Radiological features of hemoptysis-related arteries in pulmonary aspergillosis infection

Background: Hemoptysis is a condition that causes bleeding in the respiratory tract due to rupture of the bronchial artery, pulmonary artery/vein and other circulatory system. Pulmonary aspergillosis infection sometimes leads to refractory hemoptysis, and it accounts for 13-33% of all patients who underwent bronchial arterial embolization. Not only the bronchial artery but also the non-bronchial artery can be related to hemoptysis. However there have been no reports on image features of hemoptysis-related arteries (HRAs) in pulmonary aspergillosis infection. Objectives/Methods: Among 102 outpatients with pulmonary aspergillosis infection in our institution, 51 hemoptysis cases whose contrast CTs were obtained (From Jan 1st 2010 to Dec 31st 2014) Chest contrast CT at initial hemoptysis were independently interpreted and analyzed by two respiratory physicians. Results: 51 patients (34 males, 17 females). Simple pulmonary aspergilloma 30 cases, Chronic progressive pulmonary aspergillosis 20 cases, Invasive pulmonary aspergillosis 1 case. Average age at diagnosis of pulmonary aspergillosis 65.0 years old, average age at initial hemoptysis 64.9 years old. Dilation of the bronchial artery was observed in the 49 cases (96.1%), mean number of bronchial vessels was 1.3/case. The mean diameter of the bronchial arterial origin was 2.8 mm ± 0.9. HRAs with non-bronchial arterial dilation were observed in the 46 cases (90.1%), mean number of non-bronchial vessels was 6.2/case. Conclusions: It was suggested that many non-bronchial arteries are involved in the hemoptysis of patients with pulmonary aspergillosis infection.