HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (17) Citing Articles via Google Scholar Google Scholar Articles by Hoppe, H. Articles by Vock, P. Search for Related Content PubMed PubMed Citation Articles by Hoppe, H. Articles by Vock, P.

Grading Airway Stenosis Down to the Segmental Level Using Virtual Bronchoscopy^*

^* From the Institute of Diagnostic Radiology (Drs. Hoppe, Dinkel, and Vock, and Mr. von Allmen), and the Division of Pulmonology (Dr. Gugger), Inselspital, University of Berne, Switzerland; and Lung Center Hirslanden (Dr. Walder), Zurich, Switzerland.

Correspondence to: Hanno Hoppe, MD, Institute of Diagnostic Radiology, Inselspital, University of Berne, Freiburgstr 20, 3010 Berne, Switzerland; e-mail: hanno.hoppe{at}web.de

Objective: To assess the sensitivity of noninvasive virtual bronchoscopy based on multirow detector CT scanning in detecting and grading central and segmental airway stenosis using flexible bronchoscopic findings as the reference standard.

Materials and methods: In a blinded controlled trial, multirow detector CT virtual bronchoscopy and flexible bronchoscopy were used to search for and grade airway stenosis in 20 patients. CT scan data were obtained with a multirow detector CT scanner using 4 x 1 mm collimation. Flexible bronchoscopy findings were graded by a pulmonologist and served as the reference standard for 176 central airway regions (ie, trachea, main bronchi, and lobar bronchi) and 302 segmental airway regions. The extent of airway narrowing was categorized as grade 0 (no narrowing), grade 1 (< 50%), or grade 2 ( 50%).

Results: Flexible bronchoscopy revealed 30 stenoses in the central airways and 10 in the segmental airways. Virtual bronchoscopy detected 32 stenoses in the central airways (sensitivity, 90.0%; specificity, 96.6%; accuracy, 95.5%) and 22 in the segmental airways (sensitivity, 90.0%; specificity, 95.6%; accuracy, 95.5%). The number of false-positive findings was higher in the segmental airways (13 false-positive findings) than in the central airways (5 false-positive findings), which caused a lower positive predictive value for the segmental airways (40.9%) than for the central airways (84.4%). Flexible and virtual bronchoscopic gradings correlated better for central airway stenosis (r = 0.87) than for segmental airway stenosis (r = 0.61).

Conclusion: Although a high sensitivity was found for the detection of both central and segmental airway stenosis, the number of false-positive findings was higher for segmental airways. However, noninvasive multirow detector CT virtual bronchoscopy enables high-resolution endoluminal imaging of the airways down to the segmental bronchi.

Key Words: bronchi • CT • three-dimensional

This article has been cited by other articles:

				H. Asahina, K. Yamazaki, Y. Onodera, E. Kikuchi, N. Shinagawa, F. Asano, and M. Nishimura Transbronchial Biopsy Using Endobronchial Ultrasonography With a Guide Sheath and Virtual Bronchoscopic Navigation Chest, September 1, 2005; 128(3): 1761 - 1765. [Abstract] [Full Text] [PDF]

				S. Gillespie and P. A. Farling Editorial III: Preoperative assessment of the airway: should anaesthetists be making use of modern imaging techniques? Br. J. Anaesth., December 1, 2004; 93(6): 758 - 760. [Full Text] [PDF]