Division of Pediatric Pulmonary and Sleep Medicine, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Clinical Trials Innovation Unit, Translational Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Pediatr Pulmonol. 2021 Sep;56(9):2940-2948. doi: 10.1002/ppul.25536. Epub 2021 Jun 29.
Normative data for central airway dimensions are a prerequisite to objectively assess large airway pathologies. Studies with computed tomography (CT) measurements of normal trachea and bronchi size in children are scarce.
The purpose of this study is to establish normal values of central airway dimensions in children by CT.
The study included chest CT studies from children aged 0-18 years. Any condition that predisposed the patient to have an abnormal tracheal or bronchial size was excluded. Airway diameters and cross-sectional area (CSA) were measured using double oblique reconstructions at five levels: proximal trachea, mid-trachea, distal trachea, right main bronchus, and left main bronchus.
The inclusion criteria were met by 110 subjects (mean age, 10.8 years; SD, 5.2 years). Various regression models that considered the relationship between patient demographics and anteroposterior (AP) diameter, transverse diameter, and CSA at each of the five levels were assessed. R was utilized to select the best model. Multiple formulae (using patient age) were developed to calculate expected normal dimensions for five levels in the central airways on the natural log scale. Finally, z-scores were obtained for central airway dimensions at these five levels.
Normative data in pediatric central airways are crucial to identify large airway pathologies. We propose using the formulae devised in our study to calculate the predicted dimensions of central airways and their z-scores in pediatric patients. Normative data from our study will aid in objective quantification of central airways, increase clinician confidence, and provide appropriate patient care.
中央气道尺寸的规范数据是客观评估大气道病变的前提。目前，关于儿童正常气管和支气管大小的 CT 测量研究较少。
本研究旨在通过 CT 建立儿童中央气道尺寸的正常值。
本研究纳入了 0-18 岁儿童的胸部 CT 研究。排除任何可能导致气管或支气管大小异常的患者。使用双斜重建在五个层面测量气道直径和横截面积（CSA）：近段气管、中段气管、远段气管、右主支气管和左主支气管。
符合纳入标准的有 110 名受试者（平均年龄 10.8 岁，标准差 5.2 岁）。评估了考虑患者人口统计学特征与五个层面的前后径、横径和 CSA 之间关系的各种回归模型。利用 R 选择最佳模型。为五个层面的中央气道的自然对数尺度计算预期正常尺寸制定了多种公式（使用患者年龄）。最后，获得了这五个层面中央气道尺寸的 z 分数。
儿科中央气道的规范数据对于识别大气道病变至关重要。我们建议使用本研究中制定的公式来计算中央气道的预测尺寸及其 z 分数。我们研究中的规范数据将有助于中央气道的客观量化，增强临床医生的信心，并提供适当的患者护理。
