Tracheal diverticula: A retrospective analysis of patients referred for thoracic CT

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Abstract

To assess the prevalence of tracheal diverticula (TD) in patients referred for thoracic Computed Tomography (CT).

1679 consecutive patients subjected to thoracic CT examination for different causes, from January to June 2017, were included in this cohort study. CT was performed with a 64 slice CT, using a standard protocol and Multiplanar Reformat Images (MPR). A TD was defined as a thin-walled air sac at the paratracheal wall with a communication with the tracheal lumen. Congenital or acquired nature of TD was determined by the anatomical location, being usually the congenital ones located 4 to 5 cm below the vocal cords or a few centimeters above the carina in the right paratracheal area, whereas acquired ones were located at the level of the thoracic inlet, in the posterolateral tracheal wall. Presence of TD was assessed and their number and size recorded based on 2 axial diameters and size of neck.

One or more TD were found in 96 patients (5.7% of sample), with a slight preponderance (65%) in male gender. Globally, 124 TD were detected; they were solitary in 75% of cases, double in 20.8%, and in about 4.2% they were triple. Average size of the TD was 1.3×4.9 mm with a mean width of the neck of 1.9 mm. The peak of prevalence (9%) was in patients belonging to the fourth-decade group (see Table 1). According to their anatomical location, the majority (97.6%) of TD were acquired in nature and devoided of specific symptoms (see below).

Acquired TD were detected in about 1 out of 20 of thoracic CTs and were usually incidentally. Our findings show a slightly higher frequency than previously reported. The most frequent presentation was in male and as a single entity. Clinically, TD was not associated with specific symptoms, in particular with chronic cough or Chronic Obstructive Pulmonary Disease (COPD).

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