The role of MRI in the diagnosis and management of tracheal diverticulum.

BACKGROUND: Multidetector CT is currently the best imaging method for detecting tracheal diverticulum (TD). Compared with CT, MRI is radiation-free and has higher resolution. However, the MRI characteristics of this disease have not been previously reported. The present retrospective study compared the MR and CT imaging features of TD, aiming to examine the role of MRI in TD diagnosis and management. METHODS: Imaging data were collected in 26 TD patients divided into two groups, including the uninfected and infected groups. The MR and CT imaging features (size/wall/channel) of uninfected patients were compared. The performances of MRI and CT in diagnosing and monitoring therapeutic efficacy in infected TD patients were comparatively assessed. RESULTS: The uninfected group comprised 25 cases with 25 lesions confirmed by CT, including 23 lesions (92%) detected by MRI, with an average diameter of 8.5 mm (range from 3 to 15 mm). Meanwhile, the average diameter was 7.8 mm as measured by CT (range from 2.8 mm to 14.7 mm). The lesion diameters of the two cases not detected by MRI were 2.3 mm and 2 mm. MRI detected walls of all the 23 lesions (23/23), while CT detected no wall (0/23). CT showed channels in 18 lesions (18/23) versus3 for MRI (3/23). The infected case presented with a paratracheal abscess; MRI clearly showed a relationship between the abscess and the trachea, while CT could not show the lesion source. MRI also sensitively showed the whole process of lesion absorption. CONCLUSIONS: MRI can be used as a supplementary method for TD diagnosis, providing information about the wall that cannot be obtained by CT. MRI is superior to CT in diagnosing infected TD cases presenting with a paratracheal abscess, and in monitoring therapeutic efficacy in these patients.

The Role of MRI in Diagnosing and Managing Tracheal Diverticulum.

RATIONALE AND OBJECTIVES: Multidetector CT is the best imaging method to diagnose tracheal diverticulum (TD) till now. MRI characteristics of this disease is not reported before. The study report 5 cases of TD, intend to discuss the role of MRI in diagnosing and managing tracheal diverticulum (TD). MATERIALS AND METHODS: Five cases of TD (include 4 cases of uninfected TD and 1 case of infected TD) with complete CT and MR imaging data were collected and analyzed to compare MR and CT imaging features(location/size/wall/channel) of the disease. The role of MRI in monitoring therapeutic efficacy of infected TD was also discussed. RESULTS: All cases were located in the right posterolateral region of the trachea at the level between the T1 and T3 vertebrae. MRI was better in showing the wall of TD, and inferior to showing the channel (between TD and the tracheal) than CT. The diameter measured in MR images was longer than measured in CT image. MRI had equal capacity with CT in accurately display the location of the disease. MRI sensitively showed the absorption of infected TD. CONCLUSION: MRI is helpful in diagnosing TD, especially infected TD. The sign that local thickening and signal increasing of tracheal wall observed on MR images means that a paratracheal abscess may originate from TD. MRI plays an important role in monitoring therapeutic efficacy of infected TD.

Mounier-Kuhn syndrome (tracheobronchomegaly): An analysis of eleven cases.

BACKGROUND AND AIM: Mounier-Kuhn syndrome (MKS) is a congenital disorder characterized by tracheobronchomegaly resulting from the absence of elastic fibers in the trachea and main bronchi or atrophy and thinning of the smooth muscle layer. In this syndrome, dead space associated with tracheobronchomegaly increases and discharge of secretions decreases because of ineffective coughing. The most common complications are recurrent lower respiratory tract infections and bronchiectasis. We examined the clinical characteristics, radiological features, and related complications of patients with MKS. METHODS: The cases were obtained between September 2007 and November 2015. Computed tomography scans of the chest were used to diagnose tracheobronchomegaly. RESULTS: All cases (a total of 11) were males with a mean age of 63 ± 13 (range, 38-80) years. The mean diameter of the trachea was 31.53 ± 2.99 mm; the mean transverse diameter was 31.69 ± 3.10 mm and the mean sagittal diameter was 31.36 ± 3.01 mm. Complaints at the time of presentation included chronic cough, purulent sputum, dyspnea, and hemoptysis. There were recurrent pulmonary infections in seven cases, bronchiectasis in six, and tracheal diverticulum in four at the time of diagnosis. CONCLUSIONS: In this article, 11 cases with various rarely seen complications are presented and evaluated in the light of current literature. We recommend that if chronic cough, recurrent pulmonary infections, and bronchiectasis seen in a patient, MKS should be kept in mind.