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Imaging of the Upper Airway

Cylen Javidan-Nejad, Sanjeev Bhalla

Key Points

  • Tracheal and bronchial imaging can effectively be done by magnetic resonance imaging (MRI) or computed tomography (CT).
  • Multidetector CT (MDCT) is faster than MRI.
  • MDCT does not require intravenous (IV) contrast.
  • Multiplanar and three-dimensional reconstructions may enhance diagnostic certainty by better delineating the craniocaudal extent of disease.
  • The craniocaudal extent of disease defines the differential diagnosis on imaging.

Diseases of the trachea and main bronchi are uncommon. As with other respiratory conditions, initial imaging evaluation begins with chest radiography. The entire trachea (from vocal cords to carina) may not be clearly seen on a single radiographic examination because of overlapping mediastinal structures.[1] In the era of digital radiography, the radiograph can be rewindowed to better delineate the trachea and separate it from adjacent structures. This can be a helpful way to detect suspected tracheal abnormalities, but it is not practical for routine evaluation of the chest because it requires extra steps that can be time-consuming.

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Last updated: February 10, 2025