الفهرس 
Title : Evaluation of the role of MSCT Airway Mapping in guiding trans-bronchial lung biopsy in cases of inaccessible lung lesions
AbstractOnly 14 pages are availabe for public view
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Abstract
Traditional fiber-optic bronchoscopy is a widely used well established successful technique in achieving biopsies from lung lesions (Gould MK, et al, 2007). Similarly, for decades virtual bronchoscopy was considered a supplementary technique for fiber-optic bronchoscopy in cases of air way obstruction to detect aeration beyond the obstruction (HoppeH, et al, 2004). A lung lesion beyond the fourth generation was non-accessible by both fiber-optic bronchoscopy and CT or ultrasound guided biopsies (which only reach subpleural lesions or otherwise subjecting the patient to significant complications e.g. pneumothorax, bleeding, infection, fistula). Surgery was the only mean to biopsy those lesions (Memoli, J.S.W., et al, 2012). The aim of this work was using MSCT (multi-planar imaging, MinIP and surface rendering imaging) to map the bronchial tree and bronchi and assess the exact site, direction, airway findings and bronchial measurements aiming to set a MSCT airway map in order to guide trans-bronchial lung biopsy from an inaccessible lung lesion. This study was carried on 26 patients, 21 males and 5 females with age range between 35-85 years (mean age 55.88 years). It was conducted in the Radiology Department, in collaboration with Chest Department, Kasr El-Aini hospital, Cairo University in the period from January 2015 to April 2016. All patients were subjected to complete history taking, full clinical examination, routine labs, Virtual Bronchographic examination and Trans-Bronchial lung biopsy (in selected cases guided by the VB results). In this study, MSCT-VB guided the fiber-optic bronchoscopy in all patients to the proper sampling site for different lung lesions with success rate 100% and CT maps were done reaching down to the seventh order bronchial subdivision. Conclusion: MPR images together with VB images were accurate in the detection of lesions’ site, depiction of degree of narrowing, distal visualization, in the evaluation of the length of narrow segment and in measuring the distance of the lesion from the carina in selected locations. This CT map was used to guide bronchoscopy or to direct trans-bronchial needle biopsy