Bronchial Stenosis

by Janice Cook-Granroth1, Dr. Silverman2Dr. Ferguson3,
Dr. Higgins4, Dr. Hoffman1, and Dr. McLennan3

1Department of Radiology, University of Iowa, Iowa City, IA 52242
2Deptment of GI, University of Iowa, Iowa City, IA 52242
3Department of Internal, Medicine University of Iowa, Iowa City, IA 52242
4Department of Electrical Engineering, Penn State University, University Park, PA 16802




Table of Contents:
Patient History
Original CT Scan
Surface Rendered Movies
Volume Rendered Movies
Measurements

Patient History for Bronchial Stenosis

Patient is a 54 year old female with secondary breast cancer causing complete esophageal obstruction. Stents placed in esophagus, and left main bronchus to prevent closure of this after esophageal stent placement.



MPEG Movies of the airway.

Before stent placement.

After stent placement.

Original CT scan

Before stent placement:
The original trans axial section data set has 280 slices. The slices are spaced 1 mm apart with 0.5 mm overlap. Scanned on 11-07-01.

After stent placement:
The original trans axial section data set has 475 slices. The slices are spaced 1.3 mm apart with 0.6 mm overlap. Scanned on 11-26-01.

Surface rendered Movies

Before stent placement:

This movie displays the segmented airway .

This movie displays the segmented airway and part of the esophagus .

After stent placement:
Here is a picture of the airway and esophagus from the Nov. 26, 2001 scan.

This movie displays the segmented airway.

This movie displays the segmented airway, the left main bronchus stent, the air in the esophagus, and the esophagus stent.

This movie displays the segmented airway, the left main bronchus stent, and the air in the esophagus (please note that the esophagus has many tumors along the inside).

Volume rendered Movies

Before stent placement:
Movie of the airway and ribs.

Bronchoscopy

After stent placement:
This movie displays the trachea and left main bronchus from the Nov. 26, 2001 scan.

Measurements

Trachea from the 11/07/01 scan before stent placement. 

Tube Geometry Analysis Summary
Date            : Fri Nov  9 15:48:17 2001
Oblique slices  : 31
Segmented image : airseg.s161-280_flip_int
Original image  : leinfost110701_flip
Note            : trachea

Slice Area [mm^2] AP [mm] Lat [mm]               Position   Major   Minor  Orthogonal
    1      85.037  11.460   13.179  (265.59,191.23,  3.39)  12.927   8.042       8.204 
    2      32.505   6.303   10.314  (277.12,177.37,  1.42)   9.741   3.485       3.844 
    3      87.336  10.314   12.033  (274.77,180.53,  6.17)  12.619   7.449       8.103 
    4     155.300  13.752   13.752  (271.63,185.79,  6.95)  15.734  12.249      13.668 
    5     173.358  14.898   14.325  (270.22,187.67, 10.48)  16.054  12.515      15.257 
    6     192.401  15.471   14.898  (269.24,189.11, 14.35)  16.418  13.752      14.642 
    7     185.506  14.898   14.898  (268.11,191.65, 17.55)  16.388  13.752      15.128 
    8     205.534  16.044   14.898  (267.34,193.94, 21.03)  16.920  14.336      15.640 
    9     198.311  15.471   15.471  (265.78,196.62, 23.86)  16.656  14.325      14.865 
   10     205.534  16.617   16.044  (264.42,198.96, 27.08)  17.493  14.496      15.734 
   11     201.594  16.617   15.471  (262.95,201.76, 29.90)  16.930  14.325      15.128 
   12     205.862  16.617   14.898  (262.45,204.14, 33.37)  17.323  14.507      14.787 
   13     197.654  16.617   14.898  (261.27,207.39, 35.79)  17.993  13.523      13.871 
   14     204.549  16.044   15.471  (260.85,210.47, 38.64)  18.120  13.328      13.989 
   15     216.040  17.190   16.044  (260.18,213.47, 41.50)  18.796  13.377      13.523 
   16     214.727  16.617   16.617  (259.41,216.08, 44.70)  18.656  12.966      12.966 
   17     214.399  16.044   17.190  (259.18,218.39, 48.26)  19.073  13.191      13.191 
   18     204.877  14.898   17.190  (258.31,220.43, 51.89)  18.770  12.813      13.365 
   19     199.952  14.898   17.190  (258.00,221.52, 55.98)  18.514  12.580      13.092 
   20     201.922  14.325   17.763  (257.42,222.18, 60.13)  18.664  12.877      12.877 
   21     194.042  13.752   17.763  (257.05,222.98, 64.22)  18.210  12.249      12.249 
   22     182.223  13.179   16.044  (256.61,223.30, 68.37)  17.652  11.965      12.723 
   23     192.401  13.752   16.044  (256.64,223.78, 72.54)  18.120  12.369      13.523 
   24     194.371  14.325   16.044  (255.75,224.53, 76.58)  17.901  13.584      14.233 
   25     196.997  14.325   16.044  (254.78,225.34, 80.74)  18.452  13.079      13.523 
   26     209.474  15.471   16.044  (254.53,225.89, 85.05)  18.345  14.325      15.128 
   27     207.832  15.471   14.898  (253.67,227.26, 89.07)  18.273  14.325      16.227 
   28     210.787  15.471   14.898  (252.30,228.91, 92.85)  17.540  14.876      15.931 
   29     193.057  13.752   14.898  (252.14,232.09, 95.75)  17.846  12.619      16.617 
   30     139.868   9.741   16.044  (251.38,235.10, 98.75)  16.656   8.614      10.519 
   31      80.769   5.730   16.044  (251.62,238.77,101.23)  15.428   4.620       4.896

