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CT Virtual Bronchoscopy of the Central Airways in Patients With Wegener’s Granulomatosis^*

^* From the Diagnostic Radiology Department (Drs. Summers and Wood, and Mr. Aggarwal) and Division of Critical Care Medicine (Drs. Cowan and Shelhamer), Warren Grant Magnuson Clinical Center; and National Institute of Allergies and Infectious Diseases (Drs. Sneller and Langford), National Institutes of Health, Bethesda, MD.

Correspondence to: Ronald M. Summers, MD, PhD, Diagnostic Radiology Department, National Institutes of Health, Bldg. 10, Room 1C660, 10 Center Dr, MSC 1182, Bethesda, MD 20892-1182; e-mail: rms{at}nih.gov

Objectives: To compare CT virtual bronchoscopy (VB) to CT alone and to conventional bronchoscopy for evaluation of central airway stenoses in patients with Wegener’s granulomatosis.

Design: Prospective observer study, in which 18 thin-section helical CT scans of the trachea and bronchi of 11 patients with Wegener’s granulomatosis were obtained. VB was performed using surface rendering and was evaluated by one bronchoscopist and one radiologist in a blinded fashion. Bronchoscopic correlation within an average of 1.8 days of CT was available.

Measurements and results: VB displayed 188 of 198 bronchi (95%). Thirty-two of 40 stenoses (80%) were detected by VB by at least one of two physicians (double reading), and 22 of 40 stenoses (55%) were detected by a third physician reading only the CT.

Conclusions: VB depicts bronchi to the segmental level and detects the majority of central airway stenoses in patients with Wegener’s granulomatosis. A team approach is useful to attain optimal clinical benefit from VB for these patients.

Key Words: bronchoscopy • CT • endobronchial stenosis • Wegener’s granulomatosis

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