Correlation Between Computed Tomography and Endoscopy in the Characterization of Tracheal Stenosis
##plugins.themes.academic_pro.article.main##
Abstract
Introduction: Accurate preoperative evaluation of tracheal stenosis is essential for guiding treatment decisions. Bronchoscopy is considered the
"gold standard," but computed tomography (CT) provides promising results. This study aims to compare the accuracy of CT and bronchoscopy in
characterizing tracheal stenosis.
Methods: A descriptive and analytical study conducted over 10 years (2013–2023) included 20 patients with tracheal stenosis confirmed by CT and
bronchoscopy. The evaluated parameters were the distance from the stenosis to the glottis, subglottic involvement, stenosis length, stenosis grade
(Meyer-Cotton classification), and mucosal condition.
Results: The average distance from the stenosis to the glottis was 34 mm in both exams, with significant correlation (r=0.777, p=0.000). The mean
stenosis length was 17.6 mm on CT and 15.8 mm on bronchoscopy, also with significant correlation (r=0.689, p=0.001). In two cases, the stenosis
was complete and impassable by the bronchoscope. CT accurately predicted the stenosis grade in 70% of cases (r=0.736, p=0.000). Sensitivity for
detecting subglottic involvement was 50%, and for granulomas, 25%, with specificities of 94.4% and 93.8%, respectively.
Conclusion: CT correlates well with bronchoscopy in measuring the distance to the glottis, stenosis length, and grade but is less effective for detecting subglottic involvement and granulomatous lesions. Combining both techniques is recommended for optimal pre-treatment evaluation
of tracheal stenosis.
Keywords:
Sténose trachéale, bronchoscopie, tomodensitométrie, bronchoscopie virtuelle##plugins.themes.academic_pro.article.details##

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
- Acar T, Bayraktaroglu S, Ceylan N, Savas R. Computed tomography findings of tracheobronchial system diseases: a pictorial essay. Jpn J Radiol. 2015 Feb;33(2):51–8.
- Chaddha U, Murgu S. Complications of rigid bronchoscopy. Respirology. 2021;26(1):14–8.
- Carretta A, Melloni G, Ciriaco P, Libretti L, Casiraghi M, Bandiera A, et al. Preoperative assessment in patients with postintubation tracheal stenosis: Rigid and flexible bronchoscopy versus spiral CT scan with multiplanar reconstructions. Surg Endosc. 2006 Jun;20(6):905–8.
- Batra H, Yarmus L. Indications and complications of rigid bronchoscopy. Expert Review of Respiratory Medicine. 2018 Jun 3;12(6):509–20.
- Quint LE, Whyte RI, Kazerooni EA, Martinez FJ, Cascade PN, Lynch JP, et al. Stenosis of the central airways: evaluation by using helical CT with multiplanar reconstructions. Radiology. 1995 Mar;194(3):871–7.
- Ferretti GR, Knoplioch J, Bricault I, Brambilla C, Coulomb M. Central airway stenoses: preliminary results of spiral-CT-generated virtual bronchoscopy simulations in 29 patients. Eur Radiol. 1997 Jul;7(6):854–9.
- Morshed K, Trojanowska A, Szymański M, Trojanowski P, Szymańska A, Smoleń A, et al. Evaluation of tracheal stenosis: comparison between computed tomography virtual tracheobronchoscopy with multiplanar reformatting, flexible tracheofiberoscopy and intra-operative findings. Eur Arch Otorhinolaryngol. 2011 Apr;268(4):591–7.
- McInnis MC, Weisbrod G, Schmidt H. Advanced Technologies for Imaging and Visualization of the Tracheobronchial Tree. Thoracic Surgery Clinics. 2018 May;28(2):127–37.
- Hoppe H, Walder B, Sonnenschein M, Vock P, Dinkel HP. Multidetector CT Virtual Bronchoscopy to Grade Tracheobronchial Stenosis. American Journal of Roentgenology. 2002 May;178(5):1195–200.
- Calloway HE, Kimbell JS, Davis SD, Retsch-Bogart GZ, Pitkin EA, Abode K, et al. Comparison of Endoscopic versus 3D CT Derived Airway Measurements. Laryngoscope. 2013 Sep;123(9):2136–41.
- Mimouni-Benabu O, Meister L, Giordano J, Fayoux P, Loundon N, Triglia JM, et al. A preliminary study of computer assisted evaluation of congenital tracheal stenosis: A new tool for surgical decision- making. International Journal of Pediatric Otorhinolaryngology. 2012 Nov;76(11):1552–7.
- Kuo CFJ, Leu YS, Kuo R, Su CH, Yuan TC, Ke BH, et al. Three- dimensional reconstruction of trachea using computed tomography imaging as therapy for tracheal stenosis in infants. Computer Methods and Programs in Biomedicine. 2016 Aug;132:177–87.
- Yamoto M, Fukumoto K, Sekioka A, Iwazaki T, Sano K, Takahashi T, et al. Non-operative management of congenital tracheal stenosis: criteria by computed tomography. Pediatr Surg Int. 2019 Oct;35(10):1123–30.
- Godoy MCB, Saldana DA, Rao PP, Vlahos I, Naidich DP, Benveniste MF, et al. Multidetector CT Evaluation of Airway Stents: What the Radiologist Should Know. RadioGraphics. 2014 Nov;34(7):1793– 806.
- Dialani V, Ernst A, Sun M, Lee KS, Feller-Kopman D, Litmanovich D, et al. MDCT Detection of Airway Stent Complications: Comparison with Bronchoscopy. American Journal of Roentgenology. 2008 Nov;191(5):1576–80.
- Nobuyama S, Sato T, Handa H, Nishine H, Inoue T, Mineshita M, et al. Comparison of Airway Measurements for Tracheobronchial Stenosis Between Stereoscopic Bronchoscope and MD-CT. Journal of Bronchology & Interventional Pulmonology. 2017 Oct;24(4):296– 302