Role of computed tomography angiography in the evaluation of haemoptysis in children: Decoding the abnormal vessels
Background & objectives: Haemoptysis in children is potentially life-threatening. In most cases, the bleeding arises from the systemic circulation, and in 5-10 per cent of cases, it arises from the pulmonary circulation. The role of computed tomography angiography (CTA) in this setting is import...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2022-01-01
|
| Series: | Indian Journal of Medical Research |
| Subjects: | |
| Online Access: | http://www.ijmr.org.in/article.asp?issn=0971-5916;year=2022;volume=155;issue=3;spage=356;epage=363;aulast=Shera |
| _version_ | 1798019736198447104 |
|---|---|
| author | Tahleel Altaf Shera Ashu Seith Bhalla Priyanka Naranje Pankaj Meena Sushil K Kabra Arun Kumar Gupta Devasenathipathy Kandasamy |
| author_facet | Tahleel Altaf Shera Ashu Seith Bhalla Priyanka Naranje Pankaj Meena Sushil K Kabra Arun Kumar Gupta Devasenathipathy Kandasamy |
| author_sort | Tahleel Altaf Shera |
| collection | DOAJ |
| description | Background & objectives: Haemoptysis in children is potentially life-threatening. In most cases, the bleeding arises from the systemic circulation, and in 5-10 per cent of cases, it arises from the pulmonary circulation. The role of computed tomography angiography (CTA) in this setting is important. This study was undertaken (i) to study the role of single-phase split-bolus dual energy contrast-enhanced multidetector row CTA (DECTA) in the evaluation of haemoptysis in children; (ii) to analyze the patterns of abnormal vascular supply in the various aetiologies encountered.
Methods: A retrospective study of 86 patients who underwent split bolus DECTA for the evaluation of haemoptysis was performed. Final diagnoses were categorized as normal computed tomography, active tuberculosis (TB), post-infectious sequelae, non-TB active infection, cystic fibrosis (CF), non-CF bronchiectasis, congenital heart disease (CHD), interstitial lung disease, vasculitis, pulmonary thromboembolism and idiopathic pulmonary haemosiderosis. Abnormal bronchial arteries (BAs) and non-bronchial systemic collateral arteries (NBSCs) were assessed for number and site and their correlation with underlying aetiologies.
Results: A total of 86 patients (45 males, age from 0.3 to 18 yr, mean 13.88 yr) were included in the study; among these only two patients were less than five years of age. The most common cause of haemoptysis was active infection (n=30), followed by bronchiectasis (n=18), post-infectious sequelae (n=17) and CHD (n=7). One hundred and sixty five abnormal arteries were identified (108 BA and 57 NBSC), and were more marked in bronchiectasis group.
Interpretation & conclusions: Active infections and bronchiectasis are the most common causes of haemoptysis in children. While post-infectious sequelae are less common, in patients with haemoptysis, the presence of any abnormal arteries correlates with a more frequent diagnosis of bronchiectasis. NBSCs are more common in post-infectious sequelae and CHD. |
| first_indexed | 2024-04-11T16:44:28Z |
| format | Article |
| id | doaj.art-0a6a12a03ba94953a1e9a49382504713 |
| institution | Directory Open Access Journal |
| issn | 0971-5916 |
| language | English |
| last_indexed | 2024-04-11T16:44:28Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Medical Research |
| spelling | doaj.art-0a6a12a03ba94953a1e9a493825047132022-12-22T04:13:35ZengWolters Kluwer Medknow PublicationsIndian Journal of Medical Research0971-59162022-01-01155335636310.4103/ijmr.IJMR_3271_20Role of computed tomography angiography in the evaluation of haemoptysis in children: Decoding the abnormal vesselsTahleel Altaf SheraAshu Seith BhallaPriyanka NaranjePankaj MeenaSushil K KabraArun Kumar GuptaDevasenathipathy KandasamyBackground & objectives: Haemoptysis in children is potentially life-threatening. In most cases, the bleeding arises from the systemic circulation, and in 5-10 per cent of cases, it arises from the pulmonary circulation. The role of computed tomography angiography (CTA) in this setting is important. This study was undertaken (i) to study the role of