Use of 3-dimensional computed tomography reconstruction studies in the preoperative assessment of patients undergoing balloon dilatation for tracheobronchial stenosis.
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.
Rooney
Cyril P
CP
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, IA 52242, USA.
Ferguson
J Scott
JS
Barnhart
William
W
Cook-Granroth
Janice
J
Ross
Alan
A
Hoffman
Eric A
EA
McLennan
Geoffrey
G
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*