluid provides lubrication for the two pleural layers; only 2-10 ml of pleural fluid is present in healthy people. For the purposes of this review, pleural abnormalities will be divided into pleural effusion, pneumothorax, and pleural calcification.
Asunto(s)
Enfermedades Pleurales/diagnóstico , Diagnóstico Diferencial , Empiema/diagnóstico , Hemotórax/diagnóstico , Humanos , Enfermedades Pleurales/clasificación , Derrame Pleural/diagnóstico , Neumotórax/diagnóstico , Tomografía Computarizada por Rayos XRESUMEN
Radiologic findings in four patients with metastatic mixed germ-cell tumors of the testis are presented. In all cases metastases had increased in size following chemotherapy in spite of normal biomarker levels, and histological study of the residual masses showed mature teratoma with an absence of malignant cells, thus confirming the diagnosis of growing teratoma syndrome. At present CT appears to be the best technique both for diagnosis and follow-up in these patients. In one case, the growing teratoma syndrome presented as cavitation of a pulmonary nodular lesion, a finding rarely described in the literature, and with CT demonstration not reported.
Asunto(s)
Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias de Células Germinales y Embrionarias/diagnóstico por imagen , Neoplasias Retroperitoneales/diagnóstico por imagen , Teratoma/diagnóstico por imagen , Neoplasias Testiculares/patología , Adolescente , Adulto , Humanos , Neoplasias Pulmonares/secundario , Masculino , Neoplasias de Células Germinales y Embrionarias/patología , Neoplasias de Células Germinales y Embrionarias/secundario , Neoplasias Retroperitoneales/secundario , Síndrome , Teratoma/patología , Teratoma/secundario , Tomografía Computarizada por Rayos XRESUMEN
We describe a new sign of traumatic herniation of the stomach. Computed tomography (CT) shows the herniated stomach as two semicircular loops separated by a band of soft-tissue attenuation somewhat resembling a sandwich. This appearance is the axial representation of the herniated stomach.
Asunto(s)
Hernia Diafragmática Traumática/diagnóstico por imagen , Gastropatías/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto , Humanos , Masculino , Radiografía Torácica , Estómago/diagnóstico por imagenRESUMEN
We report five patients diagnosed of pulmonary hypoplasia (PH) in adulthood (age > 18 years, range 45 to 67 years). PH was left-sided in four cases. The malformations found were 2 cases of renal agenesis, 2 diaphragmatic hernias and 1 hiatal hernia. Lung function data were FEV1 0.88 +/- 0.32 L; FVC 1.30 +/- 0.52 L; FEV 1/FVC 68.5 +/- 5%. Arterial gases (with FiO2 0.21) were PaO2 63.6 +/- 24 and PaCO2 47.1 +/- 11.2 mmHg. Three cases were referred for monitoring of respiratory insufficiency (2 requiring home oxygen therapy) and two for radiographic study of chest disease. The diagnoses were made by computerized tomography (CT) of the chest. Congenital diseases due to underdeveloped lungs in the pseudoglandular phase are rarely diagnosed in adults (48 cases, including ours, have been found in the literature), and PH is rarely diagnosed, possibly because the anomalies observed are attributed to old infections. Clinical presentation is highly variable, depending in large measure on a history of smoking and repeated respiratory infections. Chest CT is at present the diagnostic tool of choice.
