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    J Korean Soc Radiol. 2010 Feb;62(2):123-130. Korean.
    Published online Feb 28, 2010.
    https://doi.org/10.3348/jksr.2010.62.2.123
    Copyright © 2010 The Korean Society of Radiology
    Original Article

    Evaluation of Tracheal and Main Bronchial Diverticula Using Thin-Section MDCT

    Sung Shick Jou, M.D., Young Tong Kim, M.D., Won Kyung Bae, M.D., Il Yung Kim, M.D., Hyung Hwan Kim, M.D. and Jong Kyu Han, M.D.
      • 1Department of Radiology, Soonchunhyang University Cheonan Hospital, Korea.
    • Address reprint requests to: Young Tong Kim, M.D., Department of Radiology, Soonchunhyung University, Cheonan Hospital 23-20 Bongmyung-dong, Cheonan 330-721, Korea. Tel. 82-41-570-3515, Fax. 82-41-579-9026, Email: ytokim@schca.ac.kr
    Received February 18, 2009; Accepted August 17, 2009.

    Abstract

    Purpose

    To evaluate the characteristics of tracheal and main bronchial diverticula in relation with emphysema.

    Materials and Methods

    A total of 967 CT images were reconstructed with 1.25 mm axial images over 2 months. The incidence, size, number, and location of the tracheal and main bronchial diverticula were analyzed using 3D medical software (Seoul, Korea). The incidence of emphysema and the relationship between emphysema and the size of the diverticula were analyzed.

    Results

    In total, 50 patients (5.1%) showed tracheal diverticula in the right posterolateral wall. In addition, 51 patients (5.2%) showed 89 (9.4%) main bronchial diverticula in the inferior wall, while 68 (72%) showed diverticula in the left posterolateral wall. Tracheal diverticula (6.4 ± 5.0 mm, 1.0 ± 0.2) were larger and fewer than the main bronchial diverticula (2.1 ± 2.0 mm, 1.8 ± 1.6) (p<0.05). Moreover, tracheal diverticula (10.3 ± 7.4 mm) with emphysema in 13 patients (26%), were larger than those without emphysema (5.1 ± 3.0 mm) (p<0.05).

    Conclusion

    On thin-section MDCT, the rates of incidence for tracheal and main bronchial diverticula are about 5%, respectively. Tracheal diverticula in the right posterolateral wall are smaller and fewer than the main bronchial diverticula, which are located primarily in the inferior wall of the left bronchus. Tracheal diverticula with emphysema are larger than those without emphysema.

    Keywords
    Diverticulum; Trachea; Bronchi; Tomography, X-Ray Computed

    Figures

    Fig. 1
    60-year-old man with tracheal diverticula and pneumonia.
    A. 1.25 mm axial CT scan shows lobulated right paratracheal air cyst (arrow) in posterolateral aspect of trachea.

    B. Coronal reformatted image shows multilobulated air cyst (arrows) in the thoracic inlet.

    C. 3D CT bronchography shows multilobulated air cyst (arrowhead) and tubular air cyst (arrow).

    Fig. 2
    29-year-old man with main bronchial diverticula.
    A. 1.25 mm axial scan shows small air cyst (arrow) bulging medial side of left main bronchus.

    B. 3D volume-rendered image shows two tiny bugling air cysts (arrow) in inferior wall of left main bronchus.

    C. Virtual bronchoscopy image shows two holes (arrow) in left main bronchus.

    Fig. 3
    64-year-old man with left main bronchial diverticula and SPN.
    A. 5 mm thickness axial scan shows left main bronchial diverticulum (arrow).

    B. In 8 months ago, same size of left main bronchial diverticulum (arrow) is seen on 5 mm thickness axial scan.

    Fig. 4
    52-year-old man with multiple main bronchial diverticula and lung cancer.
    A. 1.25 mm axial image shows irregular air cyst (arrow) in left main bronchus.

    B. Virtual bronchoscopy shows multiple holes (arrows) in both main bronchi.

    C. Photograph of bronchoscopy shows multiple holes (arrows) in both main bronchi.

    Tables

    Table 1
    Tracheal & Main Bronchial Diverticula according to the Age

    Table 2
    Size and Number of Tracheal and Main Bronchial Diverticula

    Table 3
    Underlying Pulmonary Diseases

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    MeSH Terms
    Bronchi
    Diverticulum
    Emphysema
    Humans
    Incidence
    Tomography, X-Ray Computed
    Trachea
    Metrics
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