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Updated: May 8, 2026

Image Acquisition using Portable Sonography for Emergency Airway Management
Published on: September 28, 2022
Advanced Imaging to Assess Airway Dynamics
Alister J Bates1, Robert J Fleck2, David F Smith3
1Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA; Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA; Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Abstract:
Endoscopy remains the gold standard for assessing dynamic airway abnormalities in pediatric patients, but its invasiveness and variable interoperator agreement have driven interest in imaging-based alternatives. Four-dimensional computed tomography (CT) now enables objective quantification of tracheal collapse during free breathing, while photon-counting CT achieves effective doses approaching chest radiography, fundamentally altering the risk-benefit calculus for serial monitoring. MRI approaches-from real-time cine for obstructive sleep apnea localization to retrospectively gated techniques achieving submillimeter resolution without sedation-provide radiation-free dynamic assessment. This article reviews these modalities alongside ultrasound and optical coherence tomography, with guidance for modality selection based on clinical indication.
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