Spiral-CT und 3 D-Rekonstruktion des Tracheobronchialbaumes zur Auswahl geeigneter Doppellumentuben vor Einzellungenbeatmung

Abstract
To assess the potential of 3-D spiral CT in the selection of adequate double-lumen tubes (DLT) for one-lung-ventilation. 3-D spiral CT of eight different DLTs was performed with standardized acquisition parameters: section thickness 4 mm, table speed 6 mm/s, increment 3 mm and standardised thresholds, window settings and magnification zoom. The accuracy was confirmed by measuring 3-D objects on screen and original DLTs by vernier caliper. 3-D spiral CT was performed in 20 patients preoperatively with slice thickness 4-8 mm, pitch 1-1.5, increment 4-8 mm. To select the adequate DLT size the 3-D reconstructions of the patient's tracheobronchial tree and of the DLT were superimposed by templates or computer animation. The accuracy was controlled by endoscopic and clinical measurements. The accuracy of the 3 D spiral CT was nearly 0.1 mm. The superimposition with templates was easy and reliable. The 3-D spiral CT determined DLTs were shown to fit perfectly by clinical and endoscopic measurements in all cases. 3-D reconstructions of the tracheobronchial tree obtained from routine preoperative spiral CT scans allow for an easy and accurate individual selection of double-lumen tubes.

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