Document Detail


Comparison of Dynamic Expiratory CT With Bronchoscopy for Diagnosing Airway Malacia: A Pilot Evaluation.
MedLine Citation:
PMID:  17356090     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the accuracy of dynamic expiratory CT for detecting airway malacia using bronchoscopy as the diagnostic "gold standard." MATERIALS AND METHODS: A computerized hospital information system was used to retrospectively identify all patients with bronchoscopically proven airway malacia referred for CT airway imaging at our institution during a 19-month period. CT was performed within 1 week of bronchoscopy. All patients were scanned with a standard protocol, including end-inspiratory and dynamic expiratory volumetric imaging, using an eight-detector multislice helical CT scanner. For both CT and bronchoscopy, malacia was defined as >/= 50% expiratory reduction of the airway lumen. CT and bronchoscopic findings were subsequently jointly reviewed by the radiologist and bronchoscopist for concordance. RESULTS: Twenty-nine patients (12 men and 17 women; mean age, 60 years; range, 36 to 79 years) comprised the study cohort. CT correctly diagnosed malacia in 28 of 29 patients (97%). The most common presenting symptoms were dyspnea in 20 patients (69%), severe or persistent cough in 16 patients (55%), and recurrent infection in 7 patients (24%). The estimated radiation dose (expressed as dose-length product) for the dual-phase study is 508 mGy-cm, which is comparable to a routine chest CT. CONCLUSION: Dynamic expiratory CT is a highly sensitive method for detecting airway malacia and has the potential to serve as an effective, noninvasive test for diagnosing this condition.
Authors:
Karen S Lee; Maryellen R M Sun; Armin Ernst; David Feller-Kopman; Adnan Majid; Phillip M Boiselle
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chest     Volume:  131     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-14     Completed Date:  2007-05-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  758-64     Citation Subset:  AIM; IM    
Affiliation:
Division of Thoracic Surgery and Interventional Pulmonary, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215. aernst@bidmc.harvard.edu.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bronchial Diseases / diagnosis*
Bronchoscopy*
Cartilage Diseases / diagnosis*
Cohort Studies
Exhalation / physiology*
Female
Humans
Image Processing, Computer-Assisted*
Male
Middle Aged
Radiation Dosage
Sensitivity and Specificity
Statistics as Topic
Tomography, Spiral Computed*
Tracheal Diseases / diagnosis*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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