Chest ImagingTracheal stenosis
may result from
focal disease or
diffuse diseases. The causes of tracheal
stenosis are listed in the Table 1. A number of these diseases may also affect the main stem and central bronchi.
Tracheal stenosis, Table 1. Causes of tracheal stenosis.
Patients may be asymptomatic or may present with nonspecific symptoms such a cough, dyspnoea, wheezing and stridor. The clinical course is often long term, and misdiagnosis of bronchial asthma is common. Posteroanterior and lateral radiographs that use high kilovoltage technique and proper penetration of the mediastinum provide good tracheal visualization and reveal lesions large enough to create symptoms. Tomograms are extremely sensitive in displaying tracheal tumours, but have largely been replaced by CT which demonstrates the location and extent of disease (Fig.1, Fig.2), helps characterize abnormal tissues and evaluate the thickness of the tracheal walls, and helps determine the extent of extraluminal component of the tumour (tracheal neoplasm (V:1), Fig. 1), (adenoid cystic carcinoma, pulmonary (V:1), Fig. 1).
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Sagittal (a) and coronal curvilinear (b) reformatted images of the trachea from helical CT scanning data show parietal nodulation and short coronal narrowing of the tracheal lumen. These abnormalities reflect granulomatous lesions and inflammatory stenosis occurring after longstanding tracheal intubation.
(From Grenier P., Imagerie Thoracique de lAdulte. Flammarion, Paris, France, 1996, with permission.)
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Tracheal stenosis, Fig.1 (b) | | Tracheal stenosis, Fig.2 (a) | | Tracheal stenosis, Fig.2 (b) |