ABSTRACT
This chapter reviews the technical aspects of performing and interpreting functional imaging studies of the large airways using multidetector-row computed tomography (MDCT). Volumetric data acquisition using MDCT allows for the creation of three-dimensional reconstructions and multiplanar reformations (MPR), which have the potential to aid diagnosis and preoperative planning. Advances in MDCT imaging afford the opportunity to noninvasively diagnose tracheomalacia with similar sensitivity to conventional bronchoscopy by using either paired inspiratory–dynamic expiratory CT or cine-coughing techniques. Technologists should also be trained to recognize the characteristic appearance of inspiratory and expiratory CT scans in order to ensure that the imaging sequences have been successfully performed during the appropriate respiratory maneuvers. Interpretation of CT images for the diagnosis of tracheomalacia requires careful review and comparison of both end-inspiratory and dynamic-expiratory images. When interpreting functional CT scans of patients with tracheomalacia, it is important to report the severity, distribution, and morphology.
