Spiral CT Virtual Bronchoscopy: Its Clinical Application

Objective To evaluate the clinical application of CT virtual bronchoscopy (VB).Materials and Methods CTVB was performed in 52 patients with pathologically or bronchoscopically confirmed lung diseases, including central type lung cancer (n=27), tracheal carcinoma (n=2), post operated lung cancer (n=4), bronchial diverticulum (n=1) and normal bronchus (n=18). The preprocessed source images were input into the workstation and CTVB was performed with navigator smooth software (advantage windows 3.1 GE Medical Systems).Results CTVB could vividly reveal the tracheobronchial lumens, the cartilage rings, the carina and both right and left bronchi up to the fifth branching level orifices, quite mimicking fiberoptic bronchoscopy. Of 27 cases with central type lung cancer, bronchial stenosis was seen in 23 and bronchial occlusion in 4, while the bronchial rings close to the tumor displayed blurry, smooth or disappeared, in accordance with that seen on fiberoptic bronchoscopy. Post operated bronchial stump (n=4) showed a smooth blind end. Bronchial diverticulum exhibited a local concavity on CTVB or a local protrusion on SSD. CTVB could pass through stenotic bronchi to observe the occluded bronchi from the other side.Conclusion CTVB is a noninvasive technique and can partly replace fiberoptic bronchoscopy. Combined with axial and MPR imaging, CTVB can demonstrate the extraluminal extension of tumors, however, CTVB can neither detect mucosal abnormalities nor get histologic samples.