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Chest Imaging

Sabre-sheath trachea

narrowing of the coronal diameter of the intrathoracic portion of the trachea (Fig.1). In this condition, the tracheal index (the ratio of the coronal to the sagittal diameter), as measured 1 cm above the aortic arch) is less than 0.67. By contrast, the coronal diameter of the trachea measured above the thoracic inlet is normal. Sabre-sheath trachea is a radiographic finding that is highly suggestive of chronic obstructive pulmonary disease. It can be the only radiographic finding of chronic obstructive pulmonary disease (COPD) depictable on the chest radiograph in patients with chronic bronchitis. The deformity of the trachea is fixed and rigid and the tracheal rings can be densely ossified.

PG

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Fig.1

PA chest radiograph in a patient with COPD showing a sabre-sheath trachea. (From Grenier P., Imagerie Thoracique de lAdulte. Flammarion, Paris, France, 1996, with permission.)
Sabre-sheath trachea, Fig.1