Tracheobronchial variations evaluated by multidetector computed tomography and virtual bronchoscopy

K. Vassiou, F. Kotrogianni, E. Lavdas, M. Vlychou, M. Fanariotis, D. Arvanitis, I. Fezoulidis
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引用次数: 5

Abstract

Introduction The tracheobronchial tree exhibits a wide range of variations. The purpose of this study is the investigation of the frequency and multidetector tomographic (MDCT) findings of anatomical variations of the main bronchi and of the lobar bronchi, as well as the detection of abnormal bronchi originated from the trachea, in subjects without severe bronchial pathology. Materials and methods About 872 consecutive patients who underwent thoracic MDCT examination were enrolled in the study. All MDCT data, including multiplanar reconstructions, maximum intensity projections and volume-rendered images, as well as virtual bronchoscopy, were evaluated for the detection of main bronchial variations. Various kinds of bronchial variations and anomalies, such as tracheal bronchus, accessory cardiac bronchus, bronchus hypoplasia and bronchial origin anomalies, were documented. Results In 872 subjects, the overall frequency of main bronchus variations is 2.52% (22/872). More specifically, tracheal bronchus were found in eight cases (0.9%), accessory cardiac bronchus was found in one case (0.1%), hypoplasia was found in one case (0.1%) and bronchial origin anomalies were found in 10 cases (1.14%). Conclusion The display of tracheobronchial variations is of clinical importance first because they are related to infections and, sometimes, malignancies and second in preoperative or in cases of bronchoscopic procedures. In our study, the commonest variation was the tracheal bronchus. MDCT and virtual bronchoscopy can depict tracheobronchial variations accurately and can be served as an alternative to bronchoscopy in certain cases of possible bronchial anomaly.
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多检测器计算机断层扫描和虚拟支气管镜检查评估气管支气管病变
气管支气管树表现出广泛的变异。本研究的目的是探讨在没有严重支气管病理的受试者中,主支气管和大叶支气管解剖变异的频率和多检测器断层扫描(MDCT)结果,以及源自气管的异常支气管的检测。材料与方法共纳入872例连续行胸部MDCT检查的患者。所有MDCT数据,包括多平面重建、最大强度投影和体渲染图像,以及虚拟支气管镜,都被评估用于检测主要支气管变异。记录了气管支气管、副心支气管、支气管发育不全、支气管起源异常等各种支气管变异和异常。结果872例患者中,主支气管病变的总发生率为2.52%(22/872)。其中气管支气管8例(0.9%),心副支气管1例(0.1%),发育不全1例(0.1%),支气管起源异常10例(1.14%)。结论气管支气管变异的表现具有重要的临床意义,首先是因为它们与感染有关,有时与恶性肿瘤有关,其次是在术前或支气管镜手术中。在我们的研究中,最常见的变异是气管支气管。MDCT和虚拟支气管镜检查可以准确描述气管支气管的变化,在某些可能的支气管异常病例中可以作为支气管镜检查的替代方法。
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