Obstructive lesions of the central airways: Evaluation by using spiral CT with multiplanar and three-dimensional reformations

The purpose of this study was to assess the accuracy of transverse CT scans as well as multiplanar (MPR) and three-dimensional (3D) reconstructions in the evaluation of obstructive lesions of the central airways. A total of 64 patients were evaluated for the presence of obstructive lesions of the central tracheobronchial tree with transverse spiral CT scans, multiplanar reformations (MPRs), 3D shaded surface displays (3D SSDs) and minimum intensity projections (MIPs). The findings of these modalities were then compared with those obtained at bronchoscopy. The severity, length, and shape of airway narrowing were analyzed comparatively on the four sets of images. Transverse CT scans and MPRs had a similar accuracy (99%) in detecting obstructive airway lesions. The accuracy of both was significantly higher than that of 3DSSDs (90%, p < 0.05) and MIPs (81%; p < 0.01). There was no statistically significant difference between the four imaging modalities in the analysis of the morphology of airway stenoses. Symmetric stenoses were similarly analyzed on the four sets of images, whereas MPRs and MIPs failed to depict accurately simple and complex asymmetric stenoses. Transverse CT scans are accurate in the depiction of obstructive lesions of the central airways and may be complemented by MPRs and/or 3DSSDs in their morphologic evaluation.