Multidetector CT Evaluation of Airway Stents: What the Radiologist Should Know

Abstract

Airway stents are increasingly used to treat symptomatic patients with obstructive tracheobronchial diseases who are not amenable to surgical resection or who have poor performance status, precluding them from resection. The most common conditions that are treated with tracheobronchial stents are primary lung cancer and metastatic disease. However, stents have also been used to treat patients with airway stenosis related to a variety of benign conditions, such as tracheobronchomalacia, relapsing polychondritis, postintubation tracheal stenosis, postoperative anastomotic stenosis, and granulomatous diseases. Additionally, airway stents can be used as a barrier method in the management of esophagorespiratory fistulas. Many types of stents are available from different manufacturers. Principally, they are classified as silicone; covered and uncovered metal; or hybrid, which are made of silicone and reinforced by metal rings. The advantages and disadvantages of each type of airway stent are carefully considered when choosing the most appropriate stent for each patient. Multidetector computed tomography plays an important role in determining the cause and assessing the location and extent of airway obstruction. Moreover, it is very accurate in its depiction of complications after airway stent placement.

Quantified evaluation of tracheal compression in pediatric complex congenital vascular ring by computed tomography

“…Compared with ultrasound and MRI, CT examine can display the airway more clearly for higher density resolution, and the use of DSCT imaging has gained attention recently because of the shorter time, excellent image quality, and more detailed information on cardiovascular structures in the pediatric setting 9 . Moreover, the three-dimensional volumetric acquisitions are particularly useful in the detection of tracheal compression, and definition of vascular relationships, and to display the airway without general anesthesia 6 , 11 . Hence, we performed this study evaluating VR associated with other cardiovascular diseases by DSCT scan in pediatric patients.…”

“…However, MRI requires a longer scan time, partly limiting its application in vessels of pediatrics 2 . Recently, dual-source computed tomography (DSCT) has played an increasingly important role in the diagnosis of complex congenital heart disease (CHD) due to its fast scan speed, and high image quality 9 – 11 . To the best of our knowledge, studies that focus on quantitatively evaluating VR-associated tracheal stenosis in pediatrics with CHD using DSCT and the relationship between compression and surgery are lacking 12 – 14 .…”

Chest CT with iterative reconstruction algorithms for airway stent evaluation in patients with malignant obstructive tracheobronchial diseases

“…Multi-detector computed tomography (MDCT), as a highly accurate noninvasive alternative to the reference standard bronchoscopy, plays an important role in evaluation of stent-related complications and is widely used in clinical practice. [4] Usually, CT scan is performed more than once to provide useful diagnostic information of stent-related complications during the follow-up, but consequently they contribute to a high burden of radiation dose. Therefore, it is valuable to find an approach that can optimize CT protocols to reduce radiation dose while maintaining the image quality and diagnostic accuracy.…”

Intraoperative cone beam computed tomography of tracheal stenting for stenosis and fistula diseases: a retrospective cohort study

“…Multidetector computed tomography (MDCT) is essential in airway stent placement for stenosis and fistula diseases because it can evaluate the location and extent of a lesion preoperatively and complications after airway stent placement postoperatively (8). However, this procedure must be performed in a CT laboratory, which sometimes delays the detection of complications by the surgeon during the operation.…”