single-phase split-bolus dual energy contrast-enhanced multidetector row CTA (DECTA) in the evaluation of haemoptysis in children; (ii) to analyze the patterns of abnormal vascular supply in the various aetiologies encountered. Methods: A retrospective study of 86 patients who underwent split bolus DECTA for the evaluation of haemoptysis was performed. Final diagnoses were categorized as normal computed tomography, active tuberculosis (TB), post-infectious sequelae, non-TB active infection, cystic fibrosis (CF), non-CF bronchiectasis, congenital heart disease (CHD), interstitial lung disease, vasculitis, pulmonary thromboembolism and idiopathic pulmonary haemosiderosis. Abnormal bronchial arteries (BAs) and non-bronchial systemic collateral arteries (NBSCs) were assessed for number and site and their correlation with underlying aetiologies. Results: A total of 86 patients (45 males, age from 0.3 to 18 yr, mean 13.88 yr) were included in the study; among these only two patients were less than five years of age. The most common cause of haemoptysis was active infection (n=30), followed by bronchiectasis (n=18), post-infectious sequelae (n=17) and CHD (n=7). One hundred and sixty five abnormal arteries were identified (108 BA and 57 NBSC), and were more marked in bronchiectasis group. Interpretation & conclusions: Active infections and bronchiectasis are the most common causes of haemoptysis in children. While post-infectious sequelae are less common, in patients with haemoptysis, the presence of any abnormal arteries correlates with a more frequent diagnosis of bronchiectasis. NBSCs are more common in post-infectious sequelae and CHD.http://www.ijmr.org.in/article.asp?issn=0971-5916;year=2022;volume=155;issue=3;spage=356;epage=363;aulast=Sherabronchial artery - bronchiectasis - computed tomography angiography - haemoptysis - paediatric - tuberculosis |
| spellingShingle | Tahleel Altaf Shera Ashu Seith Bhalla Priyanka Naranje Pankaj Meena Sushil K Kabra Arun Kumar Gupta Devasenathipathy Kandasamy Role of computed tomography angiography in the evaluation of haemoptysis in children: Decoding the abnormal vessels Indian Journal of Medical Research bronchial artery - bronchiectasis - computed tomography angiography - haemoptysis - paediatric - tuberculosis |
| title | Role of computed tomography angiography in the evaluation of haemoptysis in children: Decoding the abnormal vessels |
| title_full | Role of computed tomography angiography in the evaluation of haemoptysis in children: Decoding the abnormal vessels |
| title_fullStr | Role of computed tomography angiography in the evaluation of haemoptysis in children: Decoding the abnormal vessels |
| title_full_unstemmed | Role of computed tomography angiography in the evaluation of haemoptysis in children: Decoding the abnormal vessels |
| title_short | Role of computed tomography angiography in the evaluation of haemoptysis in children: Decoding the abnormal vessels |
| title_sort | role of computed tomography angiography in the evaluation of haemoptysis in children decoding the abnormal vessels |
| topic | bronchial artery - bronchiectasis - computed tomography angiography - haemoptysis - paediatric - tuberculosis |
| url | http://www.ijmr.org.in/article.asp?issn=0971-5916;year=2022;volume=155;issue=3;spage=356;epage=363;aulast=Shera |
| work_keys_str_mv | AT tahleelaltafshera roleofcomputedtomographyangiographyintheevaluationofhaemoptysisinchildrendecodingtheabnormalvessels AT ashuseithbhalla roleofcomputedtomographyangiographyintheevaluationofhaemoptysisinchildrendecodingtheabnormalvessels AT priyankanaranje roleofcomputedtomographyangiographyintheevaluationofhaemoptysisinchildrendecodingtheabnormalvessels AT pankajmeena roleofcomputedtomographyangiographyintheevaluationofhaemoptysisinchildrendecodingtheabnormalvessels AT sushilkkabra roleofcomputedtomographyangiographyintheevaluationofhaemoptysisinchildrendecodingtheabnormalvessels AT arunkumargupta roleofcomputedtomographyangiographyintheevaluationofhaemoptysisinchildrendecodingtheabnormalvessels AT devasenathipathykandasamy roleofcomputedtomographyangiographyintheevaluationofhaemoptysisinchildrendecodingtheabnormalvessels |