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Purpose The objectives of this study were to evaluate the various branching patterns of segmental bronchi in the right middle lobe (RML) and to survey the anatomical diversity and sex-related differences of these branches in a large sample of the study population. Materials and methods In this retrospective board-approved study with informed consent, 10,000 participants (5428 males and 4,572 females, mean age 50 ± 13.5 years [SD]; age range: 3–91 years) who underwent multi-slice CT (MSCT) scans from September 2019 to December 2021 were retrospectively included. The data were applied to generate three-dimensional (3D) and virtual bronchoscopy (VB) simulations of a bronchial tree using the syngo.via post-processing workstation. The reconstructed images were then interpreted to locate and classify distinct bronchial patterns in the RML. Cross-tabulation analysis and the Pearson chi-square test were used to calculate the constituent ratios of bronchial branch types and determine their significance between male and female groups. Results Our results revealed that the segmental bronchial ramifications of the RML were classified into two types mainly, i.e., bifurcation (B4, B5, 91.42%) and trifurcation (B4, B5, B*, 8.58%). There were no significant sex-related differences in the proportion of bronchial branches in the RML ( P > 0.05 ). Conclusion The current study has confirmed the presence of segmental bronchial variations in the RML lobe using 3D reconstruction and virtual bronchoscopy. These findings may have significant implications for the diagnosis of symptomatic patients and for carrying out specific procedures like bronchoscopy, endotracheal intubation, and lung resection.

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Purpose: To evaluate the various branching patterns of segmental bronchi in the right middle lobe and to survey the anatomical diversity and sex-related differences of these branches in a large sample of the study population. Materials and Methods: In this retrospective board-approved study with informed consent, 10,000 participants (5428 males, mean age 50+/-13.5 years[SD] years; age range: 3-91 years) who underwent multi-slice CT scans from September 2019 to December 2021 were retrospectively included. The data were applied to generate 3D and virtual bronchoscopy (VB) simulations of a bronchial tree using the syngo.via post-processing workstation. The reconstructed images were then interpreted to locate and classify distinct bronchial patterns in right middle lobe. Cross-tabulation analysis and the Pearson chi-square test were used to calculate the constituent ratios of bronchial branch types and determine their significance between male and female groups. Results: Our results revealed that the segmental bronchial ramifications of the right middle lobe were classified into two types mainly, i.e., bifurcation (B4, B5, 91.42%) and trifurcation (B4, B5, B*, 8.58%). There were no significant sex-related differences in the proportion of bronchial branches in RML (P>0.05). Conclusion: The current study has confirmed the presence of segmental bronchial variations in the right middle lobe using 3D reconstruction and virtual bronchoscopy. These findings may have significant implications for the diagnosis of symptomatic patients and for carrying out specific procedures like bronchoscopy, endotracheal intubation, and lung resection.

Purpose This study using multi-slice computed tomography (MSCT) aimed to analyse and correlate the length of the left main stem with potentially important clinical parameters that may influence treatment. Materials and Methods 1500 patients (851 men, 649 women; mean age 57.38 ± 11.03 [SD] years; age range: 5–85 years) who underwent the MSCT scans from September 2020 to March 2022 were retrospectively included. Using the syngo.via post-processing workstation, the data was used to generate 3D simulations of a coronary tree. The reconstructed images were then interpreted to assess the morphological features and variants of the coronary arteries. Means ± standard deviations and the percentages were calculated. Chi-square and Pearson correlation statistical data were also reported. Results We found a medium LMCA in 1206 (80.4%) cases, a long LMCA in 133 (8.9%) cases, and in 161 (10.7%) cases a short LMCA was observed. The average diameter of LMCA at its midpoint was 4.69 ± 0.74 mm. The most frequent type of division of LMCA was bifurcation in 1076 (71.7%) cases; in 424 (28.3%) of cases, the LMCA was divided into three or more branches. The dominance was right in 1339 (89.3%), left in 78 (5.2%), and co-dominant in 83(5.5%) cases. There was a positive correlation between the length and branching patterns of LMCA, χ2 = 113.993, P = 0.000 (＜0.05). Other variables like sex, age, diameter of LMCA, and coronary dominance did not show any significant correlation. Conclusion There is an association between the length of the left main stem and the branching characteristics of the left main stem which may be essential for the diagnosis and treatment of coronary artery patients.