Background: The invasive bronchoscopy (IB) is still the standard goal in the diagnosis and management of tracheal and bronchial lesions in Saudi Arabia. The present study aimed at assessment of the accuracy of non-invasive 3D- computed tomography (CT) virtual bronchoscopy technique (NICTVB) based on multidetector CT (MDCT) data in comparison with invasive bronchoscopy (IB).
Methodology: A retrospective study including 28 patients who had MDCT of the chest between April 2006 and December 2014 was carried out after evaluation of tracheal or bronchial abnormalities. The age ranged between 0-14 years with a mean of 5 years. Multiplanar reformatting (MPR), volume rendering technique and virtual bronchoscopy (VB) of the tracheal evaluation were applied and findings were compared to axial CT, IB and surgical results.
Results: Congenital tracheal stenosis was seen in 13 (46%) patients, endoluminal or extra-luminal neoplasms were detected in 5 (18%) patients, post-intubation tracheal stricture in 5 (18%) patients and post road traffic accident (RTA) stenosis in 3 (11%) patients. The pathology and its location detected on the NICTVB correlated well with Axial CT, IB or with the surgical findings.
Conclusion: NICTVB has the advantage of being a non- invasive procedure and it can visualize areas inaccessible even for the IB. Preliminary evaluation indicates that VB may be a promising non-invasive modality for the screening of bronchial obstruction and endoluminal lesion as well as for assessing the tracheobronchial tree beyond stenosis and the adjacent structures which can guide the clinician for the next step in patient management. We suggest that NICTVB could be used as well for the diagnosis and plan of management of respiratory foreign body in Saudi Arabia, where its diagnosis and management are limited to IB.
Key words: Non-invasive 3D-CT virtual bronchoscopy, multidetector CT (MDCT).
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