PMC3177409_01
Multidetector CT angiogram. (a) Axial maximum-intensity-projection image shows a necrotic nodular lesion with fibrotic components in the right middle lobe. Tortuous hypertrophied arteries and a tiny aneurysm are noted inside the lesion (arrow). (b) Coronal oblique maximum-intensity-projection image shows mildly enlarged right bronchial artery arising from right intercostobronchial trunk and coursing to the area of parenchymal abnormality (thin arrows).(c) MDCT showing fibrotic opacities in the left upper lobe with two small, thin-walled cavities and bronchiectatic changes
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MDCT angiography images showed multiple hypertrophied arteries inside the lesion with a small aneurysm (3 x 5 mm) [Figure 1a]. The right bronchial artery was mildly enlarged and could be traced to the parenchymal abnormality in the right middle lobe [Figure 1b]. MDCT also revealed fibrotic opacities in the left upper lobe with two small, thin-walled cavities and bronchiectatic changes in the left upper lobe [Figure 1c].
Superselective embolization with a microcatheter. (a) Selective arteriogram of the right bronchial artery shows hypervascularity in right middle zone with enlarged arteries and a small aneurysm (arrow). (b) After embolization with PVA particles, the hypervascular area and the aneurysm are not visualized.
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Selective arteriography confirmed the diagnosis of aneurysm of the right bronchial artery [Figure 2a]. Post-embolization angiogram showed occlusion of feeding vessels and aneurysm [Figure 2b].