[Three-dimensional reconstruction images of central airway using spiral CT: experimental and clinical studies in the demonstrability of tracheobronchial lesions].
The purpose of this study was to evaluate the role of three dimensional reconstruction image using spiral CT (3D image) for demonstrating the tracheobronchial lesions. In the experimental study using originally developed phantom, 3D images of simulated endobronchial protrusions were evaluated at combinations of detector collimation (1, 3 and 5 mm), table speed (1, 2, 3 and 5 mm/sec) and reconstruction pitch (1 and 3 mm). 3D images with 1 mm collimation, 1 mm/sec table speed, and 1 mm reconstruction pitch (1/1/1) could provide the best demonstrability of simulated endobronchial protrusions. But the condition (1/2/1) is not so inferior to 1/1/1. The stair-step artifacts were caused by the effects of rotation and aliasing, which could be reduced with slow table speed and fine reconstruction pitch. In clinical study, 3D images (1/2/1) were applied in 34 patients with hilar lung cancer and these images were compared with bronchoscopic findings. 3D images demonstrated irregular obstructions or stenoses in 15 of 16 cases with mucosal lesions, 5 of 7 cases with submucosal lesions with mucosal invasion. On the other hand, in 4 cases with submucosal lesions without mucosal invasion and 6 of 7 cases with intramural or extramural lesions, smooth stenoses were demonstrated on 3D images. In 30 of 34 cases (88.2%), 3D images corresponded to bronchoscopic findings. In conclusion, 3D images proved useful in demonstrating not only the obstructions or stenoses of central airway, but also mucosal irregularity. 3D-CT could be helpful for determining indication for transbronchial biopsy of hilar lung cancer.
Mimura
F
F
Department of Radiology, Kobe University School of Medicine.
Kusumoto
M
M
Kono
M
M
D000328:Adult; D000368:Aged; D001995:Bronchography / Q000379:methods*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D019047:Phantoms, Imaging; D011856:Radiographic Image Enhancement / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014132:Trachea / Q000000981:diagnostic imaging*