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Updated: Mar 12, 2026
Four-Dimensional Computed Tomography-Guided Valve Sizing for Transcatheter Pulmonary Valve Replacement
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Dynamic cine imaging of the Eustachian tube using four-dimensional computed tomography
1Division of Otolaryngology - Head and Neck Surgery,Dalhousie University,Halifax,Canada.
Background:
Imaging the Eustachian tube has proven difficult as it has an anatomical orientation that is not aligned with standard planes. In addition, the Eustachian tube is a dynamic structure, opening briefly during a variety of physiological manoeuvres.
Case Report:
A 54-year-old healthy and asymptomatic man underwent computed tomography utilising an area detector scanner. Multiplanar reconstruction was performed at 1 mm intervals. In addition, dynamic clips were constructed to demonstrate air and its movement in the field. Images and video were acquired whilst a Valsalva manoeuvre was being performed.
Conclusion:
Although imaging techniques have been able to visualise the Eustachian tube well in the closed state, it may be more useful to have it imaged whilst open. Area detector computed tomography scanners can be used to acquire four-dimensional images. This allows dynamic imaging of the region, to assist in the diagnosis of various types of Eustachian tube dysfunction.
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