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Multimodality Imaging of Tracheobronchial Disorders in Children¹

¹ From the Edward B. Singleton Department of Diagnostic Imaging, Texas Children’s Hospital, MC 2-2521, 6621 Fannin St, Houston, TX 77030 (S.Y., R.P.G., T.C., R.M.B., R.K.), and the Departments of Radiology (S.Y., R.P.G., T.C., R.M.B., R.K.), Pathology (M.K.D.), and Otorhinolaryngology (C.M.G.), Baylor School of Medicine, Houston, Tex. Presented as an education exhibit at the 2006 RSNA Annual Meeting. Received November 21, 2007; revision requested December 14; revision received and accepted February 7, 2008. Address correspondence to the author (email: yedururi{at}yahoo.com).

The trachea and bronchial airways in children are subject to compromise by a number of extrinsic and intrinsic conditions, including congenital, inflammatory, infectious, traumatic, and neoplastic processes. Stridor, wheezing, and respiratory distress are the most common indications for imaging of the airway in children. Frontal and lateral chest and/or neck radiography constitute the initial investigations of choice in most cases. Options for additional imaging include airway fluoroscopy, contrast esophagography, computed tomography (CT), and magnetic resonance (MR) imaging. Advanced imaging techniques such as dynamic airway CT, CT angiography, MR angiography, and cine MR imaging are valuable for providing relevant vascular and functional information in certain settings. Postprocessing techniques such as multiplanar reformatting, volume rendering, and virtual bronchoscopy assist in surgical planning by providing a better representation of three-dimensional anatomy. A systematic approach to imaging the airway based on clinical symptoms and signs is essential for the prompt, safe, and accurate diagnosis of tracheobronchial disorders in children.