HELICAL COMPUTED-TOMOGRAPHY FOR THE EVALUATION OF TRACHEAL STENOSIS

Background. Helical computed tomography with multiplanar reconstructio n (CT/MPR) was used to study proximal airway stenosis. Methods. Twenty -eight helical CT/MPR studies were obtained in 25 patients with known or suspected stenosis of the trachea or main bronchi. Computed tomogra phic results were compared with planar tomograms and bronchoscopic eva luation of the airway. Results. CT/MPR accurately demonstrated the sit e and degree of tracheal and main bronchial stenoses with a sensitivit y of 93%, a specificity of 100%, and an accuracy of 94%. There was one false negative study in a patient with tracheomalacia. In a second pa tient, a tracheal web was only apparent on nonstandard viewing windows . Conclusions. CT/MPR provides good anatomic detail and is an increasi ngly available technique. Potential drawbacks include the need for a l onger breath-hold (15 to 45 seconds) and increased complexity of data compared with conventional tomograms. Helical CT/MPR is useful in the preoperative evaluation of these patients and, as experience accumulat es, may replace the use of conventional tomograms.