A multi detector computed tomography survey of tracheal diverticulum

Area of Science:

• Pulmonary Medicine
• Radiology
• Thoracic Imaging

Background:

• Tracheal diverticulum (DV) is an incidental finding in thoracic computed tomography (CT) examinations.
• Tracheal DV has been anecdotally associated with chronic cough and chronic obstructive pulmonary disease (COPD), though evidence remains limited.
• Existing studies have not reached a consensus on the relationship between tracheal DV and COPD.

Purpose of the Study:

• To determine the incidence of tracheal DV.
• To investigate the coexistence of tracheal DV with bronchial DV.
• To assess the association between tracheal DV and hyperaeration.

Main Methods:

• Retrospective analysis of 12,800 thoracic CT scans, including 299 patients with tracheal DV.
• Evaluation of tracheal diverticula for location, size, contour, wall thickness, and communication with the tracheal lumen.
• Statistical analysis to determine the association between tracheal DV, bronchial DV, and hyperaeration, and correlation with COPD.

Main Results:

• A total of 412 tracheal diverticula were observed in 299 patients, with an overall incidence of 2.38%.
• Most tracheal diverticula (97.1%) were located in the right posterolateral trachea and were more common in men.
• No significant association was found between tracheal DV and hyperaeration, but 84 tracheal diverticula had associated bronchial DV, with 72 of these linked to COPD.

Conclusions:

• Tracheal DV is an asymptomatic finding, predominantly in the right posterolateral trachea and more prevalent in males.
• The study confirms a 2.38% incidence of tracheal DV, with no significant association with COPD.
• A significant correlation was identified between subcarinal bronchial DV and COPD, suggesting a distinct pathological relationship.