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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2011; 21(03): 191-194
DOI: 10.4103/0971-3026.85366
Chest Radiology

Multidetector CT evaluation of central airways stenoses: Comparison of virtual bronchoscopy, minimal-intensity projection, and multiplanar reformatted images

Dinesh K Sundarakumar
Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
,
Ashu S Bhalla
Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
,
Raju Sharma
Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
,
Smriti Hari
Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
,
Randeep Guleria
Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
,
Gopi C Khilnani
Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
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Abstract

Aims: To evaluate the diagnostic utility of virtual bronchoscopy, multiplanar reformatted images, and minimal-intensity projection in assessing airway stenoses. Settings and Design: It was a prospective study involving 150 patients with symptoms of major airway disease. Materials and Methods: Fifty-six patients were selected for analysis based on the detection of major airway lesions on fiber-optic bronchoscopy (FB) or routine axial images. Comparisons were made between axial images, virtual bronchoscopy (VB), minimal-intensity projection (minIP), and multiplanar reformatted (MPR) images using FB as the gold standard. Lesions were evaluated in terms of degree of airway narrowing, distance from carina, length of the narrowed segment and visualization of airway distal to the lesion. Results: MPR images had the highest degree of agreement with FB (Κ = 0.76) in the depiction of degree of narrowing. minIP had the least degree of agreement with FB (Κ = 0.51) in this regard. The distal visualization was best on MPR images (84.2%), followed by axial images (80.7%), whereas FB could visualize the lesions only in 45.4% of the cases. VB had the best agreement with FB in assessing the segment length (Κ = 0.62). Overall there were no statistically significant differences in the measurement of the distance from the carina in the axial, minIP, and MPR images. MPR images had the highest overall degree of confidence, namely, 70.17% (n = 40). Conclusion: Three-dimensional reconstruction techniques were found to improve lesion evaluation compared with axial images alone. The technique of MPR images was the most useful for lesion evaluation and provided additional information useful for surgical and airway interventions in tracheobronchial stenosis. minIP was useful in the overall depiction of airway anatomy.

Keywords

Airway - bronchoscopy - computed tomography - virtual


Publication History

Article published online:
30 July 2021

© 2011. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Pereira W Jr, Kovnat DM, Snider GL. A prospective cooperative study of complications following bronchoscopy. Chest 1978;73:813-6.
  • 2 Dialani V, Ernst A, Sun M, Lee KS, Kopman DF, Litmanovich D, et al. MDCT detection of airway stent complications: Comparison with bronchoscopy. Am J Roentgenol 2008;191:1576-80.
  • 3 McAdams HP, Palmer SM, Erasmus JJ, Patz EF, Connolly JE, Goodmann PC, et al. Bronchial anastomotic complications in lung transplant recipients: Virtual bronchoscopy for noninvasive assessment. Radiology 1998;209:689-95.
  • 4 Hoppe H, Walder B, Sonnenschein M, Vock P, Dinkel HP. Multidetector CT virtual bronchoscopy to grade tracheobronchial stenosis. Am J Roentgenol 2002;178:1195-200.
  • 5 Bernhardt LR, Welet T, Doehring W, Kropf S, Bernhardt TM. Diagnostic potential of virtual bronchoscopy advantages in comparison with axial CT rows, MPR and MinIP. Eur Radiol 2000;10:981-8.
  • 6 Bernhardt UR, Welte T, Budinger M, Bernhardt TM. Comparison of 3-D virtual bronchoscopy in patients with carcinoma esophagus invading the trachea. Br J Radiol 1998;71:1271-8.
  • 7 Fleiter T, Merkle EM, Aschoff AJ, Lang G, Stein M, Gorlich J, et al. Comparison of real time virtual and fiberoptic bronchoscopy in patients with bronchial carcinoma: Opportunities and limitations. Am J Roentgenol 1997;169:1591-5.
  • 8 Heyer CM, Kagel T, Lemburg SP, Nikolas V, Reiger CL. Evaluation of tracheobronchial anomalies in children using low-dose multidetector CT: Report of a 13-year-old boy with a tracheal bronchus and recurrent pulmonary infections. Pediatr Pulmonol 2004;38:168-73.
  • 9 LoCicero J 3rd, Costello P, Campos CT, Francalancia N, Dushay KM, Silvestri RC, et al. Spiral CT with multiplanar and three-dimensional reconstructions accurately predicts tracheobronchial pathology. Ann Thorac Surg 1996;62:811-7.
  • 10 Boiselle PM, Reynolds KF, Ernst A. Multiplanar and three-dimensional imaging of the central airways with multidetector CT. Am J Roentgenol 2002;179:301-8.