Рентгенология & Радиология, 2017, LVI 177-184

Virtual computed tomography bronchoscopy in

tracheal ruptures

  1. Mitev, N.Traykova, D. Arabadzhiev, S. Valkanov, Е. Obretenov

Abstract.

Traumatic injuries of the main airways are rare in medical practice but extremely life-threatening conditions. Fiberoptic bronchoscopy is a standard diagnostic method for proving them. Virtual bronchoscopy by 3D MDCT reconstruction, allows visualization and evaluation of the integrity of the walls of the trachea and the main bronchi and their lumen changes. The aim of this study is to share authors experience in evaluating the diagnostic capabilities of MDCT virtual bronchoscopy compared to Fiberoptic bronchoscopy for traumatic injuries of main airways. 19 patients (5 men, and 14 women, between 11 to 82 years old) with FB proven traumatic injuries of the trachea were examined MDCT virtual bronchoscopy during the period 2009–2016, findings of both methods were compared. for FB – “Olympus BF PE2” and “Fujinon EP-120T was used. VB were performed to a Philips CT „Essenza”, and 64 Siemens MDCT “Definition AS” with appropriated protocols. The diagnostic capabilities of VB compared to FB at trachea ruptures were evaluated on the approved criteria. The patients were divided into three groups according to the etiopathogenesis. The largest number of cases are post-intubation lesions; (75%) (2 men and 13 women), followed by post-traumatic lesions; (15%), (one woman and two men). Mucosal erosion after instrumental manipulation; was found in one man. In two patients both Fiberoptic and Virtual bronchoscopy established two lesions. Fiberoptic bronchoscopy reported a negative result in one patient, Virtual bronchoscopy in two. VB in this study shows a high degree of sensitivity in the assessemеnt of tracheobronchial ruptures (89.5%). Results fully comparable with FB. VB is effective method competitive to FB, for the detection of traumatic injuries of the main airways. Its success rate correlate with the location and size of the rupture and is more precise for lesions ≥7 mm.

Key words: FIBEROPTIC BRONCHOSCOPY. MDCT. VIRTUAL BRONCHOSCOPY. TRACHEA. RUPTURES