Radiography Chest Chest radiography has long been established as the initial imaging examination of choice given its portability, rapid acquisition, and interpretation time. Fartoukh et al [12], in a large retrospective study of 1,087 patients, correlated morbidity and mortality to findings on chest radiographs. However, there is discrepancy in the literature regarding the usefulness of radiographs in determining the etiology of hemoptysis. In a study of 70 patients undergoing bronchial artery embolization for massive hemoptysis, causative radiologic abnormalities were seen in 86% of the chest radiographs [39]. This was similar to an earlier study showing 82% of chest radiographs could detect the side and predict the cause of bleeding [40]. However, in a comparable study of 80 patients with massive hemoptysis, chest radiographs demonstrated the cause of bleeding in only 35% of cases, most of whom had tuberculosis or malignancy [28]. Although radiography can be useful in directing treatment to the correct site of bleeding, a study of 20 patients undergoing BAE for massive hemoptysis showed that radiography localized the site of hemoptysis in only 35% of patients [41]. Similar findings were reported in a larger study of 348 patients, which included both massive and moderate recurrent hemoptysis patients [17]. Chest radiographs were performed in all patients and were abnormal in 313 patients (90%). However, these radiographs were suggestive of the etiology of hemoptysis in only 90 patients (26%). These findings indicate that additional imaging in conjunction with chest radiograph is warranted in massive hemoptysis. Hemoptysis 44]. However, these prior variables excluded a significant portion of patients with nonmassive hemoptysis. In addition, imaging recommendations did not significantly differ between the two prior nonmassive hemoptysis variables. For these reasons, these risk factors have been removed, and there is a single nonmassive variable.
Hemoptysis. Radiography Chest Chest radiography has long been established as the initial imaging examination of choice given its portability, rapid acquisition, and interpretation time. Fartoukh et al [12], in a large retrospective study of 1,087 patients, correlated morbidity and mortality to findings on chest radiographs. However, there is discrepancy in the literature regarding the usefulness of radiographs in determining the etiology of hemoptysis. In a study of 70 patients undergoing bronchial artery embolization for massive hemoptysis, causative radiologic abnormalities were seen in 86% of the chest radiographs [39]. This was similar to an earlier study showing 82% of chest radiographs could detect the side and predict the cause of bleeding [40]. However, in a comparable study of 80 patients with massive hemoptysis, chest radiographs demonstrated the cause of bleeding in only 35% of cases, most of whom had tuberculosis or malignancy [28]. Although radiography can be useful in directing treatment to the correct site of bleeding, a study of 20 patients undergoing BAE for massive hemoptysis showed that radiography localized the site of hemoptysis in only 35% of patients [41]. Similar findings were reported in a larger study of 348 patients, which included both massive and moderate recurrent hemoptysis patients [17]. Chest radiographs were performed in all patients and were abnormal in 313 patients (90%). However, these radiographs were suggestive of the etiology of hemoptysis in only 90 patients (26%). These findings indicate that additional imaging in conjunction with chest radiograph is warranted in massive hemoptysis. Hemoptysis 44]. However, these prior variables excluded a significant portion of patients with nonmassive hemoptysis. In addition, imaging recommendations did not significantly differ between the two prior nonmassive hemoptysis variables. For these reasons, these risk factors have been removed, and there is a single nonmassive variable.