Korean J Radiol.  2000 Sep;1(3):135-141. 10.3348/kjr.2000.1.3.135.

Evaluation of Tracheobronchial Diseases: Comparison of Different Imaging Techniques

• Chen Q
• Goo JM
• Seo JB
• Chung MJ
• Lee YJ
• Im JG

• KMID: 877073
• DOI: http://doi.org/10.3348/kjr.2000.1.3.135

Abstract

OBJECTIVE
To compare the clinical utility of the different imaging techniques used for the evaluation of tracheobronchial diseases. MATERIALS AND METHODS: Forty-one patients with tracheobronchial diseases [tuberculosis (n = 18), bronchogenic carcinoma (n = 10), congenital abnormality (n = 3), post-operative stenosis (n = 2), and others (n = 8)] underwent chest radi-ography and spiral CT. Two sets of scan data were obtained: one from routine thick-section axial images and the other from thin-section axial images. Multiplanar reconstruction (MPR) and shaded surface display (SSD) images were obtained from thin-section data. Applying a 5-point scale, two observers compared chest radiography, routine CT, thin-section spiral CT, MPR and SSD imaging with regard to the detection, localization, extent, and characterization of a lesion, information on its relationship with adjacent structures, and overall information. RESULTS: SSD images were the most informative with regard to the detection (3.95 +/-0.31), localization (3.95 +/-0.22) and extent of a lesion (3.85 +/-0.42), and overall information (3.83 +/-0.44), while thin-section spiral CT scans provided most information regarding its relationship with adjacent structures (3.56 +/-0.50) and characterization of the lesion (3.51 +/-0.61). CONCLUSION: SSD images and thin-section spiral CT scans can provide valuable information for the evaluation of tracheobronchial disease.

Keyword

Bronchi, CT; Computed tomography (CT),three-dimensional; Computed tomography (CT),volume rendering

MeSH Terms

Bronchial Diseases/*radiography
Comparative Study
Female
Human
*Imaging, Three-Dimensional
Male
Middle Age
*Tomography, X-Ray Computed/methods
Tracheal Diseases/*radiography

Figure

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  Fig. 1 Bronchogenic carcinoma in a 66-year-old man. A. Coronal MPR image shows apparent total obstruction of the left main bronchus by a polypoid soft tissue lesion (arrow). B. Curved reformatted image along the axis of the left upper lobe shows focal wall thickening of the left main bronchus (arrow).

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  Fig. 2 SSD image from which unnecessary lung was removed shows the trachea and bilateral main bronchi.

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  Fig. 3 SSD image preprocessed with slice by slice editing to remove unwanted structures shows complete focal obstruction of the left upper lobar bronchus (arrow).

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  Fig. 4 Endotracheal tuberculosis in a 26-year-old woman. Posteroanterior chest radiograph shows segmental narrowing of the trachea (arrows).

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  Fig. 5 Endobronchial tuberculosis in a 67-year-old woman. A. Thin-section spiral CT shows mild irregular wall thickening (arrow) of the right main bronchus (score for detection = 4). B. SSD image shows subtle irregularity (arrow) in the right main bronchus (score for detection = 2).

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  Fig. 6 Tracheal tumor in a 54-year-old man. The histology of this tumor was not confirmed because its hypervascularity, as revealed by bronchoscopy, precluded biopsy. Coronal MPR image demonstrates the extent of concentric wall thickening of the trachea (arrows).

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  Fig. 7 Endobronchial tuberculosis in a 55-year-old woman. SSD image (A) (score for extent = 4) and coronal MPR image (B) (score for extent =2) show irregular narrowing of the left main bronchus (arrow) and complete obstruction of the left upper lobar bronchus (arrowheads).

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  Fig. 8 An outpouching lesion at the anastomotic site after sleeve left upper lobectomy in a 67-year-old man. SSD (A), routine enhanced CT (B), and coronal MPR image (C) show an outpouching lesion at the anastomotic site (arrow). For these three techniques, the respective score for relationship was 0, 4, and 3, respectively.

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