Trachea from the 11/26/01 scan after stent placement. 

Tube Geometry Analysis Summary
Date            : Thu Jan  3 16:39:07 2002
Oblique slices  : 31
Segmented image : seg4.s1-133_int
Original image  : seg4.s1-133
Note            : trachea 

Slice Area [mm^2] AP [mm] Lat [mm]               Position   Major   Minor  Orthogonal
    1      96.566  14.727    9.629  (268.37,160.84,  1.79)  15.738   6.333       6.605 
    2     133.139  11.895   13.594  (265.06,166.59,  6.05)  13.932  10.747      11.157 
    3     127.364  11.328   13.594  (265.08,168.19, 10.92)  13.641  10.195      10.821 
    4     125.439  11.895   13.027  (265.12,169.49, 15.88)  13.688   9.892      12.665 
    5     127.685  12.461   13.594  (264.69,171.44, 20.57)  13.688  10.037      12.422 
    6     137.630  13.027   13.594  (263.95,172.90, 25.40)  13.989  10.998      13.211 
    7     156.237  14.160   14.160  (262.67,174.79, 29.95)  14.954  12.227      13.428 
    8     176.449  14.727   14.160  (261.07,176.67, 34.40)  15.869  13.606      14.954 
    9     177.732  14.160   14.160  (259.98,179.36, 38.55)  16.200  13.223      14.617 
   10     200.189  15.293   15.293  (258.92,182.25, 42.56)  16.426  14.705      16.020 
   11     202.756  15.859   15.293  (257.76,185.47, 46.29)  17.338  14.340      15.748 
   12     200.831  15.859   14.727  (256.22,188.30, 50.20)  16.821  14.441      15.219 
   13     199.548  16.426   14.727  (255.62,191.09, 54.40)  17.595  13.617      14.295 
   14     196.019  15.293   15.859  (254.79,194.43, 58.12)  17.264  13.700      14.069 
   15     200.831  16.426   15.293  (254.66,198.40, 61.34)  18.134  13.040      13.711 
   16     210.455  16.426   16.426  (254.08,201.29, 65.52)  18.240  13.211      13.368 
   17     201.472  15.859   16.426  (254.28,203.85, 69.87)  18.134  12.841      12.841 
   18     196.660  14.727   16.992  (254.01,205.81, 74.50)  18.519  12.841      13.463 
   19     192.169  14.160   17.559  (253.81,206.83, 79.42)  18.134  11.948      12.370 
   20     187.357  14.160   16.992  (253.30,207.84, 84.32)  17.740  11.908      12.370 
   21     172.920  13.027   16.426  (253.11,208.22, 89.29)  17.292  11.399      11.948 
   22     175.486  13.027   15.859  (252.64,208.86, 94.21)  17.002  11.827      12.435 
   23     178.053  13.594   15.859  (251.92,209.04, 99.15)  17.731  12.227      12.665 
   24     185.111  14.160   15.293  (251.80,209.75,104.09)  17.449  13.174      14.160 
   25     192.490  14.160   15.859  (251.57,210.17,109.07)  17.264  13.606      14.954 
   26     181.582  13.594   14.160  (250.71,211.10,113.92)  16.840  13.027      14.867 
   27     178.374  14.160   14.160  (249.94,212.33,118.70)  15.748  13.606      14.954 
   28     172.278  13.594   14.160  (249.88,213.73,123.50)  15.408  13.040      14.770 
   29     177.732  13.027   15.293  (250.11,214.46,128.49)  16.229  11.948      13.700 
   30     182.224  12.461   16.426  (250.39,215.98,133.30)  17.227  11.895      12.928 
   31     132.818   9.062   19.258  (251.51,220.05,136.70)  19.465   6.230       6.333

Left Main Bronchus from the 11/07/01 scan before stent placement. 

