Application of 320-row multidetector free-breathing cine CT in diagnosis of pediatric expiratory central airway collapse

Background Pediatric expiratory central airway collapse poses diagnostic challenge due to non-specific clinical presentation with further investigations needed for definite diagnosis. The purpose of this cross-sectional study was to determine the diagnostic accuracy of 320-row multidetector free-breathing cine CT in diagnosis of pediatric expiratory central airway collapse utilizing its advantageous wide z -axis coverage. End-inspiratory and end-expiratory measurement of cross-sectional area at certain points of airway was done to calculate the percentage of expiratory central airway collapse. Flexible bronchoscopy was done thereafter as a gold standard technique for comparison. Results Among the thirty-eight pediatric patients (20 males and 18 females) enrolled in this study, free-breathing cine CT correctly diagnosed expiratory central airway collapse in 32 patients with a sensitivity of 84.2%. However, a statistically significant difference was found between the results of bronchoscopy and free-breathing cine CT as regard the site, morphology and severity of airway collapse. Conclusions 320-row multidetector free-breathing cine CT is still considered an effective noninvasive imaging modality in diagnosis of expiratory central airway collapse in pediatric population, despite the differences in perceived morphology and severity when compared to flexible bronchoscopy.