title: Use of 3-dimensional computed tomography reconstruction studies in the preoperative assessment of patients undergoing balloon dilatation for tracheobronchial stenosis.
abstract: BACKGROUND
  Balloon dilatation (BD) is a useful method of treating tracheobronchial stenosis (TBS); however, accurate preoperative identification of the lesion is difficult. Three-dimensional computed tomography (3D-CT) is an imaging method that may allow more accurate definition of the lesion(s) preoperatively.
  
  
  OBJECTIVE
  It is the aim of this study to present our finding using 3D-CT as a part of the preoperative evaluation of patients with TBS undergoing BD.
  
  
  METHODS
  We studied a prospective case series of 17 consecutive patients who underwent 29 BDs for TBS from a variety of benign and malignant causes at a tertiary care hospital. All patients had a preoperative spiral CT; these data were processed by a software program, VIDA, which was developed at this institution, and 3D-CT reconstruction images of the TBS were created. This enabled accurate preoperative anatomic definition of the lesion. The patients subsequently underwent BD.
  
  
  RESULTS
  All 17 patients had lesions identified with 3D-CT. Six patients had tracheal lesions and 12 patients had main stem lesions. One patient had combined tracheal and main stem lesions and 2 other patients had bilateral main stem lesions. Nine out of 17 patients required only one BD. One patient had a failed BD. The remaining 6 patients required more than one BD for optimal results (up to a maximum of 4). The follow-up period ranged from 1 to 34 months.
  
  
  CONCLUSIONS
  3D-CT offers accurate definition of TBS, including anatomic location, number of lesions present and status of airway distal to lesion. In this study, all preoperative lesions were correctly identified prior to BD.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, IA 52242, USA.
authors.forename: Cyril P
authors.initials: CP
authors.lastname: Rooney
authors.forename: J Scott
authors.initials: JS
authors.lastname: Ferguson
authors.forename: William
authors.initials: W
authors.lastname: Barnhart
authors.forename: Janice
authors.initials: J
authors.lastname: Cook-Granroth
authors.forename: Alan
authors.initials: A
authors.lastname: Ross
authors.forename: Eric A
authors.initials: EA
authors.lastname: Hoffman
authors.forename: Geoffrey
authors.initials: G
authors.lastname: McLennan
mesh_terms: D000328:Adult; D000368:Aged; D001982:Bronchial Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D001995:Bronchography; D002404:Catheterization; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000628:therapy; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D036542:Tomography, Spiral Computed / Q000379:methods*; D014132:Trachea / Q000000981:diagnostic imaging*; D014135:Tracheal Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*