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Trachea and Bronchi

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Abstract

This chapter describes such abnormalities of the trachea and bronchi as tracheobronchomegaly, relapsing polychondritis, tracheomalacia, saber-tooth trachea, post-intubation stenosis, bronchiectasis (cylindrical, varicose, cystic), mucous impaction, broncholithiasis, bronchopleural fistula, foreign bodies, and trauma.

Keywords

  • Tracheobronchomegaly
  • Relapsing polychondritis
  • Frown sign
  • Tracheomalacia
  • Saber-tooth trachea
  • Post-intubation tracheal stenosis, bronchiectasis
  • Signet ring sign
  • Tram tracks sign
  • Mucous impaction, broncholithiasis, bronchopleural fistula

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  • DOI: 10.1007/978-3-030-16826-1_17
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References

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  3. Kaewlai R, Avery LL, Asrani AV, Novelline RA. Multidetector CT of blunt thoracic trauma. Radiographics. 2008;28:1555–70.

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Fig. e17.1

Mounier-Kuhn syndrome. (a) Enlarged trachea (arrow) (TIF 975 kb)

Fig. e17.1

Mounier-Kuhn syndrome. (b) Enlarged main stem bronchi (black arrows) and distal bronchiectasis (white arrows) [1] (TIF 1273 kb)

Fig. e17.2

Relapsing polychondritis. Narrowing of the trachea from the subglottic region to its bifurcation (arrows) in this patient with long-standing disease [2] (TIF 798 kb)

Fig. e17.3

Relapsing polychondritis. Expiratory scan shows abnormal collapse of the bronchi with air trapping in the left lung [2] (TIF 1256 kb)

Fig. e17.4

Relapsing polychondritis. Thickening and calcification of the walls of the trachea (a). (Courtesy of Ritu Gill, MD, Boston) (TIF 958 kb)

Fig. e17.4

Relapsing polychondritis. Main stem bronchi (b) with associated tracheobronchial luminal narrowing. (Courtesy of Ritu Gill, MD, Boston) (TIF 2606 kb)

Fig. e17.5

Tracheobronchomalacia. (a) Full inspiration (TIF 527 kb)

Fig. e17.5

Tracheobronchomalacia. (b) Full expiration images at the level of the trachea demonstrate greater than 80% circumferential collapse on expiration (TIF 528 kb)

Fig. e17.5

Tracheobronchomalacia. (c) Full inspiration (TIF 566 kb)

Fig. e17.5

Tracheobronchomalacia. (d) Full expiration images at the level of the carina demonstrate greater than 80% circumferential collapse of the major bronchi (TIF 1465 kb)

Fig. e17.6

Saber-sheath trachea. There is substantial decrease in the coronal diameter of the trachea (arrows). In addition, note the circumferential pleural thickening with nodulation on the right in this patient with mesothelioma. This pleural rind has scarred and contracted the ipsilateral hemithorax, causing the mediastinum to shift to the right. (Courtesy of Gillian Lieberman, MD, Boston) (TIF 608 kb)

Fig. e17.7

ANCA-associated granulomatous vasculitis. Circumferential thickening of the tracheal mucosa. [2] (TIF 1732 kb)

Fig. e17.8

Radiation fibrosis. Right paramediastinal fibrotic changes, which developed after treatment of a lung cancer (arrows). [1] (TIF 2224 kb)

Fig e17.9

Bronchiectasis (sarcoidosis). (a) Fibrosis and traction bronchiectasis (arrows) predominantly involves the upper lobe. [1] (TIF 3390 kb)

Fig e17.9

Bronchiectasis (sarcoidosis). (b) Fibrosis and traction bronchiectasis (arrows) predominantly involves the upper lobe. [1] (TIF 1406 kb)

Fig. e17.10

Bronchiectasis (Mycobacterium avium and Mycobacterium intracellulare infection). Bronchiectasis (arrows) predominantly involves the right middle lobe and lingula [1] (TIF 1179 kb)

Fig. e17.11

Bronchiectasis (cystic fibrosis). Cystic bronchiectasis (arrows), most prominent on the left (TIF 529 kb)

Fig. e17.12

Bronchiectasia (Kartagener syndrome). (a) Cardiomegaly, dextrocardia, left middle lobe bronchiectasis, and volume loss (TIF 2244 kb)

Fig. e17.12

Bronchiectasia (Kartagener syndrome). (b) CT image confirms the dextrocardia (asterisk is in the left ventricle) and bronchiectasis (arrows), which predominantly affects the mid portion of the lung [1] (TIF 1567 kb)

Fig. e17.13

Cystic bronchiectasis. (a) In two different patients, cyst-like lesions are contiguous with dilated bronchi (arrows, b) [1] (TIF 2856 kb)

Fig. e17.13

Cystic bronchiectasis. (b) In two different patients, cyst-like lesions are contiguous with dilated bronchi (arrows, b) [1] (TIF 2318 kb)

Fig. e17.14

Bronchiectasis. Volume loss in the left lower lobe, bronchial wall thickening, diffuse opacity, and bronchi visible in the most peripheral portion of the lung [1] (TIF 2118 kb)

Fig. e17.15

Cystic bronchiectasis. Dilated, thick-walled bronchi lie adjacent to peripheral pulmonary artery branches, producing a signet ring appearance (straight white arrow). Dilated bronchi within the atelectatic middle lobe resemble a cluster of grapes (curved black arrow). Small, poorly defined centrilobular opacities seen peripherally represent fluid-filled distal airways (curved white arrows) [2] (TIF 801 kb)

Fig. e17.16

Bronchiectasis and mucoid impaction (allergic bronchopulmonary aspergillosis). (a) Central bronchiectasis and mucoid impaction (arrows) (TIF 3341 kb)

Fig. e17.16

Bronchiectasis and mucoid impaction (allergic bronchopulmonary aspergillosis). (b) Central bronchiectasis, mucoid impaction (large arrow), and distal bronchiolitis (small arrow) [1] (TIF 3308 kb)

Fig. e17.17

Mucoid impaction. Characteristic V-shaped structure (arrow) [2] (TIF 1470 kb)

Fig. e17.18

Broncholith. (a) Calcified mass (arrow) within a segmental bronchus in the right mid lung (TIF 814 kb)

Fig. e17.18

Broncholith. (b) Calcified masses within the right upper lobe bronchus (arrows) (TIF 712 kb)

Fig. e17.19

Bronchopleural fistula. (a) Coronal CT shows a gas collection (white arrow) in the left upper chest communicating with a thin upper lobe bronchus (black arrow). (Courtesy of Ritu Gill, MD, Boston) (TIF 730 kb)

Fig. e17.19

Bronchopleural fistula. (b) Volume-rendered images better shows the communication of the gas collection with the bronchial tree (white arrow). (Courtesy of Ritu Gill, MD, Boston) (TIF 916 kb)

Fig. e17.20

Bronchial laceration. Tear (long arrow) in the posterior wall of the right bronchus intermedius, with an air leak into the mediastinum () and a small right pneumothorax. Short arrows indicate multiple pulmonary lacerations in the right lung against a background of extensive bilateral pulmonary contusions. Note also the tubes in the right side of the chest [3] (TIF 741 kb)

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Eisenberg, R.L. (2020). Trachea and Bronchi. In: What Radiology Residents Need to Know: Chest Radiology . Springer, Cham. https://doi.org/10.1007/978-3-030-16826-1_17

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  • DOI: https://doi.org/10.1007/978-3-030-16826-1_17

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