Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Pediatr Pulmonol. 2024 May;59(5):1438-1448. doi: 10.1002/ppul.26934. Epub 2024 Feb 20.
To evaluate the assortment of tracheobronchial abnormalities on computed tomography angiography (CTA) in children with congenital heart disease (CHD).
In this study approved by the Institute ethics committee, CTA studies of 182 children (age range: 2 days-8 years) with CHD, performed from July 2021 to March 2023 were analyzed. Two pediatric radiologists independently assessed the tracheobronchial airways (from the trachea to lobar bronchi) for developmental and branching anomalies and airway compromise (narrowing). In cases which demonstrated airway compromise, the extent and the cause of airway narrowing were evaluated, and the etiology were divided into extrinsic and intrinsic causes. Interobserver agreement between the two radiologists was calculated using kappa statistics.
One hundred children demonstrated normal airway anatomy and no luminal narrowing. Airway narrowing was observed in 63 (34.6%) children (κ: 0.954), and developmental airway anomalies were seen in 32 (17.5%) children (κ: 0.935). Of the 63 children with airway narrowing, 47 (25.8%) children had extrinsic cause for narrowing, 11 (6%) children had intrinsic causes for narrowing, and 5 (2.7%) children had both intrinsic and extrinsic causes attributing to airway compromise. Significant airway narrowing (>50% reduction) was seen in 35 (19.2%) children (κ: 0.945).
Tracheobronchial airway abnormalities are frequently associated in children with CHD and need to be appraised preoperatively. Cross-sectional imaging with CTA provides excellent information on tracheobronchial airway anatomy and caliber as well as delineates the possible etiology of airway narrowing, thus accurately diagnosing airway anomalies.
评估先天性心脏病（CHD）患儿 CT 血管造影（CTA）检查中气管支气管异常的种类。
本研究经机构伦理委员会批准，回顾性分析了 2021 年 7 月至 2023 年 3 月间 182 例 CHD 患儿的 CTA 研究资料。两名儿科放射科医生独立评估气管支气管气道（从气管到肺段支气管）的发育和分支异常以及气道狭窄情况（狭窄）。在显示气道狭窄的病例中，评估气道狭窄的程度和原因，并将病因分为外在和内在原因。使用 Kappa 统计计算两名放射科医生之间的观察者间一致性。
100 例患儿气道解剖正常，无管腔狭窄。63 例（34.6%）患儿存在气道狭窄（κ：0.954），32 例（17.5%）患儿存在发育性气道异常（κ：0.935）。在 63 例气道狭窄的患儿中，47 例（25.8%）患儿狭窄的外在原因，11 例（6%）患儿狭窄的内在原因，5 例（2.7%）患儿狭窄的外在和内在原因并存。35 例（19.2%）患儿存在明显气道狭窄（>50%狭窄）（κ：0.945）。
气管支气管气道异常在 CHD 患儿中经常发生，需要在术前评估。CTA 提供的横断面成像可提供气管支气管气道解剖和口径的极佳信息，并描绘气道狭窄的可能病因，从而准确诊断气道异常。
