The application value of spiral CT postprocessing technique in airway stenting technique_West China Medical Journal

Authors：

 CHEN Weiyong ¹ , YU Qin ²

1. Department of Respiratory Medicine, the Seventh People’s Hospital of Chengdu, Chengdu, Sichuan 610041, P. R. China;
2. Department of Radiology, the Seventh People’s Hospital of Chengdu, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

CHEN Weiyong, Email: hospital7chen@sina.cn

Keywords：

Spiral CT technique; Postprocessing technique; Malignant airway stenosis; Tracheoesophageal fistula; Airway stenting; Application value

DOI：

10.7507/1002-0179.201607111

Video：

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Objective To investigate the application value of spiral CT postprocessing technique in the airway stent implantation technology. Methods Twenty-three patients with malignant airway stenosis or malignant tracheoesophageal fistula who needed the treatment of airway stent implantation from May 2012 to April 2016 were collected, including 19 males and 4 females with an average age of (61.6±10.0) years. Bronchoscopy and spiral CT with three-dimensional airway reconstruction were proceeded for the same patients before and after stent implantation, and the relevant data about narrow airway was measured by volume rendering, multiplanar reformation (MPR) and CT virtual endoscopy (CTVE) in a variety of ways, to confirm the location and size of narrow airway and fistulas, the degree and length of airway stenosis, as well as the distal end of the situation, and evaluate the patency of airway, the position and shape of stents, adjacent airway and complications after stenting. The positive forecast outcomes of the two inspections wascompared. Results Airway stents were placed successfully according to the data from the spiral CT airway three-dimensional reconstruction. Thirty stents were implantated in the 23 patients, including 21 column-type stents, 3 L-type stents, and 6 Y-type stents. All stents stayed in situ, with patency and no deformation.The fistulas were closed and the airways were reopened. Symptoms of cough after eating and drinking and dyspnea were relieved. The positive rates of bronchoscopy and CT examination on diagnosis of airway stenosis were both 100% (23/23). Complications: MRP showed tumor growth leading to stenosis again in 3 patients, and CTVE displayed mucous congestion in 2 patients. Conclusions The technique of 64-layer spiral CT postprocessing technique can measure the relate data of airway stricture or fistulas as a kind of convenient, quick, accurate, and noninvasive method in patients with malignant airway stenosis or tracheoesophageal fistula who need the treatment of airway stenting. It is of high reference value both to airway stent implanting and postoperative observation, and is worthy of application.

Citation： CHEN Weiyong, YU Qin. The application value of spiral CT postprocessing technique in airway stenting technique. West China Medical Journal, 2017, 32(8): 1233-1237. doi: 10.7507/1002-0179.201607111 Copy

1.	Yue J, Chen J, Dou W, et al. Comparative analysis between 64-and 320-slice spiral computed tomography in the display of coronary artery stents and diagnosis of in-stent restenosis. Exp Ther Med, 2015, 10(5): 1871-1876.
2.	Lee JW, Kim CW, Lee HC, et al. High-definition computed tomography for coronary artery stents: image quality and radiation doses for low voltage (100 kVp) and standard voltage (120 kVp) ECG-triggered scanning. Int J Cardiovasc Imaging, 2015, 31(Suppl 1): 39-49.
3.	Ito T, Tsuchikane E, Nasu K, et al. Impact of lesion morphology on angiographic and clinical outcomes in patients with chronic total occlusion after recanalization with drug-eluting stents: a multislice computed tomography study. Eur Radiol, 2015, 25(10): 3084-3092.
4.	Nagahama T, Ami K, Nakamura M, et al. Four cases of airway obstruction successfully treated by airway stenting. Gan To Kagaku Ryoho, 2012, 39(12): 1852-1854.
5.	Gompelmann D, Eberhardt R, Schuhmann M, et al. Self-expanding Y stents in the treatment of central airway stenosis: a retrospective analysis. Ther Adv Respir Dis, 2013, 7(5): 255-263.
6.	Schweigert M, Posada-González M, Dubecz A, et al. Recurrent oesophageal cancer complicated by tracheo-oesophageal fistula: improved palliation by means of parallel tracheal and oesophageal stenting. Interact Cardiovasc Thorac Surg, 2014, 18(2): 190-196.
7.	宋雙成. 分析氣道支架置入術前 64 排 CT 三維氣道成像的應用價值. 中國醫藥指南, 2014, 25(35): 161-162.
8.	Murayama H, Watanabe T, Yasuda K, et al. Evaluation of airway obstruction compressed by thoracic great vessels or their branches using multi-slice helical computed tomography. Kyobu Geka, 2009, 62(7): 527-534.
9.	魏寧, 祖茂衡, 徐浩, 等. 氣管切開插管后狹窄的螺旋 CT 診斷和氣管覆膜支架置入術的應用探討. 中華臨床醫師雜志: 電子版, 2011, 5(12): 3645-3647.
10.	陶兆武, 趙蘇. 64 排螺旋 CT 在氣管支架置入術中的應用. 中國現代醫學雜志, 2011, 21(4): 494-496.
11.	趙慶, 金艷, 秦春堂. 氣道支架置入術前 64 排 CT 三維氣道成像的應用價值. 中國實用醫藥, 2014, 16(5): 60-61.
12.	俞琴, 陳維永, 冉隆富, 等. 64 排 CT 在氣道支架置入術治療惡性食管呼吸道瘺中的臨床應用. 臨床放射學雜志, 2016, 35(1): 147-150.
13.	Andreini D, Pontone G, Mushtaq S, et al. Diagnostic accuracy of multidetector computed tomography coronary angiography in 325 consecutive patients referred for transcatheter aortic valve replacement. Am Heart J, 2014, 168(3): 332-339.
14.	D’alfonso MG, Mattesini A, Meucci F, et al. Prospectively electrocardiogram-triggered high-pitch spiral acquisition coronary computed tomography angiography for assessment of biodegradable vascular scaffold expansion: comparison with optical coherence tomography. Cardiovasc Revasc Med, 2014, 15(8): 436-438.
15.	Yoshimura M, Nao T, Miura T, et al. New quantitative method to diagnose coronary in-stent restenosis by 64-multislice computed tomography. J Cardiol, 2015, 65(1): 57-62.
16.	李培文, 李宗明, 韓新巍, 等. 覆膜 Y 型單子彈頭氣道支架治療左主支氣管胸膜瘺 12 例. 介入放射學雜志, 2014, 23(11): 1000-1004.
17.	Romaguera R, Roura G, Gomez-Lara J, et al. Longitudinal deformation of drug-eluting stents: evaluation by multislice computed tomography. J Invasive Cardiol, 2014, 26(4): 161-166.

