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

作者：Qu, Haixian; Wang, Maoqiang^*; Wang, Zhijun; Ao, Guokun; Yuan, Xiaodong; Li, Qiang; Ma, Zepeng; Xu, Qianru; Yan, Jieyu; Bai, Yanhua

来源：Academic Radiology, 2018, 25(8): 1018-1024.

DOI：10.1016/j.acra.2017.12.013

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

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 > ().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.

• 出版日期2018-8
• 单位中国人民解放军总医院; 中国人民解放军第三〇九医院