CTICasesBronchial Artery Hemorrhage
Imaging findings
Chest CT angiography in a patient with cystic fibrosis presenting with hemoptysis shows bilateral, severe upper lobe bronchiectasis and bronchial wall thickening. The bronchial arteries are markedly dilated and tortuous. A focal, active blush of extravasated contrast medium is seen adjacent to a segmental bronchus, indicating active hemorrhage.
Key takeaways
Bronchial artery hypertrophy and remodeling are common in patients with chronic inflammatory lung diseases like cystic fibrosis. Chronic inflammation leads to hypervascularity and thin-walled anastomoses that are prone to rupture. Visualizing active contrast extravasation on CTA is extremely rare but diagnostic of active hemorrhage, providing a direct target for bronchial artery embolization.
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