TY - JOUR
T1 - Imaging evaluation of tracheobronchial injuries
AU - Moser, Joanna B.
AU - Stefanidis, Konstantinos
AU - Vlahos, Ioannis
N1 - Publisher Copyright:
© RSNA, 2020.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Tracheobronchial injuries are a rare but potentially life-threatening cause of respiratory insufficiency, with high mortality rates. For patients with potentially survivable tracheobronchial injuries, imaging in the acute setting plays a key role in demonstrating the injuries and associated complications. The radiologist can improve outcomes by understanding typical injury patterns according to injury mechanism and the influence that imaging findings may have on treatment decisions. Chest radiography and cervical and thoracic CT are the mainstays of imaging in the acute setting and in follow-up, often as part of a whole-body trauma imaging series. The authors first consider the influence of normal tracheobronchial anatomy with regard to protective features, such as cartilaginous rings. They also discuss inherent points of vulnerability, such as points of relative fixation at the carina. A framework is then provided for understanding the typical distribution and morphology of tracheobronchial injuries according to cause. This includes penetrating, iatrogenic, and blunt force mechanisms, with consideration of potential complications. The authors highlight treatment strategies that require multidisciplinary collaboration, such as ventilation, minimizing injuries, and defining optimal surgical or nonsurgical treatment.
AB - Tracheobronchial injuries are a rare but potentially life-threatening cause of respiratory insufficiency, with high mortality rates. For patients with potentially survivable tracheobronchial injuries, imaging in the acute setting plays a key role in demonstrating the injuries and associated complications. The radiologist can improve outcomes by understanding typical injury patterns according to injury mechanism and the influence that imaging findings may have on treatment decisions. Chest radiography and cervical and thoracic CT are the mainstays of imaging in the acute setting and in follow-up, often as part of a whole-body trauma imaging series. The authors first consider the influence of normal tracheobronchial anatomy with regard to protective features, such as cartilaginous rings. They also discuss inherent points of vulnerability, such as points of relative fixation at the carina. A framework is then provided for understanding the typical distribution and morphology of tracheobronchial injuries according to cause. This includes penetrating, iatrogenic, and blunt force mechanisms, with consideration of potential complications. The authors highlight treatment strategies that require multidisciplinary collaboration, such as ventilation, minimizing injuries, and defining optimal surgical or nonsurgical treatment.
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U2 - 10.1148/rg.2020190171
DO - 10.1148/rg.2020190171
M3 - Article
C2 - 31977262
AN - SCOPUS:85081016506
SN - 0271-5333
VL - 40
SP - 515
EP - 528
JO - Radiographics
JF - Radiographics
IS - 2
ER -