Tube Geometry Analysis Summary
Date            : Fri Nov  9 15:10:24 2001
Oblique slices  : 15
Segmented image : airseg.s87-160_flip_int
Original image  : airseg.s87-160_flip_int
Note            : LMB

Slice Area [mm^2] AP [mm] Lat [mm]               Position   Major   Minor  Orthogonal
    1      36.445   8.022    6.303  (258.69,229.31,  3.90)   7.537   4.929       5.283 
    2      69.277  12.033    7.449  (260.32,235.76,  5.77)  12.142   5.730       6.707 
    3      74.531  12.033    7.449  (262.04,238.18, 10.50)  12.515   7.180       7.794 
    4      86.022  11.460    9.741  (263.58,240.34, 15.41)  12.723   8.042       9.398 
    5      94.887  12.033   10.314  (265.54,241.99, 20.32)  12.567   9.257       9.485 
    6     102.439  10.887   12.606  (267.35,244.48, 24.93)  12.877   8.671       8.728 
    7     102.767  10.314   13.179  (268.59,246.68, 29.88)  13.426   7.794       8.518 
    8      93.902  10.887   12.606  (270.93,248.54, 34.57)  12.927   8.595       8.895 
    9      81.754   9.741   12.033  (273.57,250.49, 39.13)  12.087   7.471       8.103 
   10      71.247   9.741   10.887  (276.62,252.34, 43.48)  10.887   6.924       7.471 
   11      71.576   9.168   10.887  (280.47,254.30, 47.08)  11.126   7.293       7.794 
   12      68.949   9.168   10.887  (284.51,255.78, 50.70)  11.022   7.338       8.103 
   13      65.666   9.168    9.741  (288.75,257.86, 53.78)  10.658   6.900       6.900 
   14      61.398   9.168    9.741  (293.42,259.14, 56.68)  10.154   6.198       7.449 
   15      54.174   8.595    8.595  (299.46,260.20, 57.91)   9.398   6.533       6.994

Left Main Bronchus from the 11/26/01 scan after stent placement. 

Tube Geometry Analysis Summary
Date            : Thu Jan  3 17:07:57 2002
Oblique slices  : 15
Segmented image : seg3.s134-186_int
Original image  : seg3.s134-186
Note            : lmb

Slice Area [mm^2] AP [mm] Lat [mm]               Position   Major   Minor  Orthogonal
    1      51.972   8.496    7.930  (259.68,219.28,  5.49)   8.811   6.333       8.010 
    2      68.975   9.062   10.195  (263.72,221.99,  8.15)  11.663   6.820       7.097 
    3      62.559   9.629    9.629  (264.82,223.24, 12.44)  11.243   6.021       6.021 
    4      65.767   8.496   10.762  (266.52,224.07, 16.64)  11.399   6.408       7.097 
    5      86.620   9.629   11.895  (269.16,225.67, 20.04)  12.108   7.869       8.664 
    6     102.340  10.762   12.461  (271.53,227.53, 23.51)  12.728   8.793       9.629 
    7     110.682  10.762   13.027  (273.92,229.36, 27.01)  13.368   9.220       9.745 
    8     102.661  11.328   12.461  (277.19,230.71, 29.98)  12.576   9.133       9.695 
    9      95.282  10.195   11.328  (280.22,232.12, 33.10)  12.576   8.793      10.085 
   10      91.433  10.195   11.895  (282.95,234.05, 36.20)  11.895   8.866       9.062 
   11      94.320  10.195   11.895  (286.41,235.52, 38.77)  11.948   9.290      10.258 
   12      93.357   9.629   11.895  (289.83,236.97, 41.41)  11.552   9.133       9.220 
   13      86.941   9.062   11.328  (293.61,238.01, 43.75)  11.385   8.496       8.571 
   14      78.921   9.629   10.762  (297.52,239.02, 45.89)  10.895   8.247       9.133 
   15      51.010   7.930    9.629  (301.24,240.54, 48.26)   9.646   4.314       4.567




©1994-2002 Division of Physiologic Imaging, Dept. of Radiology, Univ. of Iowa


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Last modified: Thu Jan 3 15:35:03 CST 2002