| ObjectiveThe length,inner diameter and angle of the airway in the intersection area between right main bronchus,right middle bronchus and right upper lobe bronchus(hereinafter referred to as the intersection area)were measured,and the correlation with gender,age and height was analyzed,aiming to provide references for the further measurement of airway parameters and the design and selection of airway stents in this area.Materials and MethodsAnalysis of the chest MSCT data of 240 patients was made,who were admitted to the Department of Physical Examination in the First Affiliated Hospital of Zhengzhou University from June to December 2018.There were 126 males and 114 females.The average age was 43.02±11.56 years,while the range was from 26 to 75.The participants were divided into the younger group(18-45 years old)and the older group(greater than 45 years old)according to age.The average height of the participants was 163.64±8.72cm(151-182cm),who were divided into low height group(<165cm)and high height group(?165cm)according to height.The scan range should cover the trachea and bronchus of the neck and chest.The layer thickness of 0.6 mm should be selected for the radial line measurement,and the mediastinal window(the window width of 400 Hu and the window level of 100 Hu)should be selected for the CT window.According to the midpoint of the right main bronchus,the right middle bronchus,and the right upper lobe bronchial opening,the MPR(Multi-Layer Reconstruction)is performed perpendicular to the airway wall to obtain an axial thin layer image of the relevant airway.The inner diameter and length of the right main bronchus,the right middle bronchus(near and distal)and the right upper lobe bronchus were measured;the angle between the right upper lobe bronchus and the right middle bronchus;the angle between the right main bronchus and the right middle bronchus.All variables were expressed as mean ± standard deviation.Airway diameter values and airway angle analysis for different genders,ages,and heights were analyzed using independent sample t test.The results were considered to be statistically significant if p < 0.05.This study was approved by the ethics committee of the First Affiliated Hospital of Zhengzhou University.Result1.Different gendersThe length(RBL)and the inner diameter(RBD)of the right main bronchus for males were 22.74±0.80 mm and 15.99±2.65 mm,respectively;females were 18.81±1.61 mm and 14.31±1.60 mm,respectively.The right middle bronchus length(IBL),proximal end diameter(IBPD)and distal end diameter(IBDD)for males were 18.98±1.20 mm,13.91±0.87 mm and 10.87±0.72 mm,respectively;females were 16.82 ±0.83 mm,12.45±0.36 mm and 9.68±0.51 mm,respectively.The bronchial length(RSBL)and inner diameter(RSBD)of the male right upper lobe for males were 12.16±0.89 mm and 8.87±0.72 mm,respectively;females were 11.18±0.64 mm and 7.69±0.51 mm,respectively.The angle between the right upper lobe of the male and the right middle bronchus(RSB-IB°)and the angle between the right main bronchus and the right middle bronchus(RB-IB°)for males were(92.53±10.09)° and(162.75±4.34)°,respectively;females were(84.15±10.35)° and(168.10±5.82)°,respectively.2.Different agesThe length(RBL)and inner diameter(RBD)of the right main bronchus of the younger group were(22.20±2.17)mm and(15.70±2.62)mm,respectively;the older group were(19.60±2.18)mm and(15.56±1.85)mm,respectively.The length(IBL),proximal end diameter(IBPD)and distal end diameter(IBDD)of the right middle bronchus of the younger group were(18.79±1.68)mm,(13.93±1.03)mm and(10.64±0.94)mm,respectively;the older group were(17.11 ± 1.11)mm,(12.63 ± 0.64)mm and(9.91 ± 0.67)mm.The length(RSBL)and inner diameter(RSBD)of the anterior superior bronchus of the younger group were(12.40±0.76)mm and(8.64±0.97)mm,respectively;the older group were(11.23±0.75)mm and(7.91±0.67)mm,respectively.The angle between the right upper lobe bronchus and the right middle bronchus(RSB-IB°)and the angle between the right main bronchus and the right middle bronchus(RB-IB°)of the younger group were(88.49±11.02)° and(165.12±4.34)°,respectively;the older group were(83.96 ± 13.23)° and(166.52 ± 5.78)°,respectively.3.Different heights:The length(RBL)and inner diameter(RBD)of the right main bronchus of the low height group were(18.16±1.69)mm and(13.75±1.70)mm,respectively;the high height group were(23.04±0.82)mm and(16.48 ± 2.62)mm,respectively.The length(IBL),proximal end diameter(IBPD)and distal end diameter(IBDD)of the right middle bronchus of the low height group were(16.27±0.93)mm,(12.22±0.25)mm and(9.61±0.57)mm,respectively;the high height group were(19.51 ± 1.25)mm,(14.39 ± 0.87)mm and(11.06 ± 0.84)mm,respectively.The length(RSBL)and inner diameter(RSBD)of the right upper lobe bronchus of the low height group were(10.92±0.44)mm and(7.62±0.57)mm,respectively,and the high height group were(12.67±0.69)mm and(9.05±0.84)mm,respectively.The angle between the right upper lobe bronchus and the right middle bronchus(RSB-IB°)and the angle between the right main bronchus and the right middle bronchus(RB-IB°)of the low height