3D spiral CT of the tracheobronchial tree.

OBJECTIVE: Because of intrinsic limitations of transverse cross-sectional imaging methods, CT sometimes is insufficient for adequate evaluation of complex tracheobronchial anomalies. This article describes a complementary 3D procedure specifically dedicated to the study of the tracheobronchial tree. MATERIALS AND METHODS: The procedure combines a specific spiral CT acquisition with 2 or 4 mm collimation, 3D surface rendering of the tracheobronchial aerial content, and double obliquity multiplanar reformats directly planned on the 3D virtual object. It was performed in 11 complex cases including 3 stented benign or malignant stenoses and 2 single lung transplantations. RESULTS: Easier understanding of the tracheobronchial status was achieved in all cases. In three cases, the procedure yielded relevant diagnostic information that neither fiberoptic endoscopy nor transverse CT had provided, leading to significant modification of patient management. CONCLUSION: Three-dimensional spiral CT of the bronchial tree with secondary reformation seems suitable in clinical practice for selected cases