1. Yue J, Chen J, Dou W, et al. Comparative analysis between 64-and 320-slice spiral computed tomography in the display of coronary artery stents and diagnosis of in-stent restenosis. Exp Ther Med, 2015, 10(5): 1871-1876.
2. Lee JW, Kim CW, Lee HC, et al. High-definition computed tomography for coronary artery stents: image quality and radiation doses for low voltage (100 kVp) and standard voltage (120 kVp) ECG-triggered scanning. Int J Cardiovasc Imaging, 2015, 31(Suppl 1): 39-49.
3. Ito T, Tsuchikane E, Nasu K, et al. Impact of lesion morphology on angiographic and clinical outcomes in patients with chronic total occlusion after recanalization with drug-eluting stents: a multislice computed tomography study. Eur Radiol, 2015, 25(10): 3084-3092.
4. Nagahama T, Ami K, Nakamura M, et al. Four cases of airway obstruction successfully treated by airway stenting. Gan To Kagaku Ryoho, 2012, 39(12): 1852-1854.
5. Gompelmann D, Eberhardt R, Schuhmann M, et al. Self-expanding Y stents in the treatment of central airway stenosis: a retrospective analysis. Ther Adv Respir Dis, 2013, 7(5): 255-263.
6. Schweigert M, Posada-González M, Dubecz A, et al. Recurrent oesophageal cancer complicated by tracheo-oesophageal fistula: improved palliation by means of parallel tracheal and oesophageal stenting. Interact Cardiovasc Thorac Surg, 2014, 18(2): 190-196.
7. 宋雙成. 分析氣道支架置入術前 64 排 CT 三維氣道成像的應用價值. 中國醫藥指南, 2014, 25(35): 161-162.
8. Murayama H, Watanabe T, Yasuda K, et al. Evaluation of airway obstruction compressed by thoracic great vessels or their branches using multi-slice helical computed tomography. Kyobu Geka, 2009, 62(7): 527-534.
9. 魏寧, 祖茂衡, 徐浩, 等. 氣管切開插管后狹窄的螺旋 CT 診斷和氣管覆膜支架置入術的應用探討. 中華臨床醫師雜志: 電子版, 2011, 5(12): 3645-3647.
10. 陶兆武, 趙蘇. 64 排螺旋 CT 在氣管支架置入術中的應用. 中國現代醫學雜志, 2011, 21(4): 494-496.
11. 趙慶, 金艷, 秦春堂. 氣道支架置入術前 64 排 CT 三維氣道成像的應用價值. 中國實用醫藥, 2014, 16(5): 60-61.
12. 俞琴, 陳維永, 冉隆富, 等. 64 排 CT 在氣道支架置入術治療惡性食管呼吸道瘺中的臨床應用. 臨床放射學雜志, 2016, 35(1): 147-150.
13. Andreini D, Pontone G, Mushtaq S, et al. Diagnostic accuracy of multidetector computed tomography coronary angiography in 325 consecutive patients referred for transcatheter aortic valve replacement. Am Heart J, 2014, 168(3): 332-339.
14. D’alfonso MG, Mattesini A, Meucci F, et al. Prospectively electrocardiogram-triggered high-pitch spiral acquisition coronary computed tomography angiography for assessment of biodegradable vascular scaffold expansion: comparison with optical coherence tomography. Cardiovasc Revasc Med, 2014, 15(8): 436-438.
15. Yoshimura M, Nao T, Miura T, et al. New quantitative method to diagnose coronary in-stent restenosis by 64-multislice computed tomography. J Cardiol, 2015, 65(1): 57-62.
16. 李培文, 李宗明, 韓新巍, 等. 覆膜 Y 型單子彈頭氣道支架治療左主支氣管胸膜瘺 12 例. 介入放射學雜志, 2014, 23(11): 1000-1004.
17. Romaguera R, Roura G, Gomez-Lara J, et al. Longitudinal deformation of drug-eluting stents: evaluation by multislice computed tomography. J Invasive Cardiol, 2014, 26(4): 161-166.

West China Medical Journal

The application value of spiral CT postprocessing technique in airway stenting technique

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