2D and 3D CT imaging correlated to rigid endoscopy in complex laryngo-tracheal stenoses

The aim of this study was to compare 2D and 3D CT imaging in the pre- and p ostoperative evaluation of complex benign larynges-tracheal airway stenoses with rigid endoscopy, considered as the gold standard. Six patients (aged 5-72 years) with a total of nine complex laryngo-tracheal stenoses underwen t non-contrast helical CT scans (slice thickness 3 mm, pitch 1.3, reconstru ction interval 1.5 mm) before and after surgical resection. With prototype software, virtual endoscopy (VE) post-processing algorithms were applied to the imaging data sets. The VE and multiplanar 2D findings were compared wi th rigid endoscopy, considered as standard of reference. All nine stenoses were correctly identified on 3D images and their anatomical locations corre ctly assessed on 2D reconstructions. Artifacts were met when patients were unable to suspend their breath, leading to one false-positive result. Two-d imensional images and 3D VE of tracheal stenoses proved to be efficient and complementary to the rigid endoscopy, permitting a reliable endoluminal 3D view and evaluation of the surrounding anatomical structures. Limitations of this technique relate to the maximal spatial resolution of 1.5 mm, the l ack of color, and the inability to assess the mucosa. Virtual endoscopy is for complex laryngo-tracheal stenoses an excellent complement for rigid end oscopy, remaining the method of reference, and may be indicated with compli cated pathological structures.