title: Digital radiographic measurement of the main bronchi: a pilot study.
abstract: BACKGROUND
  Conventional chest radiographs do not afford consistently good visualisation of the main bronchi and sub-carinal angle. Improved visualisation would facilitate accurate measurement of the airways, definition of normal radiographic anatomy and, possibly, earlier identification of extrinsic compression or displacement.
  
  
  OBJECTIVE
  The main objective of this study was to establish whether the paediatric main bronchi and sub-carinal angle could be measured consistently on AP supine chest images obtained using a specific digital radiographic system (DRS).
  
  
  METHODS
  The proximal bronchial diameters were measured on supine DRS chest images of 102 children between the ages of 6 months and 13 years.
  
  
  RESULTS
  The left and right main bronchi could be seen clearly and measured in over 90% of cases, with intraclass correlation co-efficients of reliability indicating high intra- and inter-observer agreement. The sub-carinal angle had lower intra- and inter-observer agreement.
  
  
  CONCLUSIONS
  Supine chest images acquired using DRS facilitate accurate measurement of the main bronchi and sub-carinal angle in children. Further work is required to establish population-specific age-related norms for bronchial dimensions. These could serve as reference standards for early detection of deviations from normal.
authors.affiliation: Medical Imaging Research Unit, Department of Human Biology, School of Child & Adolescent Health, Red Cross Children's War Memorial Hospital, University of Cape Town, South Africa. vsanders40@gmail.com
authors.forename: V M
authors.initials: VM
authors.lastname: Sanders
authors.forename: R D
authors.initials: RD
authors.lastname: Pitcher
authors.forename: T S
authors.initials: TS
authors.lastname: Douglas
authors.forename: M A
authors.initials: MA
authors.lastname: Kibel
authors.forename: R B
authors.initials: RB
authors.lastname: Daya
authors.forename: A B
authors.initials: AB
authors.lastname: van As
mesh_terms: D001995:Bronchography; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010865:Pilot Projects; D011856:Radiographic Image Enhancement / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed