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The Respiratory Tract

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Book cover Comparative Interpretation of CT and Standard Radiography of the Chest

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Abstract

Airways may be affected by a variety of diseases. Diseases of the large airways can result from abnormalities of the wall (intrinsic abnormalities) or from compression from adjacent structures (extrinsic abnormalities). Intrinsic abnormalities are classified as either focal or diffuse, depending on the extent of involvement of the airways. The diffuse abnormalities are less common and usually benign, most of the time caused by autoimmune illnesses or multisystem disorders. Focal abnormalities include tumors, infections, granulomatous diseases, and iatrogenic disorders. Focal disease tends to produce decreased airway diameter. The diffuse diseases may be divided into those that increase the diameter and those that decrease the diameter of the airway. Plain chest radiography remains a convenient first-line investigation for any patient who presents with respiratory symptoms and signs. The air within the trachea and main bronchi gives good, inherent radiographic contrast. Well-penetrated films may demonstrate tracheobronchial pathology: however, abnormalities of the major airways can easily be missed on radiographs. Computed Tomography (CT) has been shown to be superior to conventional radiography in the detection of abnormalities of the airways. The axial CT images are primarily used for diagnostic purposes. Two-dimensional and three-dimensional reformatted images offer a number of advantages, such as a better assessment of the craniocaudal extent of disease and the ability to detect subtle airway stenoses.

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References

  • Al-Mubarak HF, Husain SA. Tracheobronchomegaly-Mounier-Kuhn syndrome. Saudi Med J. 2004;25(6):798–801

    PubMed  Google Scholar 

  • Bachman AL, Teixidor HS. The posterior tracheal band: a reflector of local superior mediastinal abnormality. Br J Radiol. 1975;48(569):352–359

    Article  PubMed  CAS  Google Scholar 

  • Barker AF. Bronchiectasis. N Engl J Med. 2002;346(18):1383–1393

    Article  PubMed  Google Scholar 

  • Baumgartner WA, Mark JB. Metastatic malignancies from distant sites to the tracheobronchial tree. J Thorac Cardiovasc Surg. 1980;79(4):499–503

    PubMed  CAS  Google Scholar 

  • Boiselle PM. Multislice helical CT of the central airways. Radiol Clin North Am. 2003;41(3):561–574

    Article  PubMed  Google Scholar 

  • Boyden EA. The nomenclature of the bronchopulmonary segments and their blood supply. Dis Chest. 1961;39:1–6

    Article  Google Scholar 

  • Braman SS, Whitcomb ME. Endobronchial metastasis. Arch Intern Med. 1975;135(4):543–547

    Article  PubMed  CAS  Google Scholar 

  • Breatnach E, Abbott GC, Fraser RG. Dimensions of the normal human trachea. AJR Am J Roentgenol. 1984;142(5):903–906

    PubMed  CAS  Google Scholar 

  • Brock R. The anatomy of the bronchial tree. London: Oxford University Press; 1946

    Google Scholar 

  • Callan E, Karandy EJ, Hilsinger Jr RL. “Saber-sheath” trachea. Ann Otol Rhinol Laryngol. 1988;97(5 Pt 1):512–515

    PubMed  CAS  Google Scholar 

  • Colletti PM, Beck S, Boswell Jr WD, Radin DR, Yamauchi DM, Ralls PW, Balchum OJ. Computed tomography in endobronchial neoplasm’s. Comput Med Imaging Graph. 1990;14(4):257–262

    Article  PubMed  CAS  Google Scholar 

  • Currie DC, Cooke JC, Morgan AD, Kerr IH, Delany D, Strickland B, Cole PJ. Interpretation of bronchograms and chest radiographs in patients with chronic sputum production. Thorax. 1987;42(4):278–284

    Article  PubMed  CAS  Google Scholar 

  • Daum TE, Specks U, Colby TV, Edell ES, Brutinel MW, Prakash UB, DeRemee RA. Tracheobronchial involvement in Wegener’s granulomatosis. Am J Respir Crit Care Med. 1995;151(2 Pt 1):522–526

    PubMed  CAS  Google Scholar 

  • Dennie CJ, Coblentz CL. The trachea: normal anatomic features, imaging and causes of displacement. Can Assoc Radiol J. 1993;44(2):81–89

    PubMed  CAS  Google Scholar 

  • Doolittle AM, Mair EA. Tracheal bronchus: classification, endoscopic analysis, and airway management. Otolaryngol Head Neck Surg. 2002;126(3):240–243

    Article  PubMed  Google Scholar 

  • Fraser C, Müller, Paré (1999) Synopsis of diseases of the chest. 3rd edn

    Google Scholar 

  • Fraser RG, Fraser RS, Renner JW, Bernard C, Fitzgerald PJ. The roentgenologic diagnosis of chronic bronchitis: a reassessment with emphasis on parahilar bronchi seen end-on. Radiology. 1976;120(1):1–9

    PubMed  CAS  Google Scholar 

  • Freundlich IM, Libshitz HI, Glassman LM, Israel HL. Sarcoidosis. Typical and atypical thoracic manifestations and complications. Clin Radiol. 1970;21(4):376–383

    Article  PubMed  CAS  Google Scholar 

  • Gamsu G, Webb WR. Computed tomography of the trachea: normal and abnormal. AJR Am J Roentgenol. 1982;139(2):321–326

    PubMed  CAS  Google Scholar 

  • Ghaye B, Szapiro D, Fanchamps JM, Dondelinger RF. Congenital bronchial abnormalities revisited. Radiographics. 2001;21(1):105–119

    PubMed  CAS  Google Scholar 

  • Gruden JF, Webb WR, Sides DM. Adult-onset disseminated tracheobronchial papillomatosis: CT features. J Comput Assist Tomogr. 1994;18(4):640–642

    Article  PubMed  CAS  Google Scholar 

  • Hamper UM, Fishman EK, Khouri NF, Johns CJ, Wang KP, Siegelman SS. Typical and atypical CT manifestations of pulmonary sarcoidosis. J Comput Assist Tomogr. 1986;10(6):928–936

    Article  PubMed  CAS  Google Scholar 

  • Hansell DM. Bronchiectasis. Radiol Clin North Am. 1998;36(1):107–128

    Article  PubMed  CAS  Google Scholar 

  • Haskin PH, Goodman LR. Normal tracheal bifurcation angle: a reassessment. AJR Am J Roentgenol. 1982;139(5):879–882

    PubMed  CAS  Google Scholar 

  • Horsfield K, Cumming G. Morphology of the bronchial tree in man. J Appl Physiol. 1968;24(3):373–383

    PubMed  CAS  Google Scholar 

  • Im JG, Chung JW, Han SK, Han MC, Kim CW. CT manifestations of tracheobronchial involvement in relapsing polychondritis. J Comput Assist Tomogr. 1988;12(5):792–793

    Article  PubMed  CAS  Google Scholar 

  • Jackson CL, Huber JF. Correlated applied anatomy of the bronchial tree and lungs with a system of nomenclature. Dis Chest. 1943;9:319–326

    Article  Google Scholar 

  • Karabulut N. CT assessment of tracheal carinal angle and its determinants. Br J Radiol. 2005;78(933):787–790

    Article  PubMed  CAS  Google Scholar 

  • Kim SJ, Im JG, Kim IO, Cho ST, Cha SH, Park KS, Kim DY. Normal bronchial and pulmonary arterial diameters measured by thin section CT. J Comput Assist Tomogr. 1995;19(3):365–369

    Article  PubMed  CAS  Google Scholar 

  • Kim JS, Muller NL, Park CS, Lynch DA, Newman LS, Grenier P, Herold CJ. Bronchoarterial ratio on thin section CT: comparison between high altitude and sea level. J Comput Assist Tomogr. 1997a;21(2):306–311

    Article  PubMed  CAS  Google Scholar 

  • Kim JS, Muller NL, Park CS, Grenier P, Herold CJ. Cylindrical bronchiectasis: diagnostic findings on thin-section CT. AJR Am J Roentgenol. 1997b;168(3):751–754

    PubMed  CAS  Google Scholar 

  • Kim HY, Im JG, Song KS, Lee KS, Kim SJ, Kim JS, Lee JS, Lim TH. Localized amyloidosis of the respiratory system: CT features. J Comput Assist Tomogr. 1999;23(4):627–631

    Article  PubMed  CAS  Google Scholar 

  • Kiryu T, Hoshi H, Matsui E, Iwata H, Kokubo M, Shimokawa K, Kawaguchi S. Endotracheal/endobronchial metastases: clinicopathologic study with special reference to developmental modes. Chest. 2001;119(3):768–775

    Article  PubMed  CAS  Google Scholar 

  • Kubik S, Muntener M. Bronchus abnormalities: tracheal, eparterial, and pre-eparterial bronchi. Fortschr Geb Röntgenstr Nuklearmed. 1971;114(2):145–163

    Article  PubMed  CAS  Google Scholar 

  • Kwong JS, Muller NL, Miller RR. Diseases of the trachea and main-stem bronchi: correlation of CT with pathologic findings. Radiographics. 1992;12(4):645–657

    PubMed  CAS  Google Scholar 

  • Lee KS, Bae WK, Lee BH, Kim IY, Choi EW. Bronchovascular anatomy of the upper lobes: evaluation with thin-section CT. Radiology. 1991;181(3):765–772

    PubMed  CAS  Google Scholar 

  • Manning JE, Goldin JG, Shpiner RB, Aberle DR. Case report: tracheobronchopathia osteochondroplastica. Clin Radiol. 1998;53(4):302–309

    Article  PubMed  CAS  Google Scholar 

  • Marom EM, Goodman PC, McAdams HP. Diffuse abnormalities of the trachea and main bronchi. AJR Am J Roentgenol. 2001;176(3):713–717

    PubMed  CAS  Google Scholar 

  • Mata JM, Caceres J. The dysmorphic lung: imaging findings. Eur Radiol. 1996;6(4):403–414

    Article  PubMed  CAS  Google Scholar 

  • Matsuoka S, Uchiyama K, Shima H, Ueno N, Oish S, Nojiri Y. Bronchoarterial ratio and bronchial wall thickness on high-resolution CT in asymptomatic subjects: correlation with age and smoking. AJR Am J Roentgenol. 2003;180(2):513–518

    PubMed  Google Scholar 

  • Meyer CA, White CS. Cartilaginous disorders of the chest. Radiographics. 1998;18(5):1109–1123. quiz 1241-1102

    PubMed  CAS  Google Scholar 

  • Meyer CN, Dossing M, Broholm H. Tracheobronchopathia osteochondroplastica. Respir Med. 1997;91(8):499–502

    Article  PubMed  CAS  Google Scholar 

  • Michet Jr CJ, McKenna CH, Luthra HS, O’Fallon WM. Relapsing polychondritis. Survival and predictive role of early disease manifestations. Ann Intern Med. 1986;104(1):74–78

    PubMed  Google Scholar 

  • Miller BH, Rosado-de-Christenson ML, McAdams HP, Fishback NF. Thoracic sarcoidosis: radiologic-pathologic correlation. Radiographics. 1995;15(2):421–437

    PubMed  CAS  Google Scholar 

  • Naidich DP, McCauley DI, Khouri NF, Stitik FP, Siegelman SS. Computed tomography of bronchiectasis. J Comput Assist Tomogr. 1982;6(3):437–444

    Article  PubMed  CAS  Google Scholar 

  • Naidich DP, Zinn WL, Ettenger NA, McCauley DI, Garay SM. Basilar segmental bronchi: thin-section CT evaluation. Radiology. 1988;169(1):11–16

    PubMed  CAS  Google Scholar 

  • Ouellette H. The signet ring sign. Radiology. 1999;212(1):67–68

    PubMed  CAS  Google Scholar 

  • Prince JS, Duhamel DR, Levin DL, Harrell JH, Friedman PJ (2002) Nonneoplastic lesions of the tracheobronchial wall: radiologic findings with bronchoscopic correlation. Radiographics 22(Spec No):S215–S230

    Google Scholar 

  • Reiff DB, Wells AU, Carr DH, Cole PJ, Hansell DM. CT findings in bronchiectasis: limited value in distinguishing between idiopathic and specific types. AJR Am J Roentgenol. 1995;165(2):261–267

    PubMed  CAS  Google Scholar 

  • Ritsema GH. Ectopic right bronchus: indication for bronchography. AJR Am J Roentgenol. 1983;140(4):671–674

    PubMed  CAS  Google Scholar 

  • Savoca CJ, Austin JH, Goldberg HI. The right paratracheal stripe. Radiology. 1977;122(2):295–301

    PubMed  CAS  Google Scholar 

  • Screaton NJ, Sivasothy P, Flower CD, Lockwood CM. Tracheal involvement in Wegener’s granulomatosis: evaluation using spiral CT. Clin Radiol. 1998;53(11):809–815

    Article  PubMed  CAS  Google Scholar 

  • Staats BA, Utz JP, Michet Jr CJ. Relapsing polychondritis. Semin Respir Crit Care Med. 2002;23(2):145–154

    Article  PubMed  Google Scholar 

  • Stark P. Radiology of the trachea. Stuttgart: Thieme; 1991. p. 54–78

    Google Scholar 

  • Stark P. Imaging of tracheobronchial injuries. J Thorac Imaging. 1995;10(3):206–219

    Article  PubMed  CAS  Google Scholar 

  • Stark P, Norbash A. Imaging of the trachea and upper airways in patients with chronic obstructive airway disease. Radiol Clin North Am. 1998;36(1):91–105

    Article  PubMed  CAS  Google Scholar 

  • Stauffer JL, Olson DE, Petty TL. Complications and consequences of endotracheal intubation and tracheotomy. A prospective study of 150 critically ill adult patients. Am J Med. 1981;70(1):65–76

    Article  PubMed  CAS  Google Scholar 

  • Stern EJ, Graham CM, Webb WR, Gamsu G. Normal trachea during forced expiration: dynamic CT measurements. Radiology. 1993;187(1):27–31

    PubMed  CAS  Google Scholar 

  • Stone T, Reynolds JH, Williams HJ. Imaging of large and small airway diseases. Imaging. 2006;18:139–150

    Article  Google Scholar 

  • Takasugi JE, Godwin JD. Radiology of chronic obstructive pulmonary disease. Radiol Clin North Am. 1998;36(1):29–55

    Article  PubMed  CAS  Google Scholar 

  • Webb WR. Radiology of obstructive pulmonary disease. AJR Am J Roentgenol. 1997;169(3):637–647

    PubMed  CAS  Google Scholar 

  • Webb WR, Stein MG, Finkbeiner WE, Im JG, Lynch D, Gamsu G. Normal and diseased isolated lungs: high-resolution CT. Radiology. 1988;166(1 Pt 1):81–87

    PubMed  CAS  Google Scholar 

  • Woodring JH. Improved plain film criteria for the diagnosis of bronchiectasis. J Ky Med Assoc. 1994;92(1):8–13

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium

    Walter De Wever

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  1. Walter De Wever
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Correspondence to Walter De Wever .

Editor information

Editors and Affiliations

  1. Clinique Saint Luc, Dept. Radiology, Université Catholique Louvain, avenue Hippocrate 10, Bruxelles, 1200, Belgium

    Emmanuel E. Coche

  2. Service Imagerie Médicale, CHU de Liège, Liège, 4000, Belgium

    Benoit Ghaye

  3. Academisch Ziekenhuis, Afd. Radiologie, Vrije Universiteit Brussel, Laarbeeklaan 101, Bruxelles, 1090, Belgium

    Johan de Mey

  4. Academisch Ziekenhuis, Afd. Radiologie, Universiteit Gent, De Pintelaan 185, Gent, 9000, Belgium

    Philippe Duyck

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De Wever, W. (2011). The Respiratory Tract. In: Coche, E., Ghaye, B., de Mey, J., Duyck, P. (eds) Comparative Interpretation of CT and Standard Radiography of the Chest. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-79942-9_10

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  • DOI: https://doi.org/10.1007/978-3-540-79942-9_10

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