Eliashar R, Davros W, Gramlich T, Moffett K, Eliachar I, Esclamado R, Strome M
Department of Otolaryngology and Communicative Disorders, Cleveland Clinic Foundation, USA.
Ann Otol Rhinol Laryngol. 2000 Oct;109(10 Pt 1):906-12. doi: 10.1177/000348940010901003.
We performed a prospective masked animal study to determine whether virtual bronchoscopy, a noninvasive computed tomography technique, can accurately measure upper airway stenosis. Virtual bronchoscopy creates a 3-dimensional endoscopic image from spiral computed tomography data. Laryngotracheal stenosis was endoscopically induced in 18 dogs. The excised larynges were examined by endoscopy, virtual bronchoscopy, and macrodissection. Measurements were made of the anteroposterior (A-P) diameter, the left-right (L-R) diameter, the full length of stenosis in the sagittal plane, and the length of the tightest stenotic segment. Each measurement method was performed independently. All investigators were unaware of measurements made by others. The measurements obtained through virtual bronchoscopy and actual endoscopy were compared to those made at dissection by interclass correlation coefficients (ICCs). Endoscopy was better than virtual bronchoscopy in measuring the A-P diameter (ICC = .79, p < .0001; ICC = .42, p = .01). Both were equally effective in measuring the L-R diameter (ICC = .53, p = .0062; ICC = .52, p = .0064). The endoscopes could not assess the full length of the stenosis, whereas virtual bronchoscopy measured it fairly accurately (ICC = .72, p = .0001). Virtual bronchoscopy relatively accurately measured the length of the tightest stenotic segment (ICC = .68, p = .0002), whereas endoscopy produced measurements in only 11 of 18 larynges, and the measurements were less accurate (ICC = .45, p = .0068). Virtual bronchoscopy can provide good measurements of stenotic lesions in the airway. It is more accurate than actual endoscopy in determining the length of stenosis. It may therefore be useful as an adjunct imaging method in preoperative planning for reconstructive surgery.
我们进行了一项前瞻性双盲动物研究，以确定虚拟支气管镜检查（一种非侵入性计算机断层扫描技术）能否准确测量上气道狭窄。虚拟支气管镜检查可根据螺旋计算机断层扫描数据生成三维内镜图像。我们对18只犬进行了内镜诱导喉气管狭窄。对切除的喉部进行了内镜检查、虚拟支气管镜检查和大体解剖。测量了前后径（A-P）、左右径（L-R）、矢状面狭窄全长以及最狭窄段的长度。每种测量方法均独立进行。所有研究人员均不知道其他人员的测量结果。通过组内相关系数（ICC）将虚拟支气管镜检查和实际内镜检查获得的测量结果与解剖时的测量结果进行比较。在内镜测量前后径方面，内镜检查优于虚拟支气管镜检查（ICC = 0.79，p < 0.0001；ICC = 0.42，p = 0.01）。在测量左右径方面，二者同样有效（ICC = 0.53，p = 0.0062；ICC = 0.52，p = 0.0064）。内镜无法评估狭窄的全长，而虚拟支气管镜检查能较为准确地测量（ICC = 0.72，p = 0.0001）。虚拟支气管镜检查能相对准确地测量最狭窄段的长度（ICC = 0.68，p = 0.0002），而内镜检查仅在18个喉部中的11个中获得了测量结果，且测量结果准确性较低（ICC = 0.45，p = 0.0068）。虚拟支气管镜检查能够很好地测量气道狭窄病变。在确定狭窄长度方面，它比实际内镜检查更准确。因此，它可能作为重建手术术前规划中的辅助成像方法。
