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MDCT Detection of Airway Stent Complications: Comparison with Bronchoscopy

¹ Center for Airway Imaging, Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave., Boston, MA 02215.
² Department of Interventional Pulmonary Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.

OBJECTIVE. The objective of our study was to evaluate the detection rate of central airway stent complications using MDCT as compared with bronchoscopy.

MATERIALS AND METHODS. A review was performed of all consecutive patients undergoing MDCT and bronchoscopy for suspected complications of airway stents during an 18-month period. MDCT images were interpreted in a blinded fashion by an experienced thoracic radiologist before bronchoscopy was performed, and the accuracy of MDCT was determined using bronchoscopy as the gold standard. MDCT images were specifically assessed for the presence of the following complications: narrowing of stent lumen due to granulation tissue or secretions (or both), stent fracture, stent invasion by adjacent neoplasm, stent migration, and perforation of adjacent airways.

RESULTS. The study population was composed of 21 patients, with mean age of 48 years (range, 16–79 years), who underwent tracheal (n = 3), tracheobronchial (n = 7), or bronchial (n = 11) stent placement for benign (n = 13) or malignant (n = 8) airway disorders. Eleven of 21 stents were metallic and the remaining 10 were silicone. Thirty complications were detected in 21 patients, including stent luminal narrowing due to granulation tissue or secretions (or both) (n = 13), stent migration (n = 9), stent fracture (n = 4), stent invasion by adjacent neoplasm (n = 3), and tracheal perforation (n = 1). MDCT accurately detected 29 (97%) of the 30 complications diagnosed by bronchoscopy. There was one false-negative case in which MDCT failed to detect a stent fracture. There were no false-positive diagnoses of stent complications.

CONCLUSION. MDCT is highly accurate for detecting airway stent complications.

Keywords: airway stents • bronchoscopy • interventional radiology • MDCT • stent complications

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