Abstract：Objective To explore the influence of respiratory motion on central airway values and its clinical significance.Methods Sixty healthy volunteers were selected and multi-slice spiral CT(MSCT) was used to scan the whole lung at the end of deep inspiration and at the end of expiration. There were 32 males and 28 females with an age ranged from 25 to 54 years, with an average age of (34±9.1) years. We used multiplanar reconstruction technique and used (window width 500 Hu, window level -100 Hu) to measure the cross-sectional area of the central airway at the end of inspiration and at the end of expiration. We calculated the collapse index and measured left principal bronchus-right principal bronchus (the angle of carina, ∠C), right upper lobe-intermediate bronchial angle (∠RI), right middle lobar bronchus-right inferior lobar bronchus angle (∠RMI), left upper lobe bronchus-left inferior lobar bronchus angle(∠LUI), respectively.Results At the end of expiration, the cross sectional areas of the central airway were reduced, the differences were statistically significant (all P values<0.05). The collapse index of tracheal is 19.7%±8.6%; Right principal bronchus, intermediate bronchus, right upper lobe bronchus, right middle lobar bronchus and right inferior lobar bronchus's collapse index was 21.4%±9.6%, 14.7%±6.2%, 15.5%±5.7%, 10.1%±3.6%, 24.5%±9.1%, respectively; Left principal bronchus, left upper lobe bronchus and left inferior lobar bronchus's collapse index was 24.0%±9.4%, 15.1%±5.0%, 27.6±10.7%, respectively. In the left central airway, there were significant differences in bronchial collapse index at different levels (F=32.696, P<0.05); The collapse index of the left principal bronchus and the left lower lobe bronchus was larger, and the difference was statistically significant compared with the left upper lobe bronchial collapse index (all P values<0.05); In the right central airway, there were significant differences in bronchial collapse index at different levels (F=38.154, P<0.05); The collapsible index of the right principal bronchus and right lower lobe bronchus were larger, and the difference was statistically significant compared with the right upper lobe bronchus, middle bronchus and right middle lobe bronchus (all P values <0.05). At the end of expiration, ∠C was increased, ∠RI, ∠RMI and ∠LUI was decreased, and the differences were statistically significant (all P values<0.01). Among them, ∠LUI had the greatest change. At the end of deep inspiration, the axial section of the central airway was mostly round or oval. At the end of expiratory, 51 cases (85%, 51/60) of trachea, 42 cases of left principal bronchus (70%, 42/60), 49 cases of right principal bronchus (82%, 49/60) showed posterior membrane flattening or slight anterior arch shape. The morphological change of lobar bronchus was not obvious.Conclusions MSCT is an effective tool for the observation and measurement of the central airway. The degree of change in the cross-sectional area and the angle of the central airway is different, it is helpful to guide the clinical selection of the appropriate type of airway stent, and also beneficial to explore and develop airway stents with more physiological adaptability.
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Li Lei, Han Xinwei, Cao Jing, Wang Suya, Hua Chengfei, Kang Tai. Imaging study of inspiratory phase and expiratory phase of the central airway based on multi-slice spiral CT. Chinese Journal of Anatomy and Clinics, 2018, 23(1): 27-32.
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2018, Vol. 23 
