Archive for the ‘Airway’ Category

Grading Airway Stenosis Down to the Segmental Level Using Virtual Bronchoscopy: Conclusion

As demonstrated in our study, virtual bronchoscopy may be used for the evaluation of both central and segmental airway stenosis. This enables the evaluation of the segmental airways distal to a stenosis, which is impassable for flexible bronchoscopy. Other potential clinical uses of virtual bronchoscopy include the planning of flexible bronchoscopy, the identification of abnormal […]

Grading Airway Stenosis Down to the Segmental Level Using Virtual Bronchoscopy: Flexible bronchoscopy procedures

Because virtual bronchoscopy has an interactive design, we used the multiview mode at the workstation in combination with axial CT scan slices and multiplanar reformats for analysis of the airways. This is particularly useful for orientation within the tracheobronchial tree, and permits differentiation between intraluminal tumor growth and extraluminal airway compression. Furthermore, axial and reformatted […]

Grading Airway Stenosis Down to the Segmental Level Using Virtual Bronchoscopy: Airway stenosis

Compared to the central airways, we found a higher rate of false-positive stenoses in the segmental bronchi. In our study, intraluminal mucus deposition caused more false-positive segmental airway readings (seven) than false-positive central airway readings (four). It has been reported that the segmental airways seem to be more susceptible to the deposition of mucus and […]

Grading Airway Stenosis Down to the Segmental Level Using Virtual Bronchoscopy: Discussion

We evaluated the success rate of noninvasive, multirow detector CT virtual bronchoscopy in detecting and grading central and segmental airway stenosis. In our present study, virtual bronchoscopy enabled high-resolution endoluminal imaging of the airways including segmental bronchi. Virtual bronchoscopy of segmental airway stenosis provides important additional information on the tracheobronchial tree and was not evaluated […]

Grading Airway Stenosis Down to the Segmental Level Using Virtual Bronchoscopy: Analysis Per Patient

Nine findings were true-positive, and 13 were false-positive. The 13 false-positive findings were for the left upper lobar apicoposterior segmental bronchus (B I/II) [two patients], the left upper lobar anterior segmental bronchus (B III) [two patients], the right lower lobar superior segmental bronchus (B VI), the right upper lobar apical segmental bronchus (B I) [two […]

Grading Airway Stenosis Down to the Segmental Level Using Virtual Bronchoscopy: Central Airways

Flexible bronchoscopy revealed a total of 30 central airway stenoses. Thirteen stenoses were judged to be grade 1, and 17 were judged to be grade 2. Virtual bronchoscopy detected a total of 32 stenoses. Fourteen stenoses were judged to be grade 1, and 18 were judged to be grade 2. Figure 1 shows a grade […]

Grading Airway Stenosis Down to the Segmental Level Using Virtual Bronchoscopy: Statistical Analysis

The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of virtual bronchoscopy were calculated from 2 X 2 contingency tables, with confidence intervals derived from binomial distribution. A Fisher exact test was used to test for significance in field entries smaller than five where the x2 test was not applicable. Assessments by virtual […]

Grading Airway Stenosis Down to the Segmental Level Using Virtual Bronchoscopy: CT Scan Image Analysis

Table 1 shows the anatomic classification of the tracheobronchial tree, which was divided into 27 regions (9 central airway regions and 18 segmental airway regions). For image analysis, a virtual bronchoscopic fly-through of the tracheobronchial tree was performed in a central-to-peripheral direction by a fully board-certified radiologist specializing in chest radiology. For optimal orientation within […]

Grading Airway Stenosis Down to the Segmental Level Using Virtual Bronchoscopy: CT Scanning

Patients were only included if they had undergone both CT scanning and flexible bronchoscopy. The mean interval between virtual bronchoscopy and flexible bronchoscopy was 5.4 days (range, 0 to 17 days). Eventually, 17 of the 20 patients had lung cancer as the final diagnosis. Histologic diagnoses included non-small cell lung cancer (14 diagnoses) and small […]

Grading Airway Stenosis Down to the Segmental Level Using Virtual Bronchoscopy

Noninvasive imaging of the airways has made remarkable progress in the past decade. The introduction of multirow detector CT scanners has made it possible to acquire high-resolution images of the upper, central, and segmental airways within a short acquisition time. The CT scan data can be reformatted into three-dimensional images to create virtual bronchoscopic renderings […]

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