Asunto(s)
Pulmón/anomalías , Anciano , Femenino , Humanos , Pulmón/diagnóstico por imagen , Pulmón/embriología , Masculino , Persona de Mediana Edad , Radiografía Torácica , Pruebas de Función Respiratoria , Tomografía Computarizada por Rayos XRESUMEN
La enfermedad causada por SARS-CoV-2 (Covid-19) se ha convertido en una pandemia mundial y en consecuencia en un problema de salud pública. Se han descrito múltiples complicaciones asociadas a la COVID-19, entre ellas alteraciones de la coagulación. Si bien es conocido que la infección induce un estado protrombótico, también se han descrito complicaciones hemorrágicas en estos pacientes, sobre todo en pacientes anticoagulados. Presentamos dos casos de hematoma pulmonar espontáneo en pacientes con neumonía COVID-19 y terapia anticoagulante. Nuestro objetivo es describir esta complicación, que, aunque poco frecuente, conviene tener en cuenta en pacientes anticoagulados y con COVID-19 concomitante (AU)
The disease caused by Sars-Cov-2 (Covid-19) has become a worldwide pandemic and consequently a public health problem. Multiple complications associated with Covid-19 have been described, including coagulation abnormalities. Although the infection is known to induce a prothrombotic state, hemorrhagic complications have also been reported in patients with Covid-19, especially in anticoagulated patients. We present two cases of spontaneous pulmonary hematoma in patients with Covid-19 undergoing anticoagulant treatment. We aim to describe this complication, which although uncommon, should be taken into account in anticoagulated patients with Covid-19 (AU)
Asunto(s)
Humanos , Masculino , Anciano , Infecciones por Coronavirus/complicaciones , Neumonía Viral/complicaciones , Pandemias , Hematoma/diagnóstico por imagen , Hematoma/etiología , Anticoagulantes/efectos adversos , Enfermedades Pulmonares/diagnóstico por imagen , Enfermedades Pulmonares/etnología , Tomografía Computarizada por Rayos XAsunto(s)
Inmunocompetencia , Tuberculosis Pulmonar/complicaciones , Aspergilosis/complicaciones , Aspergilosis/diagnóstico por imagen , Enfermedades Bronquiales/diagnóstico por imagen , Enfermedades Bronquiales/microbiología , Fístula Bronquial/diagnóstico por imagen , Fístula Bronquial/microbiología , Cálculos/diagnóstico por imagen , Cálculos/microbiología , Constricción Patológica/diagnóstico por imagen , Constricción Patológica/microbiología , Empiema Tuberculoso/diagnóstico por imagen , Empiema Tuberculoso/microbiología , Fístula Esofágica/diagnóstico por imagen , Fístula Esofágica/microbiología , Gangrena , Humanos , Pulmón/diagnóstico por imagen , Pulmón/patología , Enfermedades Pulmonares/diagnóstico por imagen , Enfermedades Pulmonares/microbiología , Enfermedades del Mediastino/diagnóstico por imagen , Enfermedades del Mediastino/microbiología , Mediastinitis/diagnóstico por imagen , Mediastinitis/microbiología , Enfermedades Pleurales/diagnóstico por imagen , Enfermedades Pleurales/microbiología , Radiografía , Recurrencia , Fístula del Sistema Respiratorio/diagnóstico por imagen , Fístula del Sistema Respiratorio/microbiología , Tuberculosis Pleural/diagnóstico por imagen , Tuberculosis Pulmonar/diagnóstico por imagenRESUMEN
OBJETIVOS: La inmunoterapia es un nuevo tratamiento en estadios avanzados del cáncer de pulmón de célula no pequeña (CPCNP) que modula la respuesta inmunitaria frente a células malignas. Un reto para el radiólogo es la valoración del fenómeno de la pseudoprogresión, en la que se observa un aumento o aparición de lesiones por infiltración de células inflamatorias, con posterior disminución o desaparición de estas, hecho que traduce en realidad la respuesta al tratamiento. El objetivo fue determinar la frecuencia de pseudoprogresión en pacientes con CPCNP en estadios avanzados tratados con nivolumab. PACIENTES Y MÉTODOS: Se incluyeron 56 pacientes con CPCNP en estado avanzado tratados con nivolumab en segunda línea o posterior. Se analizaron las tomografías computarizadas (TC) realizadas durante el período de tratamiento. Se consideró pseudoprogresión tumoral al aumento o aparición de lesiones con posterior disminución o desaparición en una TC de control realizada a las 4-8 semanas. Se realizó un análisis descriptivo. RESULTADOS: No se pudo valorar la existencia de pseudoprogresión en 15 pacientes porque no se disponía de al menos dos TC (por cambio de tratamiento o fallecimiento). Se observó pseudoprogresión tumoral en un 12,2% (5/41) de los pacientes, en la mayoría de los casos antes de las 12 semanas del inicio del tratamiento (en el 4. ° ciclo). Un 40% (2/5) de los pacientes con pseudoprogresión presentó un segundo episodio, que se produjo de forma tardía, a partir de las 12 semanas del inicio del tratamiento. CONCLUSIÓN: Se observó pseudoprogresión tumoral en un 12,2% de los pacientes con CPCNP tratados con nivolumab. El aumento o aparición de lesiones debe valorarse evolutivamente para evitar diagnosticar erróneamente progresión de la enfermedad
