Computed tomography imaging feature of post-intubation tracheal stenosis and its clinical significance

Ke Zhang; Ning Wei; Hao XU; Maoheng ZU; Wenliang Wang; Jinchang Xiao; Xun Wang

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Computed tomography imaging feature of post-intubation tracheal stenosis and its clinical significance

VernacularTitle:气管插管后狭窄27例的CT影像特征及其临床指导意义
Author: Ke ZHANG ; Ning WEI ; Hao XU ; Maoheng ZU ; Wenliang WANG ; Jinchang XIAO ; Xun WANG
Publication Type:Journal Article
Keywords: tracheal intubation; tracheal stenosis; tracheotomy; imaging; spiral computed tomography
From: Journal of Interventional Radiology 2014;(5):418-421
CountryChina
Language:Chinese
Abstract: Objective To explore the spiral computed tomography (CT) imaging feature of post-intubation tracheal stenosis (PITS) and to discuss its clinical significance. Methods The clinical data and CT imaging findings of 27 patients with PITS were retrospectively analyzed. The location, degree and shape of PITS were analyzed, and the imaging features were summarized. Based on the imaging features the etiology of PITS was suggested, and the role of imaging feature in assessing PITS condition and in planning clinical management was evaluated. Results A total of 35 tracheal strictures were detected in the 27 patients. The location of the strictures included trachea incision site (n=10), balloon level (n=5) and distal end of tube (n = 20). In all patients the degree of stenosis was > 30%. Localized stenosis was seen in 15 cases, which presented as “hourglass”or “girdle”shape. Segmental stenosis was found in 4 cases, which was characterized by a “ribbon” or “dumbbell” stricture on CT scans. Complex stenosis was found in 8 cases. With the help of imaging findings, all patients got timely, proper and individualized treatment. Conclusion PITS has typical imaging characteristics. Spiral CT scanning should be regarded as the imaging examination of first choice. Based on the different imaging characteristics, the relevant departments can evaluate patient’s condition and make individualized treatment plan. The imaging finding is very helpful for anesthesiologists and other clinicians in recognizing and in managing the post-intubation tracheal stenosis.