Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Jan;16(1):46-53.
doi: 10.1016/j.acra.2008.05.020.

Prevalence of tracheal collapse in an emphysema cohort as measured with end-expiration CT

Robert A Ochs  1 , Iva Petkovska, Hyun J Kim, Fereidoun Abtin, Matthew Brown, Jonathan Goldin
Affiliations

Prevalence of tracheal collapse in an emphysema cohort as measured with end-expiration CT

Robert A Ochs et al. Acad Radiol. 2009 Jan.

Abstract

Rationale and objectives: To retrospectively investigate the prevalence of tracheal collapse in an emphysema cohort. The occurrence of a large degree of tracheal collapse may have important implications for the clinical management of respiratory symptoms and air trapping in patients with emphysema.

Materials and methods: Paired full-inspiratory and end-expiratory thin-section volumetric computed tomographic scans were available for 1071 long-term smokers with clinically and physiologically confirmed emphysema. The percentage reduction in the cross-sectional tracheal luminal area from full-inspiration to end-expiration was automatically computed at 2.5-mm intervals along the centerline of the trachea using customized software.

Results: Maximal tracheal collapse did not follow a normal distribution in the emphysema cohort (P < .0001, skewness/kurtosis tests for normality); the median collapse was 18% (intraquartile range, 11%-30%). Statistically significant differences were found in the distribution of maximal collapse by gender (P < .005, Wilcoxon rank sum test). Overall, 10.5% of men and 17.1% of women showed evidence of tracheomalacia on the basis of the criterion of a reduction of 50% or greater in cross-sectional tracheal luminal area at end-expiration.

Conclusion: This study offers insights into the prevalence of tracheal collapse in a cohort of patients with emphysema; future work is needed to determine the possible relationship between tracheal collapse and air trapping in subjects with emphysema.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Example of an analysis report; reformatted coronal and sagittal views along the trachea are shown at both inspiration (top-left) and end-expiration (top-right) breathhold; the color-coded degree of collapse is shown at each measurement point along the trachea (top-middle); examples cross-sectional views of the trachea at both inspiration levels are shown side-by-side at selected locations (bottom).
Figure 2
Figure 2
Histogram of the maximal collapse of the tracheal lumen area elicited with the end-expiration CT for each gender.
Figure 2
Figure 2
Histogram of the maximal collapse of the tracheal lumen area elicited with the end-expiration CT for each gender.
Figure 3
Figure 3
Scatter plot of the relationship between age and maximal trachea collapse. There was a slight relationship between the degree of trachea collapse and age for both genders in the emphysema cohort.
Figure 4
Figure 4
The shape of the collapse of the trachea may take different forms. Subject (a), a 71 year old female, had a greater collapse of the posterior membrane. Subject (B), a 73 year old male, showed a greater collapse in the lateral axis.
Figure 4
Figure 4
The shape of the collapse of the trachea may take different forms. Subject (a), a 71 year old female, had a greater collapse of the posterior membrane. Subject (B), a 73 year old male, showed a greater collapse in the lateral axis.
See this image and copyright information in PMC

References

    1. Carden KA, Boiselle PM, Waltz DA, Ernst A. Tracheomalacia and tracheobronchomalacia in children and adults: an in-depth review. Chest. 2005;127(3):984–1005. - PubMed
    1. Jokinen K, Palva T, Nuutinen J. Chronic bronchitis: a bronchologic evaluation. ORL J Otorhinolaryngol Relat Spec. 1976;38:178–186. - PubMed
    1. Jokinen K, Palva T, Sutinen S, Nuutinen J. Acquired tracheobronchomalacia. Ann Clin Res. 1977;9:52–57. - PubMed
    1. Herzog H. Expiratory stenosis of the trachea and great bronchi by loosening of the membraneous portion; plastic chip repair. Thoraxchirurgie. 1958;5:281–391. - PubMed
    1. Ikeda S, Hanawa T, Konishi T, et al. Diagnosis, incidence, clinicopathology and surgical treatment of acquired tracheobronchomalacia. Nihon Kyobu Shikkan Gakkai Zasshi. 1992;30:1028–1035. - PubMed

Publication types