Journal List > J Korean Soc Radiol > v.62(2) > 1086708

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Jou, Kim, Bae, Kim, Kim, and Han: Evaluation of Tracheal and Main Bronchial Diverticula Using Thin-Section MDCT
Chest Radiology
Original Article

Journal of the Korean Society of Radiology 2010; 62(2): 123-130.

Published online: 28 February 2010

DOI: https://doi.org/10.3348/jksr.2010.62.2.123

Evaluation of Tracheal and Main Bronchial Diverticula Using Thin-Section MDCT

Sung Shick Jou, M.D., Young Tong Kim, M.D., Won Kyung Bae, M.D., Il Yung Kim, M.D., Hyung Hwan Kim, M.D., Jong Kyu Han, M.D.

1Department of Radiology, Soonchunhyang University Cheonan Hospital, Korea.

Address reprint requests to: Young Tong Kim, M.D., Department of Radiology, Soonchunhyung University, Cheonan Hospital 23-20 Bongmyung-dong, Cheonan 330-721, Korea. Tel. 82-41-570-3515, Fax. 82-41-579-9026, ytokim@schca.ac.kr

Received 18 February 2009       Accepted 17 August 2009

Copyright © 2010 The Korean Society of Radiology

Abstract

Purpose

To evaluate the characteristics of tracheal and main bronchial diverticula in relation with emphysema.

Materials and Methods

A total of 967 CT images were reconstructed with 1.25 mm axial images over 2 months. The incidence, size, number, and location of the tracheal and main bronchial diverticula were analyzed using 3D medical software (Seoul, Korea). The incidence of emphysema and the relationship between emphysema and the size of the diverticula were analyzed.

Results

In total, 50 patients (5.1%) showed tracheal diverticula in the right posterolateral wall. In addition, 51 patients (5.2%) showed 89 (9.4%) main bronchial diverticula in the inferior wall, while 68 (72%) showed diverticula in the left posterolateral wall. Tracheal diverticula (6.4 ± 5.0 mm, 1.0 ± 0.2) were larger and fewer than the main bronchial diverticula (2.1 ± 2.0 mm, 1.8 ± 1.6) (p<0.05). Moreover, tracheal diverticula (10.3 ± 7.4 mm) with emphysema in 13 patients (26%), were larger than those without emphysema (5.1 ± 3.0 mm) (p<0.05).

Conclusion

On thin-section MDCT, the rates of incidence for tracheal and main bronchial diverticula are about 5%, respectively. Tracheal diverticula in the right posterolateral wall are smaller and fewer than the main bronchial diverticula, which are located primarily in the inferior wall of the left bronchus. Tracheal diverticula with emphysema are larger than those without emphysema.

Keywords: Diverticulum, Trachea, Bronchi, Tomography, X-Ray Computed

Figures and Tables

Fig. 1

60-year-old man with tracheal diverticula and pneumonia.

A. 1.25 mm axial CT scan shows lobulated right paratracheal air cyst (arrow) in posterolateral aspect of trachea.
B. Coronal reformatted image shows multilobulated air cyst (arrows) in the thoracic inlet.
C. 3D CT bronchography shows multilobulated air cyst (arrowhead) and tubular air cyst (arrow).
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Fig. 2

29-year-old man with main bronchial diverticula.

A. 1.25 mm axial scan shows small air cyst (arrow) bulging medial side of left main bronchus.
B. 3D volume-rendered image shows two tiny bugling air cysts (arrow) in inferior wall of left main bronchus.
C. Virtual bronchoscopy image shows two holes (arrow) in left main bronchus.
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Fig. 3

64-year-old man with left main bronchial diverticula and SPN.

A. 5 mm thickness axial scan shows left main bronchial diverticulum (arrow).
B. In 8 months ago, same size of left main bronchial diverticulum (arrow) is seen on 5 mm thickness axial scan.
jksr-62-123-g003
Fig. 4

52-year-old man with multiple main bronchial diverticula and lung cancer.

A. 1.25 mm axial image shows irregular air cyst (arrow) in left main bronchus.
B. Virtual bronchoscopy shows multiple holes (arrows) in both main bronchi.
C. Photograph of bronchoscopy shows multiple holes (arrows) in both main bronchi.
jksr-62-123-g004
Table 1

Tracheal & Main Bronchial Diverticula according to the Age

jksr-62-123-i001
Table 2

Size and Number of Tracheal and Main Bronchial Diverticula

jksr-62-123-i002
Table 3

Underlying Pulmonary Diseases

jksr-62-123-i003

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