INTRODUCTION

Multidetector computed tomography (MDCT) has emerged as the primary imaging modality for the assessment of the central airways. Current generation MDCT scanners can provide high-spatial-resolution images of the entire central airways in just a matter of seconds, and exceptional quality two-dimensional (2D) multiplanar and three-dimensional (3D) reformation images can be generated simply in a few minutes. MDCT imaging is particularly useful for the evaluation of airway stenoses, endobronchial neoplasms, and complex congenital airway disorders. In addition to providing exquisite anatomic detail of the tracheobronchial tree, the use of dynamic expiratory MDCT imaging can provide important functional information about the airways, including the diagnosis of tracheobronchomalacia. Furthermore, MDCT has become a pivotal imaging tool for the bronchoscopist both preprocedurally, by helping to plan and guide bronchoscopic procedures, and postprocedurally, by providing a noninvasive imaging method for follow-up after interventions.

MULTIDETECTOR COMPUTED TOMOGRAPHY IMAGING: AXIAL, 2D MULTIPLANAR, AND 3D RECONSTRUCTION IMAGES

MDCT-acquired, high-spatial-resolution axial images provide exquisitely detailed anatomic and pathologic information about the airways. The precise size and shape of the airway lumen (Figure 2.1), as well as the presence and distribution of airway wall thickening and/or calcification, can be clearly illustrated (Figure 2.2). Conventional axial images also help to define the relationship of the airways to adjacent structures and extraluminal abnormalities not visible on bronchoscopy.