Pnömomediastinumlu hastalarda bilgisayarlı tomografide trakeobronşiyal açıların değerlendirilmesi

Öz

Amaç: Pnömomediastinumlu hastalarda bilgisayarlı tomografide (BT) trakeobronşiyal çapları ve trakeobronşiyal bifurkasyon açılarını araştırmak. Gereç ve yöntem: Hastanemizin Radyoloji Arşivinde, pnömomediastinumlu (PP) 63 hasta ve normal BT bulguları olan (PN) 63 hastanın BT taramaları retrospektif olarak değerlendirildi. Pnömomediastinumlu hastalarda, BT görüntülerindeki mediastinal hava miktarı görsel olarak üç dereceye ayrıldı. Tüm hastalarda BT görüntülerinde torasik anteroposterior mesafe (TAPD) ve transvers torasik mesafe (TTD), trakea ve bronşların anteroposterior (AP) çapları, trakea uzunluğu (TL), sağ ana bronş açısı (RMBA), sol ana bronş açısı (LMBA), subkarinal açı (SCA) ve interbronşiyal açı (IBA) ölçüldü. Tüm ölçümler pnömomediastinumlu ve pnömomediastinumsuz hastalar arasında karşılaştırıldı. Bulgular: PN grubunda torasik AP çapı ve sol ana bronş çapında cinsiyete bağlı anlamlı bir fark gözlendi. Pnömomediastinumlu hastalar arasında %22,2'si (n=14) 1. derece, %30,2'si (n=19) 2. derece ve %47,6'sı (n=30) 3. dereceydi. PN hastalarında trakea uzunluğu ve sol ana bronş çapı, PP hastalarına göre daha yüksekti. PP grubunda ortalama SCA 75,06±23,40° idi ve PN grubuna göre anlamlı derecede daha büyüktü (p=0,001). LMBA, PN grubunda PP grubuna göre anlamlı derecede daha yüksekti (p=0,003). Sonuç: Daha dar LMBA, daha kısa trakea uzunluğu, daha büyük torasik AP çapı ve daha geniş SCA'ya sahip bireyler, barotravma durumunda pnömomediastinum gelişme riski daha yüksek olabilir.

Anahtar Kelimeler

• Pnömomediastinum
• subkarinal açı
• trakea
• bronşlar
• bilgisayarlı tomografi

Evaluation of tracheobronchial angles on computed tomography in patients with pneumomediastinum

Öz

Purpose: To investigate tracheobronchial diameters and tracheobronchial bifurcation angles on computed tomography (CT) in patients with pneumomediastinum. Materials and methods: CT scans of 63 patients with pneumomediastinum (PP) and 63 patients with normal CT findings (PN) were retrospectively evaluated in the Radiology Archives of our hospital. In PP, the extent of mediastinal air on CT images was visually classified into three grades. Thoracic anteroposterior distance (TAPD) and transverse thoracic distance (TTD), anteroposterior (AP) diameters of the trachea and bronchi, tracheal length (TL), right main bronchus angle (RMBA), left main bronchus angle (LMBA), subcarinal angle (SCA), and interbronchial angle (IBA) were measured on CT images in all patients. All measurements were compared between patients with and without pneumomediastinum. Results: A significant sex-related difference was observed in thoracic AP diameter and left main bronchus diameter in the PN group. Among PP, 22.2% (n=14) were grade 1, 30.2% (n=19) were grade 2, and 47.6% (n=30) were grade 3. Tracheal length and left main bronchus diameter were higher in PN patients compared to PP patients. The mean SCA was 75.06±23.40° in the PP group and was significantly greater than in the PN group (p=0.001). LMBA was significantly higher in the PN group compared with the PP group (p=0.003). Conclusion: Individuals with a narrower LMBA, shorter tracheal length, larger thoracic AP diameter, and wider SCA may be at greater risk of developing pneumomediastinum in the setting of barotrauma.

Anahtar Kelimeler

• Pneumomediastinum
• subcarinal angle
• trachea
• bronchi
• computed tomography

Kaynakça

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