Multi-Detector Row Computed Tomographic Evaluation of Bronchopleural Fistula

Abstract

To evaluate the usefulness of multi-detector row computed tomography (CT) in the diagnosis of bronchopleural fistula (BPF) and to correlate CT features with clinical, bronchoscopic, and surgical findings. Twenty-four patients had a final diagnosis of BPF. Thin-section axial and coronal multiplanar reformation images from multi-detector row CT datasets were assessed by 2 radiologists in consensus. The CT direct sign of BPF was a fistulous tract between the bronchus or lung and pleural space. The indirect signs were air bubbles beneath the bronchial stump or suspected fistula. Computed tomography demonstrated fistulous tract (central type, 3; peripheral type, 11) or indirect signs of BPF (central type, 3; peripheral type, 6), whereas bronchoscopy demonstrated 2 fistula openings (all central type) and indirect signs of BPF (central type, 2; peripheral type, 1). Thin-section axial and multiplanar reformation images are helpful in the diagnosis of BPF. Multi-detector row CT can be an initial diagnostic modality of BPF.