1 / 31

Laryngo- Tracheal Stenosis (LTS)

Laryngo- Tracheal Stenosis (LTS). Definition: luminal narrowing of the throat or airways Etiology: intubation for mechanical ventilation, trauma, airway surgery, reflux, malformations (EA, Vessels......) Therapy planing needs to know: number, site, degree, extent, & dynamics.

ting
Télécharger la présentation

Laryngo- Tracheal Stenosis (LTS)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Laryngo- Tracheal Stenosis (LTS) • Definition: • luminal narrowing of the throat or airways • Etiology: • intubation for mechanical ventilation, trauma, airway surgery, reflux, malformations (EA, Vessels......) • Therapy planing needs to know: • number, site, degree, extent, & dynamics

  2. LTT – Clin. Examination • Palpation, Percussion • Auskultation • Inspection • Indirect: Larynx only Mirror, Microlaryngoskopy • Direct: Larynx & Trachea

  3. Imaging of LTS • Conv. X-Rays: • Chest-X, Softtissue X-Rays • Fluoroscopy • Conv. Tomography • Magnetresonance Tomography • Spiral Computertomography • 3D Reconstructions • Virtuelle Endoscopy

  4. LTS Imaging – Conv.XRay

  5. LTS Imaging – Softtissue XRay

  6. LTS Imaging - Fluoro

  7. LTS Imaging – conv.Tomo

  8. LTS Imaging – MR

  9. LTS Imaging – Spiral CT

  10. LTS Imaging – 3D • Multiplanare Rekonstruktionen • Minimum Intensity Projection • Shaded Surface Display • Volume Rendering • (Kombinationen)

  11. LTS Imaging – VE

  12. LTS – VE „Impact“ • Study: n=19 • Patients: n=15 • Controlls: n=4 • Comparision – reporting with/without VE - 2 observers: • Axiale Schichten, MPR • Axiale Schichten, MPR und VE

  13. LTS – VE „Impact“ E.Sorantin et al. Ped Radiol (2002) 32: 8-15

  14. LTS Quantification – Endoscopy • High interobserverariability!!!!Jewett et al. Ann Otol Rhinol Laryngol 1999)

  15. LTS – Quantification

  16. LTS - Quantifizierung • Visual – semi-quantitative

  17. LTS Quantification – Spiral CT • Interobserver Variance • 3 Observer, 22 Trachealstenoseses

  18. LTS – Quantification • 3D-Cross sectional profile: • Airway Segmentation • Extraction of the centerline: • Skeletonisation. • Orthogonal on centerline  3D cross sectional profile • Caliber change  change in the cross sectional area

  19. LTT - Skeleton

  20. LTS – Quantification Vocal Chords Subgl.Space Stenosis Upper border Sternum Lower border Cricoid

  21. LTS - ValidationPhantoms • Accuracy and Precision

  22. Clinical Studies • Patients (n=36 24 weeks to 92a) • all invested by endoscopy and CT • Normal controls (n=18)

  23. LTS - ValidationPhantoms • length measuremtens: 1% error

  24. Results - Phantoms • Theoretical vs computed cross sectional profile

  25. Results - Phantoms Accuracy ( LTS length, degree)

  26. Results - Phantoms Precision ( LTS length, degree)

  27. Results - Clinical Studies

  28. Results - Clinical Studies

  29. Conclusions • Realistic 3D reconstructions from S-CT are possible • Virtual endoscopy presents data in a familiar way for the ENT surgeon • 3D cross sectional charts: • provide quantitative information • number • site • lenght • degree

  30. Conclusions • 3D cross sectional charts: • accurate • precise • caliber changes up to 20% in normals ROAD MAPPING ACHIEVED

  31. Other Possibilities • Usuage of the central path: • for automated steering of a virtual camera • Volume Rendering: • adjustment of the opacity curve according the segmented airways

More Related