Role of multidetector CT virtual bronchoscopy in the evaluation of post-tracheostomy tracheal XXXX --a preliminary study.

@entity1 @entity850 @entity238 @entity5862
AIM: To study the technique and utility of virtual bronchoscopy (virtual reality endobronchial simulation, VRES) as a tool to evaluate post-tracheostomy tracheal stenoses and to correlate the findings of virtual and invasive bronchoscopy and to follow-up treated lesions or those currently under treatment that were initially diagnosed with VRES. METHODOLOGY: This prospective study comprised nine @entity1 in the age group 13 to 65 years presenting with breathlessness and stridor following one or multiple tracheostomies. They underwent plain CT using a multidetector CT (MDCT) scanner (Siemens Volume Zoom) using narrow (1 mm) collimation. These thin slice images were post-processed using an Irix-based workstation with a ' @entity238 -Through' endoscopy application. These @entity1 also underwent a rigid (three @entity1 ) or fiberoptic (six @entity1 ) bronchoscopy. RESULTS: Of the nine @entity1 that underwent VRES, five were found to have stenoses, three had obstructing granulation tissue, one had an obstructing membrane and one had @entity5862 . The invasive bronchoscopic findings supported the VRES diagnosis in all but one case of @entity850 , one of granulation tissue and the case with @entity5862 . Membranes and @entity5862 were relatively difficult to diagnose without the corresponding axial and multiplanar images. VRES achieved a higher sensitivity, while invasive bronchoscopy a higher specificity. CONCLUSIONS: VRES proved to be comparable to invasive bronchoscopy in the depiction of post-tracheostomy tracheal stenoses, with a notable advantage in critical stenoses in that the airway distal to the @entity850 could be assessed with VRES but not with invasive bronchoscopy. A preliminary VRES was found to be of assistance in the selection of @entity1 for the more invasive therapeutic procedures such as laser ablation of granulation tissue and its follow-up.
