Gilbert R Ferretti MD,PHD, Presenter: Nothing to Disclose

Laurent Aubaud, Abstract Co-Author: Nothing to Disclose

Nathalie Choury, Abstract Co-Author: Nothing to Disclose

Adrien Jankowski MD, Abstract Co-Author: Nothing to Disclose

Max Coulomb MD, Abstract Co-Author: Nothing to Disclose

Jean Louis Pepin MD,PHD, Abstract Co-Author: Nothing to Disclose

to evaluate the role of dynamic expiratory imaging using multidetector CT (MDCT) in comparison to end expiratory imaging in patients clinically suspected of tracheomalacia.

70 consecutive patients (43 men and 37 women. Mean age, 57 years. Range, 12-88) were prospectively evaluated with MDCT (16 DAS). 3 acquisitions of the central airways were obtained (100 kV, 40 mAs) with 1.5 slice thickness and 36mm/sec, mean acquisition time: 4.5 sec: 1) at the end of inspiration; 2) at the end of expiration; 3) during dynamic expiration. Percentage changes in cross-sectional area at 3 level of the trachea (cervical, upper thoracic, and lower thoracic), right and left main bronchus were measured. Evaluation of the results were tested using 3 thresholds as definition of TBM: >30%, >50%, >70% of narrowing.

26 of 70 patients (37%) had a narrowing > 30% at the end of inspiration as compare to 37 (53%) during dynamic expiration; the figures were 8.5% and 33% for a threshold value of 50% and 0 and 10% for threshold value of 70% (p=0,02), respectively. Airway collapse extended to 3 or more levels in 3 patients (6%) at the end of inspiration as compare to 16 (23%) patients during dynamic expiration (threshold: 30%); the figures were 0 patient and 9 patients (13%) (threshold: 50%) respectively.

MDCT during dynamic expiratory acquisition is more sensitive than acquisition at the end expiration to demonstrate the instability of the central airways, whatever the threshold was used to define an abnormal airway collapse

Ferretti, G, Aubaud, L, Choury, N, Jankowski, A, Coulomb, M, Pepin, J, MDCT Evaluation of Tracheobronchomalacia: Comparison of End Expiratory to Dynamic Expiratory Volumetric Acquisitions.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4414548.html