OBJECTIVES: Immunotherapy is a new treatment in advanced lung cancer that works by modulating the immune response against malignant cells. One aspect that is challenging for radiologists in the evaluation of the response to immunotherapy is the phenomenon of pseudoprogression, in which the infiltration of inflammatory cells causes lesions to increase in size or new lesions to appear and then decrease in size or disappear. Pseudoprogression actually represents a response to treatment. We aimed to determine the frequency of pseudoprogression in patients with advanced stages of lung cancer treated with nivolumab. PATIENTS AND METHODS: We included 56 patients with advanced stages of lung cancer treated with nivolumab as a second-line or later treatment. We analyzed CT studies done while patients were undergoing nivolumab treatment. Tumor pseudoprogression was defined as an increase in the size of lesions or appearance of new lesions followed by a decrease in size or disappearance of these lesions on follow-up CT studies 4 to 8 weeks later. We did a descriptive analysis. RESULTS: In 15 patients, it was impossible to evaluate possible pseudoprogression because a second CT study was unavailable due to change of treatment or death. Tumor pseudoprogression was observed in 5 (12.2%) of the 41 patients, in most cases within 12 weeks of treatment initiation (in the fourth cycle). A second episode of pseudoprogression occurred in 2 (40%) of the 5 patients with an initial episode; the second episode occurred more than 12 weeks after treatment initiation. CONCLUSION: Tumor pseudoprogression occurred in 12.2% of patients with advanced stage lung cancer treated with nivolumab. An increase in lesion size or the appearance of new lesions must be assessed over time to avoid mistaking pseudoprogression for true progression of disease
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Antineoplásicos Inmunológicos/uso terapéutico , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico por imagen , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/tratamiento farmacológico , Nivolumab/uso terapéutico , Tomografía Computarizada por Rayos X , Carcinoma de Pulmón de Células no Pequeñas/patología , Progresión de la Enfermedad , Neoplasias Pulmonares/patología , Estudios RetrospectivosRESUMEN
The neuroradiological features of six intracranial and one intraorbital haemangiopericytomas (HP) are reviewed. CT was performed before and after IV contrast medium in 5 patients. In 2 patients MRI was performed before and after contrast medium; in another, only unenhanced images were obtained. Five patients were studied by selective external and internal carotid artery angiography. Women constituted 5 of the 7 patients, and the mean age was 50.5 years, thus the sex and age distribution did not differ from that of typical meningiomas. Contrary to previous reports, calcification was present in two of the intracranial HP, and bone erosion was clearly seen in one intracranial HP and the orbital lesion. On MRI the tumours showed no differences from angioblastic meningiomas. All 6 intracranial HP were aggressive: all recurred following treatment and extracerebral metastasis occurred in one case.
Asunto(s)
Diagnóstico por Imagen , Hemangiopericitoma/diagnóstico , Neoplasias Meníngeas/diagnóstico , Meningioma/diagnóstico , Neoplasias Orbitales/diagnóstico , Adulto , Anciano , Angiografía Cerebral , Medios de Contraste , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/diagnóstico , Tomografía Computarizada por Rayos XRESUMEN
We present three cases of breast lesions labeled as probable intramammary lymph nodes that showed an increase in size on follow-up mammography. Contrast-enhanced MRI was performed and the three lesions showed strong and rapid uptake of the intravenous contrast. Core needle biopsy established the diagnosis of lymphoid hyperplasia in all three patients. Because intramammary lymph nodes affected by benign processes can present findings similar to malignant lesions, the usefulness of contrast-enhanced MRI in these cases is controversial.
