Utility of multidetector CT and virtual bronchoscopy in tracheobronchial obstruction in children.
OBJECTIVE
The aim of this study was to evaluate the potential use of multidetector CT (MDCT) and virtual bronchoscopy (VB) in the evaluation of tracheobronchial patency in children with suspected bronchial obstruction and to compare its findings with fibreoptic/rigid bronchoscopy or surgery.


METHODS
A total of 43 children (15 girls, 28 boys) with clinically suspected bronchial obstruction underwent contrast enhanced MDCT, using an age- and weight- adjusted low dose protocol. Post-processing was performed and VB and multiplanar reformations (MPR) were obtained at the same sitting. Findings obtained at MDCT and VB were compared with fibreoptic/rigid bronchoscopy and surgery.


RESULTS
Obstructive pathology was found in 26 children, which included endoluminal foreign body, mucus plugs in 13 children, endobronchial tumour in three children and extrinsic compression (lymph node, aberrant Vessels, mediastinal cysts/tumours) of the tracheobronchial tree in 10 children. In 17 children, no obstructive lesion was identified. Excellent positive correlation was obtained, between MDCT-VB and bronchoscopy/surgery, however, in one child with endobronchial obstruction caused by tracheitis, low dose MDCT-VB was normal, but bronchoscopy revealed granularity and plaques.


CONCLUSIONS
MDCT-Virtual bronchoscopy is useful in evaluating bronchial stenosis and obstruction caused by both endoluminal pathology and external compression and has the advantage of looking beyond stenosis. Its main application lies in providing the exact location of suspected foreign body, prior to bronchoscopy. However, it fails to disclose exact nature of obstructing pathology.
Sodhi
Kushaljit Singh
KS
Department of Radiodiagnosis, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India. sodhiks@gmail.com
Aiyappan
Senthil Kumar
SK
Saxena
Akshay Kumar
AK
Singh
Meenu
M
Rao
Kln
K
Khandelwal
Niranjan
N
D000402:Airway Obstruction / Q000175:diagnosis* / Q000601:surgery; D001982:Bronchial Diseases / Q000175:diagnosis* / Q000601:surgery; D001999:Bronchoscopy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000175:diagnosis; D005260:Female; D005547:Foreign Bodies / Q000175:diagnosis; D006801:Humans; D007223:Infant; D008297:Male; D014057:Tomography, X-Ray Computed / Q000379:methods*