[Spiral CT and 3-D reconstruction of the tracheobronchial tree for the selection of the proper double-lumen tubes before individual lung ventilation].

PURPOSE

To assess the potential of 3-D spiral CT in the selection of adequate double-lumen tubes (DLT) for one-lung-ventilation.

MATERIALS AND METHODS

3-D spiral CT of eight different DLTs was performed with standardized acquisition parameters: section thickness 4 mm, table speed 6 mm/s, increment 3 mm and standardised thresholds, window settings and magnification zoom. The accuracy was confirmed by measuring 3-D objects on screen and original DLTs by vernier caliper. 3-D spiral CT was performed in 20 patients preoperatively with slice thickness 4-8 mm, pitch 1-1.5, increment 4-8 mm. To select the adequate DLT size the 3-D reconstructions of the patient's tracheobronchial tree and of the DLT were superimposed by templates or computer animation. The accuracy was controlled by endoscopic and clinical measurements.

RESULTS

The accuracy of the 3 D spiral CT was nearly 0.1 mm. The superimposition with templates was easy and reliable. The 3-D spiral CT determined DLTs were shown to fit perfectly by clinical and endoscopic measurements in all cases.

CONCLUSION

3-D reconstructions of the tracheobronchial tree obtained from routine preoperative spiral CT scans allow for an easy and accurate individual selection of double-lumen tubes.