Digital radiographic measurement of the main bronchi: a pilot study

Ann Trop Paediatr. 2009 Sep;29(3):209-16. doi: 10.1179/027249309X12467994693932.


Background: Conventional chest radiographs do not afford consistently good visualisation of the main bronchi and sub-carinal angle. Improved visualisation would facilitate accurate measurement of the airways, definition of normal radiographic anatomy and, possibly, earlier identification of extrinsic compression or displacement.

Aim: The main objective of this study was to establish whether the paediatric main bronchi and sub-carinal angle could be measured consistently on AP supine chest images obtained using a specific digital radiographic system (DRS).

Subjects and methods: The proximal bronchial diameters were measured on supine DRS chest images of 102 children between the ages of 6 months and 13 years.

Results: The left and right main bronchi could be seen clearly and measured in over 90% of cases, with intraclass correlation co-efficients of reliability indicating high intra- and inter-observer agreement. The sub-carinal angle had lower intra- and inter-observer agreement.

Conclusion: Supine chest images acquired using DRS facilitate accurate measurement of the main bronchi and sub-carinal angle in children. Further work is required to establish population-specific age-related norms for bronchial dimensions. These could serve as reference standards for early detection of deviations from normal.

MeSH terms

  • Bronchography*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Male
  • Pilot Projects
  • Radiographic Image Enhancement / methods*
  • Retrospective Studies
  • Tomography, X-Ray Computed