Airway Measurements in Tracheobronchial Stenosis Using Endobronchial Ultrasonography During Stenting

Abstract

To assess airway measurements, endobronchial ultrasonography (EBUS) and multidetector, row computed tomography (MDCT) images were compared in patients with tracheal stenosis. Airway stenting was performed on 31 patients, 25 malignant and 6 benign. EBUS and MDCT images were compared before intervention to assess the degree of airway narrowing at 212 sites. Of these, 130 sites were considered normal and 82 abnormal. For malignant stenosis, airway measurements were taken at 160 sites including 112 normal and 48 abnormal. For benign stenosis, airway measurements were taken at 52 sites including 18 normal and 34 abnormal. This technique enables the EBUS probe to measure the distal end to the proximal end of the stenosis whereby the inflated balloon size changes according to the degree of stenosis. The diameter and length of the stenotic sites measured by EBUS and MDCT were nearly equal in all patients. Significant correlation was seen at all 212 sites (r=0.805, P<0.0001), 130 normal (r=0.758, P<0.0001) and 82 abnormal (r=0.654, P<0.0001). For malignant cases, there was significant correlation in a total of 160 sites (r=0.810, P<0.0001), 112 normal (r=0.782, P<0.0001) and 48 abnormal (r=0.564, P<0.0001). Benign cases showed significant correlations in total 52 sites (r=0.780, P<0.0001), 18 normal (r=0.778, P<0.0001) and 34 abnormal (r=0.731, P<0.0001). This EBUS technique was successful in establishing accurate airway measurements for suitable airway stent sizes in interventional procedures, especially in cases with tracheobronchial malacia.