Asunto(s)
Mama/patología , Ganglios Linfáticos/patología , Imagen por Resonancia Magnética , Anciano , Biopsia con Aguja , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/cirugía , Carcinoma Ductal de Mama/diagnóstico , Carcinoma Ductal de Mama/cirugía , Medios de Contraste/administración & dosificación , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Humanos , Hiperplasia , Aumento de la Imagen , Inyecciones Intravenosas , Ganglios Linfáticos/diagnóstico por imagen , Mamografía , Mastectomía , Persona de Mediana Edad , Recurrencia Local de Neoplasia/diagnósticoRESUMEN
Venous aneurysm of the azygos arch is a very rare cause of mediastinal mass and is usually an incidental finding on chest radiography. Nowadays the diagnosis is made by non-invasive tests such as thoracic CT scanning and/or magnetic resonance imaging. The case is described of an asymptomatic woman in whom a mediastinal mass due to an azygos vein aneurysm was diagnosed by non-invasive procedures, the aetiology of which, in all probability, was idiopathic.
Asunto(s)
Aneurisma/diagnóstico por imagen , Vena Ácigos/diagnóstico por imagen , Femenino , Humanos , Enfermedades del Mediastino/diagnóstico por imagen , Persona de Mediana Edad , Cintigrafía , Tomografía Computarizada por Rayos XRESUMEN
Chest radiographs and high-resolution chest CT scans were performed in a 30-year-old man with a history of intravenous drug abuse and diffuse micronodular infiltrates. Transbronchial biopsy gave a diagnosis of cellulose granulomatosis of the lung. Cellulose granulomatosis should be considered in the differential diagnosis of pulmonary interstitial disease, especially in the setting of intravenous drug abuse.
Asunto(s)
Celulosa , Granuloma de Cuerpo Extraño/etiología , Enfermedades Pulmonares/etiología , Abuso de Sustancias por Vía Intravenosa/complicaciones , Adulto , Celulosa/efectos adversos , Granuloma de Cuerpo Extraño/diagnóstico por imagen , Infecciones por VIH/complicaciones , Humanos , Enfermedades Pulmonares/diagnóstico por imagen , Masculino , Tomografía Computarizada por Rayos XRESUMEN
The objective of this study was to assess the usefulness of stereotactic large-core needle biopsy (LCNB) in the management of nonpalpable breast lesions (NBL) and compare it with stereotactic fine-needle aspiration biopsy (SFNA) performed simultaneously in a significant number of cases. From November 1993 through June 1997, 510 consecutive patients with NBL underwent 14-gauge LCNB with 354 women undergoing simultaneous 21-gauge SFNA in the same lesson. Mammographic findings lesion size, number of core biopsy specimens, complications and diagnoses of both techniques were analysed. Surgical biopsy, tumorectomy or mastectomy was indicated for malignancy or poor correlation between SFNA or LCNB results and clinical or radiological findings. Values of diagnostic accuracy of both LCNB and SFNA were determined. The ratio benign surgical biopsies/malignant surgical biopsies (BB/CB) of the series was calculated. A total of 171 patients underwent surgical treatment: in 31 (18.1%) a benign process or atypical ductal hyperplasia was the final diagnosis. The ratio BB/CB was 0.22. Sensitivity and specificity were 93.2 and 100%, respectively, for LCNB, and 77.2 and 92.3%, respectively, for SFNA with cytological analysis. Large-core needle biopsy provides more accurate diagnosis than SFNA in the management of nonpalpable breast lesions and obviates a surgical diagnostic procedure in a significant number of cases.
