Röttgen R, Schürmann D, Pinkernelle J, Herzog H, Lopez-Häninnen E, Lehmkuhl L, Lorenz M, Hothan T, Felix R, Schröder R J
Klinik für Strahlenheilkunde, Campus Virchow-Klinikum, Charité, Universitätsmedizin Berlin.
Rofo. 2005 Mar;177(3):338-43. doi: 10.1055/s-2005-857903.
To compare virtual with flexible bronchoscopy for the detection of bronchial stenoses.
In a retrospective study, we compared the results of 26 patients, who had clinical suspected pathologies of the tracheobronchial airways and underwent both flexible bronchoscopy and multislice CT with 3D surface rendering of the airways. Flexible bronchoscopy and virtual bronchoscopy were compared as to the rate of detecting bronchial stenoses. For statistical analysis, we divided the tracheobronchial tree in the following sections: trachea, 2 main bronchi, 6 lobar bronchi, 18 segmental bronchi and 36 subsegmental bronchi, corresponding to 63 bronchial sections for each patient (on average) and a total of 1638 bronchial sections for all 26 patients. We graded the bronchial stenosis as less than 50 %, as 50 to 95 % and as complete obstruction.
Virtual bronchoscopy detected 25 bronchial stenoses, while flexible bronchoscopy only revealed 17 stenoses. Stenoses with a diameter less than 50 % were found with virtual bronchoscopy 14 times and with flexible bronchoscopy 10 times. Stenoses with a diameter between 50 and 95 % were detected 7 and 4 times, respectively, and complete obstructions 4 and 3 times, respectively. Tracheobronchial stenoses were well recognized with virtual bronchoscopy. Moreover, the virtual method enabled the visualization of high-grade stenoses and post-stenotic areas that could not be passed by the fiberoptic bronchoscope. Virtual bronchoscopy detected stenoses at a higher rate but the difference was not statistically significant (stenoses < 50 %: p = 0.352, 50 - 95 %: p = 0.339, complete obstruction: p = 0.696).
Virtual bronchoscopy is a useful non-invasive method for the diagnostic evaluation of the tracheobronchial tree. In comparison with flexible bronchoscopy, virtual bronchoscopy is superior in revealing high-grade stenoses and visualizing post-stenotic areas.
比较虚拟支气管镜检查与可弯曲支气管镜检查对支气管狭窄的检测效果。
在一项回顾性研究中，我们比较了26例临床怀疑有气管支气管气道病变且同时接受了可弯曲支气管镜检查和气道三维表面重建多层CT检查的患者的检查结果。比较了可弯曲支气管镜检查和虚拟支气管镜检查对支气管狭窄的检测率。为进行统计分析，我们将气管支气管树分为以下部分：气管、2条主支气管、6条叶支气管、18条段支气管和36条亚段支气管，每位患者平均对应63个支气管节段，26例患者共计1638个支气管节段。我们将支气管狭窄分为小于50%、50%至95%以及完全阻塞。
虚拟支气管镜检查发现了25处支气管狭窄，而可弯曲支气管镜检查仅发现了17处狭窄。直径小于50%的狭窄在虚拟支气管镜检查中发现14次，在可弯曲支气管镜检查中发现10次。直径在50%至95%之间的狭窄分别被检测到7次和4次，完全阻塞分别被检测到4次和3次。虚拟支气管镜检查能很好地识别气管支气管狭窄。此外，虚拟方法能够显示纤维支气管镜无法通过的高度狭窄和狭窄后区域。虚拟支气管镜检查的狭窄检测率更高，但差异无统计学意义（狭窄<50%：p = 0.352，50 - 95%：p = 0.339，完全阻塞：p = 0.696）。
虚拟支气管镜检查是一种用于气管支气管树诊断评估的有用的非侵入性方法。与可弯曲支气管镜检查相比，虚拟支气管镜检查在显示高度狭窄和可视化狭窄后区域方面更具优势。
