Type:
Educational Exhibit
Keywords:
Connective tissue disorders, Diagnostic procedure, Computer Applications-Virtual imaging, Digital radiography, CT, Thorax, Respiratory system
Authors:
A. Guell Bara, S. A. Bolivar Cuevas, E. Carreno Garcia, A. Conejero Olesti, A. Dorca Duch, H. I. Jofre Grimaldo, P. Luburich; L'Hospitalet de Llobregat, Barcelona/ES
DOI:
10.1594/ecr2018/C-1927
Background
Non-neoplastic lesions of the tracheobronchial wall are rare.
However,
they constitute a group of heterogeneous diseases that can cause severe respiratory symptoms and,
sometimes,
be associated with systemic disorders,
which can have a significant impact on the quality of life of the patient.
Therefore,
it is of paramount importance for the general radiologist to be familiar with the imaging characteristics of these abnormalities.
In order to better understand these radiological features,
it is important to remember some anatomical characteristics of the tracheobronchial wall:
- The trachea is composed of 16-22 incomplete cartilaginous rings disposed in axial plane,
showing discontinuity of posterior part.
The anterior side is composed of different layers of mucosa,
submucosa,
cartilage,
muscle and adventitia,
whereas the cartilaginous rings are closed on the posterior side by the thin trachealis muscle.
For this reason,
conditions affecting cartilage (such as recurrent polychondritis) will show radiological features different from other conditions such as vasculitis or granulomatous diseases.
- The diameter of the normal trachea varies according to gender.
It ranges from 13-25 mm in coronal diameter and 13-27 mm in sagittal diameter in male; and from 10-21 mm in coronal diameter and 10-23 mm in sagittal diameter in female.
The protocol we use to study tracheobronchial wall conditions consists in end-inspiratory high-resolution computed tomographic (HRCT) and end-expiratory HRCT,
using multiplanar reconstructions for a further understanding of the images.