Calle Toro Juan,  Ali Krim Ahmed,  Venkatakrishna Shyam Sunder,  Bester Dewald,  Lucas Susan,  Goussard Pierre,  Andronikou Savvas

Final Pr. ID: Poster #: SCI-038

Lymphobronchial TB (LBTB) in children refers to airway narrowing by tuberculous lymphadenopathy. Diagnosis is made invasively using flexible bronchoscopy or noninvasively with CT, which can include minimum intensity projection (MinIP) reconstructions.

Our aim was to generate standardized coronal minimum intensity projection CT reconstructions and compare these with flexible bronchoscopy in children with LBTB. Read More

Authors:  Calle Toro Juan , Ali Krim Ahmed , Venkatakrishna Shyam Sunder , Bester Dewald , Lucas Susan , Goussard Pierre , Andronikou Savvas

Keywords:  Trachea, CT, Lymphobronchial TB

Tupprasoot Raksa,  Langan Dean,  Sury Mike,  Arthurs Owen

Final Pr. ID: Poster #: SCI-001

Endotracheal or nasotracheal intubation can be difficult in preterm infants in an intensive care environment, with a high rate of endobronchial tube placement. We measured tracheal length and diameter in a population of post mortem fetuses to define the relationship between gestational age or body weight and tracheal size, in order to see whether this could help future tube selection or correct placement. Read More

Authors:  Tupprasoot Raksa , Langan Dean , Sury Mike , Arthurs Owen

Keywords:  Trachea, perinatal, intubation, MRI

Averill Lauren,  Tomatsu Shunji,  Theroux Mary

Final Pr. ID: Poster #: CR-044

Morquio A syndrome is an autosomal recessive lysosomal storage disorder characterized by skeletal dysplasia and progressive disability due to orthopedic complications, spinal cord compression and airway compromise. Although the bony changes and cervical spine instability have been well described in the radiology literature, the importance of imaging the airway in these patients has received scant attention. The purpose of this poster is to illustrate the progressive abnormality of the thoracic inlet and trachea seen in children and young adults with Morquio A syndrome.
The interplay of pectus carinatum, hypertrophied clavicular heads and upper thoracic kyphosis leads to bony narrowing of the thoracic inlet. Furthermore, glycosaminoglycan deposition degrades the structural integrity of the tracheal wall, creating a twisted and floppy airway. Additional crowding by a crossing tortuous right brachiocephalic artery and sometimes the thyroid gland contribute to progressive narrowing of the trachea at the thoracic inlet. Imbalance of growth between the skeleton and the airway and blood vessels may also play a role.
We present a series of patients with Morqiuo A syndrome, with multimodality imaging depicting the complex anatomy of the thoracic inlet contributing to airway compromise. Radiographs of the neck, chest or spine can suggest airway narrowing with a tilted hourglass shape of the trachea seen in the frontal projection; lateral views, though, are often limited. MRI of the cervical spine, frequently acquired to evaluate the craniocervical junction, also allows for assessment of the thoracic inlet including the trachea and crossing right brachiocephalic artery. CT angiogram of the chest can more clearly delineate vascular, bony and airway relationships in individuals with declining respiratory function or unexpected airway difficulty during anesthetic management. Three dimensional rendering and airway fly-through techniques may help guide anesthetic care and, in extreme cases, airway reconstruction. The imaging features of the thoracic inlet in this group of Morquio A patients are correlated with clinical phenotype, pulmonary function tests, and bronchoscopy when available. Read More

Authors:  Averill Lauren , Tomatsu Shunji , Theroux Mary

Keywords:  trachea, skeletal dysplasia, brachiocephalic artery

Das Prasnjeet,  Thomen Robert,  Halula Sarah,  Woods Jason,  Fleck Robert

Final Pr. ID: Poster #: SCI-082

CT is often performed and advocated in patients with risk factors for or symptoms of tracheomalacia (TM). However, TM is traditionally defined as a 50% decrease in the cross-sectional area of the airway during a forced expiratory maneuver. This basis for detecting TBM was never meant for use in CT and leads to the under diagnosis of TM in young children by CT and typically requires inspiratory/expiratory CT (IECT). Additionally, some pictures archiving systems do not have tools to measure area. The aim of this investigation is to show that TM is under diagnosed by IECT relative to bronchoscopy and to develop a “view box” parameter to improve sensitivity while maintaining specificity in identifying the trachea as normal or affected by TM.
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Authors:  Das Prasnjeet , Thomen Robert , Halula Sarah , Woods Jason , Fleck Robert

Keywords:  Bronchoscopy, trachea, bronchomalacia, airway, dynamic CT