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Tracheal collapse diagnosed by multidetector computed tomography: evaluation of different image analysis methods.

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  • 1Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark.

European Clinical Respiratory Journal
|May 1, 2018
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Summary

Diagnosing tracheal collapse with multidetector computed tomography (MDCT) is challenging as four methods identified different patients. Bronchoscopy remains crucial when MDCT results are inconclusive, especially correlating symptoms with maximal collapse.

Keywords:
MDCTcorrelationdiagnosisexcessive tracheal collapseprevalencepulmonary function test

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Area of Science:

  • Medical Imaging
  • Pulmonology
  • Diagnostic Techniques

Background:

  • Bronchoscopy is the gold standard for diagnosing tracheal collapse.
  • Multidetector computed tomography (MDCT) is increasingly used for suspected tracheal collapse.
  • Currently, no definitive gold standard exists for CT image analysis of tracheal collapse.

Purpose of the Study:

  • To evaluate four distinct methods for diagnosing tracheal collapse using MDCT.
  • To assist clinicians in interpreting MDCT images for tracheal collapse in daily practice.

Main Methods:

  • Retrospective analysis of 374 high-resolution CT scans (inspiratory and expiratory).
  • Four analysis methods based on cross-sectional area or volume at specific tracheal locations or regions.
  • Comparison of existing and a novel MDCT image analysis method.

Main Results:

  • Prevalence of tracheal collapse ranged from 10.7% to 19.5% in patients with mixed lung diseases.
  • All four MDCT analysis methods showed high correlation (0.764-0.856) but identified different patient cohorts.
  • No significant correlation between symptoms and the degree of collapse was found, except for maximal collapse.

Conclusions:

  • MDCT methods for tracheal collapse diagnosis are not interchangeable and identify different patient groups.
  • Diagnosis of excessive tracheal collapse should not solely rely on MDCT findings.
  • Bronchoscopy is recommended for definitive diagnosis when MDCT is inconclusive, particularly when symptoms correlate with maximal collapse.