Role of multislice computed tomography in evaluation of congenital tracheobronchial branching anomalies

Abstract

ObjectiveThe purpose of this study was to shed some light on different tracheobronchial branching anomalies as well as evaluating the role of multislice CT (MSCT) examination in accessing of them. Knowledge of different tracheobronchial branching anomalies and their nomenclature is mandatory for radiologists, bronchoscopists and chest surgeons. Multiplanar and 3D reconstruction CT images provide an important complementary method of viewing these branching anomalies and offer the potential to improve diagnostic confidence and accuracy and enhance communication and planning for any interventional chest procedure. Patients and methodsThe study involved 50 patients presented to radiology department with different chest complaints in the period from February to July 2017 and only cases with CT picture suggestive of tracheobronchial branching anomalies were included in this study Tracheobronchial tree was studied using different protocols of MSCT (NECT, CECT, CTPA, HRCT, VB). Tracheobronchial branching anomalies were an incidental finding in all cases. ResultsTracheobronchial branching anomalies due to upper lobe anomalies represent 52% of total anomalies (26 cases) and the commonest cause of the upper lobe anomalies is pre-eparterial bronchus (9 cases). Lower lobe anomalies were found in 6% of cases (3 cases) and all due to suprasuperior bronchus. Cardiac bronchus was found in 14% of patients (7cases), and one case was diagnosed as bridging anomaly. Branching anomalies affecting entire lung were detected in 13cases (26%) most commonly sintus inversus (6 cases). ConclusionThe role of MSCT imaging in the evaluation of tracheobronchial branching anomalies is central, being accurate and non-invasive.