A Multi Detector Computed Tomography Survey of Tracheal Diverticulum

Abstract

Objective: Tracheal diverticulum (DV) is an incidental finding in thoracic computed tomography examinations. Tracheal DV may be associated with chronic cough and chronic obstructive pulmonary disease (COPD). A few studies have investigated the relationship between tracheal DV and COPD. There is still no consensus on the relationship. The purpose of this study was to determine the incidence of tracheal DV and its coexistence with bronchial DV and hyperaeration. Materials and Methods:For the study, 299 patients from a total number of 12 800 patients who underwent a thoracic computed tomography examination were included. Tracheal diverticula were evaluated for localization, size, contour, wall thickness and communication with the tracheal lumen. The association of tracheal DV with bronchial DV and hyperaeration was also noted. The relationship between tracheal DV and hyperaeration was analyzed. Results:Of the 299 patients, a total of 412 tracheal diverticula were observed. Out of these, 148 of the tracheal diverticula were in females, and 264 of the tracheal diverticula were in male patients. The incidence of tracheal DV was determined to be 2.38% in this study. In total, 400 of the tracheal diverticula (97.1%) were located at the right posterolateral aspect of the trachea, and 320 of the tracheal diverticula were associated with hyperaeration. There was no significant relation between the tracheal DV and hyperaeration. However, 84 of 412 tracheal diverticula had a bronchial DV, and 72 of 84 of these bronchial DV were associated with COPD. Statistical analysis indicated a significant correlation with COPD and bronchial DV (p<0.05). Conclusion:Tracheal DV is often asymptomatic and mostly located in the right posterolateral aspect of the trachea. Tracheal DV is more common in men than in women. The incidence of tracheal DV was 2.38% in this study. Our data demonstrate that there was no significant association between tracheal DV and COPD. However, there was a significant association between subcarinal bronchial DV and COPD.Key Words: Bronchi, Chronic Obstructive Pulmonary Disease, computed tomography, diverticula, trachea ÖzetAmaç: Trakeal divertiküller, toraks bilgisayarlı tomografi incelemesinde insidental olarak saptanır. Kronik öksürük ya da kronik obstrüktif akciğer hastalıkları ile birlikte görülebilir. Literatürde trakeal divertikül ve kronik obstrüktif akciğer hastalıkları arasındaki ilişkiyi araştı-ran az sayıda çalışma olmakla birlikte çalışmalar arasında hala çelişki bulunmaktadır. Bizim bu çalışma ile amacımız trakeal divertiküllerin insidansını ve trakeal divertikülün, bronşial divertikül ve havalanma fazlalığı ile ilişkisini araştırmaktır. Gereç ve Yöntem:Kasım 2009-2011 tarihleri arasında toplamda 12 800 hastaya toraks bilgisayarlı tomografisi yapıldı ve çalışmaya sadece 299 olgu dahil edildi. Trakeal divertiküllerin lokalizasyonu, boyutu, konturu, duvar kalınlığı ve trakea lümeni ile ilişkisi değerlendirildi. Ayrıca bronşial divertikül ve havalanma fazlalığı ile ilişkisi araştırıldı. İstatikse...

Paratracheal air cysts: prevalence and relevance to pulmonary emphysema and bronchiectasis using thoracic multidetector CT

“…In addition, Bae et al (4) reported fewer irregular-shaped cysts than our study (7.2% vs. 29.3%). In our study, a connection with the trachea was established in 46 cysts (56.1%), which is a much higher rate than those reported by several previous studies (4,8,10,15). However, a study by Cheng et al (9) did report a rate of 55% for connection between the cyst and the trachea, as in our study.…”

“…The reported prevalence of PTACs ranges from 0.75% to 8.1% (4,(6)(7)(8). There have been a limited number of studies reporting the incidence of PTACs related to COPD or emphysema as detected by CT, and the reported results are variable (4,6,(8)(9)(10)(11). The relationship between PTACs and pulmonary emphysema or bronchiectasis is still unclear.…”

Tracheal Diverculum: A Rare Entity Diagnosed in the Context of Blunt Thoracic Trauma Report of A Case

“…It is a rare entity with an estimated incidence of 2.4% [1] . In most cases TD is located at the right posterolateral region of the trachea (97.1%) and rarely at the controlateral side (2.9%) [1] .…”

“…It is a rare entity with an estimated incidence of 2.4% [1] . In most cases TD is located at the right posterolateral region of the trachea (97.1%) and rarely at the controlateral side (2.9%) [1] . It is lined by the same ciliated columnar epithelium of the trachea and its lumen is in communication, though often difficult to demonstrate, with that of the airways.…”

Acquired Tracheal Diverticulum as an Unexpected Cause of Endotracheal Tube Cuff Leak

“…Tracheal diverticulum in adults is a mucosal herniation that occurs in the weak parts of the tracheal wall due to increased intraluminal pressure [8]. In the retrospective analysis of chest CT scans performed in a population of patients with no traumatic pathology, one study demonstrated an incidence of tracheal diverticulum of 2.38%, many of them associated with COPD, especially those with a bronchial localization [8]. Unlike congenital tracheal diverticulum, those acquired are larger and present a more extensive connection with the trachea [2].…”