Koletsis Efstratios N, Kalogeropoulou Christine, Prodromaki Eleni, Kagadis George C, Katsanos Konstantinos, Spiropoulos Konstantinos, Petsas Theodore, Nikiforidis George C, Dougenis Dimitris
Department of Cardiothoracic Surgery, School of Medicine, University of Patras, Greece.
J Cardiothorac Surg. 2007 Apr 12;2:18. doi: 10.1186/1749-8090-2-18.
We evaluated the ability of 3D-CT and virtual bronchoscopy to estimate trachea stenosis in comparison to conventional axial CT and fiberoptic bronchoscopy, with a view to assist thoracic surgeons in depicting the anatomical characteristics of tracheal strictures.
Spiral CT was performed in 16 patients with suspected tracheal stenoses and in 5 normal subjects. Tracheal stenoses due to an endoluminal neoplasm were detected in 13 patients, whilst post-intubation tracheal stricture was observed in the other 3 patients. Multiplanar reformatting (MPR), volume rendering techniques (VRT) and virtual endoscopy (VE) for trachea evaluation were applied and findings were compared to axial CT and fiberoptic bronchoscopy. The accuracy of the procedure in describing the localization and degree of stenosis was tested by two radiologists in a blinded controlled trial.
The imaging modalities tested showed the same stenoses as the ones detected by flexible bronchoscopy and achieved accurate and non-invasive morphological characterization of the strictures, as well as additional information about the extraluminal extent of the disease. No statistically significant difference was observed between the bronchoscopic findings and the results of axial CT estimations (P = 1.0). No statistically significant differences were observed between bronchoscopic findings and the MPR, VRT and VE image evaluations (P = 0.705, 0.414 and 0.414 respectively).
CT and computed generated images may provide a high fidelity, noninvasive and reproducible evaluation of the trachea compared to bronchoscopy. They may play a role in assessment of airway patency distal to high-grade stenoses, and represent a reliable alternative method for patients not amenable to conventional bronchoscopy.
我们评估了三维计算机断层扫描（3D-CT）和虚拟支气管镜检查与传统轴向CT和纤维支气管镜检查相比，在估计气管狭窄方面的能力，旨在帮助胸外科医生描绘气管狭窄的解剖特征。
对16例疑似气管狭窄患者和5例正常受试者进行螺旋CT检查。13例患者检测到腔内肿瘤导致的气管狭窄，另外3例患者观察到插管后气管狭窄。应用多平面重组（MPR）、容积再现技术（VRT）和虚拟内镜（VE）进行气管评估，并将结果与轴向CT和纤维支气管镜检查结果进行比较。在一项双盲对照试验中，由两名放射科医生测试该方法在描述狭窄部位和程度方面的准确性。
所测试的成像方式显示出与柔性支气管镜检查相同的狭窄情况，并实现了对狭窄的准确且无创的形态学特征描述，以及有关疾病腔外范围的额外信息。支气管镜检查结果与轴向CT估计结果之间未观察到统计学上的显著差异（P = 1.0）。支气管镜检查结果与MPR、VRT和VE图像评估结果之间也未观察到统计学上的显著差异（分别为P = 0.705、0.414和0.414）。
与支气管镜检查相比，CT和计算机生成图像可为气管提供高保真、无创且可重复的评估。它们可能在评估重度狭窄远端的气道通畅性方面发挥作用，并且对于不适合传统支气管镜检查的患者而言是一种可靠的替代方法。
