Diagnosis of tracheal instability: Inspiratory and expiratory spiral CT and cine CT.

In tracheo- and bronchomalacia, localization and determination of collapse is necessary for planning a surgical procedure. We compared inspiratory and spiral CT,: cine CT, and bronchoscopy and evaluated the relevance of each method. Methods: Seventeen patients with suspected or verified tracheal sto nosis or collapse underwent paired inspiratory and exspiratory spiral CT an d cine CT during continuous respiration (temporal increment 100 ms). The tr acheal: cross-sectional area was calculated and compared, Results: In addit ion to bronchoscopy, further information concerning localization, extent, c ollapse, stability of the tracheal wall,: distal portions of the stenosis, and extraluminal compressions was obtained. A significantly higher degree o f tracheal collapse was seen using cine CT compared to paired spiral CT (p< 0.002), The findings changed the further surgical procedure In 3/17 patient s. Further distal stenoses were excluded and bronchoscopy was verified in a nother 10/17. Conclusion: Paired inspiratory and expiratory spiral CT local izes tracheal stenoses and demonstrates clinically relevant extraluminal co mpression. Improved evaluation of expiratory collapse and further informati on of localized tracheal instability is provided by cine CT.