Asunto(s)
Biopsia con Aguja/métodos , Neoplasias de la Mama/patología , Mastectomía , Técnicas Estereotáxicas , Anciano , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/cirugía , Femenino , Estudios de Seguimiento , Humanos , Mamografía , Persona de Mediana Edad , Estudios Prospectivos , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
Stereotactic core needle biopsy (SCNB) allows specific histopathologic diagnoses to be made without surgery and has been demonstrated to be an accurate, cost-effective method of diagnosing breast disease, particularly nonpalpable lesions. However, recent studies have concluded that the diagnosis of atypical ductal hyperplasia (ADH) by means of SCNB has resulted in nearly equal odds that a coexisting malignant lesion will be missed. Furthermore, others have concluded that SCNB diagnosed as DCIS cannot reliably indicate the absence of tumor invasion in surgical excision. Between 1993 and 1998, 1,221 consecutive SCNB of mammographically identified lesions were performed using a 14-gauge automated device with an average of 5.3 cores obtained per lesion. ADH was identified in 19 (1.6%) lesions and DCIS in 89 (7.3%). Surgical biopsy was performed in 89 of these patients and histopathologic results from SCNB and surgical biopsies were reviewed and correlated. In 12 cases of ADH diagnosed by SCNB, surgical biopsy showed ADH in 8 (67%) cases and DCIS in the other 4 (33%) cases. In 77 cases of DCIS diagnosed by SCNB, a surgical biopsy showed DCIS in 55 (71%) cases, 6 more cases (8%) had DCIS with focal microinvasion, and 15 (19%) had invasive ductal carcinoma. In one case no residual tumor was found at surgery. In the author's patient population, the diagnosis of ADH at SCNB indicates high probability of DCIS or residual ADH in the surgical biopsy. The diagnosis of DCIS at SCNB is confirmed in the majority of surgical biopsies; however, a significant number of cases may show microinvasion or invasive carcinoma.
Asunto(s)
Biopsia con Aguja/métodos , Neoplasias de la Mama/patología , Carcinoma in Situ/patología , Carcinoma Ductal de Mama/patología , Neoplasias de la Mama/cirugía , Carcinoma Ductal de Mama/cirugía , Diagnóstico Diferencial , Femenino , Humanos , Hiperplasia/patología , Estudios Prospectivos , Sensibilidad y EspecificidadRESUMEN
La hemoptisis amenazante es una situación grave que precisa de un diagnóstico y tratamiento rápidos. Uno de los tratamientos de elección es la embolización. La evaluación inicial se dirige a localizar el origen y la causa del sangrado. El avance tecnológico de la TC multidetector (TCMD) ha supuesto un cambio en el manejo de estos pacientes. La angio-TCMD permite evaluar la causa rápida e incruentamente, y localizar los vasos implicados; es particularmente útil para detectar arterias bronquiales ectópicas, arterias sistémicas no bronquiales o seudoaneurismas pulmonares. Hacer sistemáticamente una angio-TCMD antes de la embolización permite planificar mejor el tratamiento. En este artículo revisamos la fisiopatología y las causas de la hemoptisis amenazante (incluyendo la hemoptisis criptogenética), la técnica del estudio de la angio-TCMD y describimos cómo evaluar sistemáticamente las imágenes (parénquima pulmonar, vía aérea y estructuras vasculares) (AU)
Life-threatening hemoptysis is a severe condition that requires rapid diagnosis and treatment. One of the treatments of choice is embolization. The initial assessment aims to locate the origin and cause of bleeding. The technological advance of the development of multidetector computed tomography (MDCT) has changed the management of patients with life-threatening hemoptysis. MDCT angiography makes it possible to evaluate the cause of blee- ding and locate the vessels involved both rapidly and noninvasively; it is particularly useful for detecting ectopic bronchial arteries, nonbronchial systemic arteries, and pulmonary pseudoaneurysms. Performing MDCT angiography systematically before embolization enables better treatment planning. In this article, we review the pathophysiology and causes of life-threatening hemoptysis (including cryptogenic hemoptysis) and the MDCT angiography technique, and we review how to systematically evaluate the images (lung parenchyma, airways, and vascular structures) (AU)