Bronchography via the fibreoptic bronchoscope.

Abstract

We have reviewed the results of 167 consecutive bronchograms carried out through the fibreoptic bronchoscope at the end of the bronchoscopic examination. Additional diagnostic information was obtained in 61 (37%) of the patients. Bronchiectasis was the most common finding and was particularly frequent in older patients with haemoptysis and a normal chest radiograph, in those with a chronic productive cough with a normal chest radiograph, and in a heterogeneous group with persistent lobar shadowing. The relative ease with which good quality bronchograms can be obtained via the fibreoptic bronchoscope has led us to discard more conventional methods except in children.During the last 20 years there has been a general decline in the use of bronchography. This has resulted from a variety of factors, most important of which are the decline in incidence of bronchiectasis and the advent of fibreoptic bronchoscopy, coupled with the opinion that bronchography rarely provides useful information not otherwise obtainable by more specific and less disagreeable and hazardous methods. The widely differing use of bronchography' -suggests that there is no clearcut agreement as to which patients will benefit from the procedure. With the advent of fibreoptic bronchoscopy there is no need for the two techniques to be mutually exclusive,4 for the bronchoscope provides excellent, safe access to the whole bronchial tree for radio-opaque contrast media. We have reviewed the results of performing bronchography as an addition to fibreoptic bronchoscopy and have attempted to assess its clinical usefulness. Methods

Does bronchography have a role in the assessment of patients with haemoptysis?

“…We previously considered that patients under 40 with haemoptysis and a normal chest radiograph did not merit bronchography. 3 This larger and more specific study shows, however, that it is of diagnostic value even in this age group.…”