Ruptures of trachea and bronchi diagnosed by virtual bronchoscopy with multidetector computed tomography and fiberoptic bronchoscopy – advantages and shortcomings of methods

Abstract

Introduction/Objective Fiberoptic bronchoscopy often is too aggressive, which requires the use of other noninvasive diagnostic methods. The study presents research results on the diagnostic capabilities of virtual bronchoscopy with multidetector computed tomography and fiberoptic bronchoscopy in traumatic abnormalities of trachea and main bronchi.

Methods A total of 21 patients (six males and 15 females) at the ages of 11–82 years (50.65 ± 19.8) were studied by the methods of virtual bronchoscopy with multidetector computed tomography and fiberoptic bronchoscopy. The diagnostic capabilities of virtual bronchoscopy as compared to fiberoptic bronchoscopy were assessed by established criteria.

Results Ruptures of the trachea and/or bronchi were proven by fiberoptic bronchoscopy in 21 patients and by virtual bronchoscopy in 19 patients. The greatest frequency was reported for the post-intubation ruptures (15 patients, 71.42% with virtual bronchoscopy; 16 patients, 76.19% with fiberoptic bronchoscopy), followed by post-traumatic ruptures (three patients, 14.29%); ruptures of trachea and the left lower lobar bronchus as a result of an advanced neoplasm of the esophagus (one patient, 4.76%), diagnosed by both methods; mucosal erosion after instrumental manipulations (4.76%, after fiberoptic bronchoscopy).

Conclusion Achieved diagnostic accuracy in ruptures of trachea and bronchi by virtual bronchoscopy is 90.47% and by fiberoptic bronchoscopy it is 100%. In terms of localization, shape and size, almost complete correspondence of changes with those of fiberoptic bronchoscopy was found. The presence of abundant secretion in virtual bronchoscopy may be interpreted incorrectly and efficiency of virtual bronchoscopy decreases.

Keywords: diagnostic capabilities; traumatic abnormalities; trachea; bronchi