| Objective:To explore the influence of respiratory movement to the physiological values of human central airway; To explore the correlation between physiological values of central airway and gender, age, height, weight as well as BMI of the people. To provide help for the diagnosis of central airway diseases, the selection of tracheal intubation and airway stent. Materials and methods:126 cases(69 male, 57 female) with plain CT scan and enhanced CT scan on chest are collected, which were from the patients of the First Affiliated Hospital of Zhengzhou University from November 2014 to May 2015. All patients who had chest plain and enhanced CT scan were underwent the plain scan at the end of deep expiratory and were underwent the enhanced scan at the end of deep inspiratory. The scan scope covered all tracheal and bronchi of patients' necks and chests. Before the examinations, all patientsheight, weight, age and BMI were well recorded and calculated. All raw datas of CT scan were reconstructed for continuous thin slice images with the thickness of 0.625 mm. All the images were transfered to GE post-processing workstation, choose the suitable window level(WL) and window width(WW) [(WW500Hu, WL-100Hu) ?(WW400Hu, WL40Hu) ?(WW1000Hu, WL-700Hu)]to measure the tracheal length(TL),the length and diameter of principal bronchus(LBL?RBL?LBD?RBD),diameter and area(TCD?TSD?CSA) of trachea at 2 cm above than tracheal carina,Left upper lobe bronchial diameter ?length?area(LUBD?LUBL?LUBA),Right upper lobe bronchial diameter ?length?area(RUBD?RUBL?RUBA),Intermediate bronchial diameter?length?area(IBD?IBL?IBA),subcarinal angle(SCA). Calculated changes of dimensions under different respiratory statuses. Two groups were divided according to patients' ages, with which young group( ages of 18 to 45) and elder group( ages of 46 to 75). Analysis of variance was adopted to compare central airway physiological values of different weights?heights and BMI. Independent-samples t test was adopted to compare different genders and ages. Pair t test was adopted to compare different respiration condition. The protocol was approved by the Committee on the Ethics of Zhengzhou University. Results:1?Central airway dimensions at deep inspiratory condition:(105.8±12.8)mm for TL,(45.7±5.3)mm for LBL,(15.4±4.0)mm for RBL,(17.8±3.2)mm for TCD,(17.6±2.9)mm for TSD,(13.8±2.2)mm for LBD,(15.1±2.3)mm for RBD,(9.7 + 1.4) mm for LUBD,(10.7 + 2.2) mm for RUBD;(12.5±1.8)mm?(11.2±2.0)mm for LUBL?RUBL;(12.7 + 1.5) mm and(8.7 + 1.9) mm for IBPD and IBDD,(28.1±5.4)mm for IBL,(240.8±72.3)mm2 for CSA,(59.5±5.0)mm2?(58.3±6.3)mm2 ?(130.2±7.3)mm2for LUBA?RUBA?IBA;(76.7±17.0)°for SCA;(95.7±14.0)°for right principal bronchus and right upper lobe bronchial angle,(164.0±7.0)°for right principal bronchus and intermediate bronchial angle,(94.0±12.3)°for right upper lobe bronchus and intermediate bronchial angle,(98.5±14.8)°for left upper lobe bronchus and left lower lobe bronchial angle.2?Central airway dimensions at deep expiratory condition:(98.9±11.9)mm for TL,(43.2±4.9)mm for LBL,(14.5±3.6)mm for RBL,(16.6±3.0)mm for TCD,(15.2±3.0)mm for TSD,(13.0±2.1)mm for LBD,(14.6±2.0)mm for RBD,(8.9±1.3)mm for LUBD,(9.9±2.2)mm for RUBD,(12.1±1.7)mm?(10.8±1.9)mm for LUBL?RUBL;(11.9±1.4) mm and(8.1±1.7) mm for IBPD and IBDD,(25.9 + 5.3) mm for IBL,(197.3±66.3)mm2for CSA;(50.4±4.8)mm2?(51.2±5.1)mm2 ?(115.1±6.3)mm2for LUBA?RUBA?IBA;(84.6±16.2)°for SCA.(86.0±12.9)°for right principal bronchus and right upper lobe bronchial angle,(157.9±7.2)°for right principal bronchus and intermediate bronchial angle,(102.6±9.8)°for right upper lobe bronchus and intermediate bronchial angle,(87.1±13.4)°for left upper lobe bronchus and left lower lobe bronchial angle.3?Central airway dimensions were differ significantly among different gender, age and height(P<0.05),while these were not differ significantly among different weight and BMI.(P>0.05).Central airway dimensions have correlation with gender, age and height, but have no correlation with weight and BMI. Most of the central airway dimensions of male are larger than these of female, while the SCA of male is smaller than that of female. Tracheal length and subcarinal angle of in elder group are smaller than these in young group, while TCD and TSD in elder group are larger than these in young group. There was positive correlation between height and TL?LBL?RBL?TCD?TSD?LBD?RBD, while there was negative correlation between height and SCA.4?Respiratory movement can make changes of physiological values of the central airway, Inspiratory movement can make the central airway ‘s length and diameter larger, carinal angle becomes small, The angle between the lobes of the bronchus becomes larger and the difference is statistically significant; respiration of male and young people in the central airway diameter change value of the larger.5 ? Physiological values of the central airway were statistically significant difference among lung window?mediastinum window and fat window;the diameters and areas of trachea were significantly different at different sections;the diameters of bronchus were significantly different between axial view and coronal view;there was not significantly different of bronchus diameters between coronal view and calculated values using Pythagorean theorem. Conclusions:Spiral CT is the ideal medical tool to observe and measure the diameter and shape of trachea and principal bronchus. This research provides central airway dimensions of the normal population, explores the dimensions changes under different respiratory conditions as well as their influential factors, and presents new anatomical datas. Central airway dimensions have correlation with gender, age and height, but have no correlation with weight and BMI. There was positive correlation between height and TL?LBL?RBL?TCD?TSD?LBD?RBD, while there was negative correlation between height and SCA. Respiratory moment can change the dimensions of trachea and principal bronchus, which is more evident among the male and young people.Physiological values of human central airway can provide a reference for selecting different type of airway stent for different gender, age and height. |
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