group were(80.50±9.27)° and(169.53±3.08)°,respectively;the high height group groups were(94.86±10.84)° and(161.73±3.12)°,respectively.4.The effect of different gender,age and height on airway diameter and angleThe diameter and length of the right main bronchus,the right middle bronchus(near and distal),and the right upper lobe bronchus: the males were larger than females;the younger ages were larger than older ones;the high height group were larger than low height group.The difference was statistically significant(p<0.05).The angle between the right upper lobe bronchus and the right middle bronchus: the males were larger than female,the high height group were larger than low height group.The difference was statistically significant(p<0.05).There was no statistical difference between the different age groups(p>0.05).The angle between the right main bronchus and the right middle bronchus: the males were smaller than females;the high height group were smaller than low height group,the difference was statistically significant(p<0.05).There was no statistical difference between the different age groups(p>0.05).ConclusionMSCT is an ideal tool for clinically measuring airway length,inner diameter,and angle.In normal people,the length of the right main bronchus,the right middle bronchus and the right upper bronchus are related to gender,age,and height.For these parameters,men are larger than women,younger people are larger than middle-aged or old people,and taller heights are higher than those of lower heights.The angle formed is related to gender and height,but not to age;the upper right bronchus and right middle bronchus of the male are larger than the female,the tallers are larger than those of lower heights;the right main bronchus and the right middle bronchus of the male are smaller than the female,the high height is less than the low height.The measurement data of tracheal diameter and angle can be used as reference for the measurement of airway parameters and the design and selection of airway stents in clinical intersections.ObjectiveThe clinical efficacy of small Y-shaped airway stent and bronchial trunk branching internal stent in the treatment of airway diseases were comparatively analyzed,which were developed in the right main bronchus and the intersection area between right middle bronchus and right upper lobe bronchus(hereinafter referred to as the intersection area).Materials and MethodsFrom June 2016 to March 2019,68 patients with right airway disease who underwent Y-shaped airway stenting in the Department of Interventional Radiology,Zhengzhou University First Affiliated Hospital were selected.According to the airway stent used,these patients were divided into 2 groups,namely small Y-shaped airway stent group,in which 38 patients(28 males and 10 females)were treated by small Y-shaped airway stents,and bronchial trunk branching internal stent group(30 patients,23 males and 7 females concluded)where bronchial trunk branching internal stents were used.All patients were followed up for 1-33 months by clinic or telephone.The end point of follow-up was death or until March 2019.Baseline data and complications were collected from the two groups and compared using two independent sample t-tests and chi-square tests.Survival analysis was performed by the Kaplan-Meier method.Quantitative data are expressed as mean ± standard deviation.All statistical results were considered statistically significant at p < 0.05.ResultA total of 68 patients were enrolled in the study,with 51 males and 17 females,respectively.The airway stents were all smooth and the technical success rate was 100%.Between the small Y-shaped airway stent group and bronchial trunk branching internal stent group,there was no statistical difference(p>0.05)between age,gender,the time between the appearance of symptoms and the first consultation,preoperative hospital stays,intraoperative time of stent placement,indications,primary disease and lesion site.Between two groups,there was no significant difference between the main complication of postoperative sputum occlusion,stent displacement,stent restenosis,sputum retention and hemoptysis(p>0.05).However,the bronchial trunk branching internal stent group did not have loose mouth closure and stent displacement,and the incidence of other complications was lower than the small Y-shaped airway stent group.The median follow-up time of the bronchial trunk branching internal stent group was 11 months(1-33 months),the percentage of death was 40%(12/30),and the median survival time was 19 months.The median follow-up time of the small Y-shaped airway stent group was 11 months(1-15 months),22 patients died(22/38,57.89%)with a median survival of 13 months.The overall survival of patients with bronchial trunk branching internal stent group was longer than that of the small Y-shaped airway stent group,and there was a statistical difference(P=0.049).ConclusionCompared with the small Y-shaped airway stent,the bronchial trunk branching internal stent has better clinical efficacy. |
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