Digital radiographic measurement of the main bronchi: a pilot study

• Published in: Annals of tropical paediatrics Vol. 29; no. 3; pp. 209 - 216
• Main Authors: Sanders, V. M., Pitcher, R. D., Douglas, T. S., Kibel, M. A., Daya, R. B., van As, A. B
• Format: Journal Article
• Language: English
• Published: Leeds Taylor & Francis 01.09.2009; Maney
• Subjects: Biological and medical sciences; Bronchography; Child; Child, Preschool; Female; General aspects; Humans; Infant; Male; Medical sciences; Pilot Projects; Radiographic Image Enhancement - methods; Retrospective Studies; Tomography, X-Ray Computed; Pediatrics; Tropical medicine
• ISSN: 0272-4936; 1465-3281; 1465-3281
• DOI: 10.1179/027249309X12467994693932

Background: Conventional chest radiographs do not afford consistently good visualisation of the main bronchi and sub-carinal angle. Improved visualisation would facilitate accurate measurement of the airways, definition of normal radiographic anatomy and, possibly, earlier identification of extrinsic compression or displacement. Aim: The main objective of this study was to establish whether the paediatric main bronchi and sub-carinal angle could be measured consistently on AP supine chest images obtained using a specific digital radiographic system (DRS). Subjects and Methods: The proximal bronchial diameters were measured on supine DRS chest images of 102 children between the ages of 6 months and 13 years. Results: The left and right main bronchi could be seen clearly and measured in over 90% of cases, with intraclass correlation co-efficients of reliability indicating high intra- and inter-observer agreement. The sub-carinal angle had lower intra- and inter-observer agreement. Conclusion: Supine chest images acquired using DRS facilitate accurate measurement of the main bronchi and sub-carinal angle in children. Further work is required to establish population-specific age-related norms for bronchial dimensions. These could serve as reference standards for early detection of deviations from normal.