Excessive dynamic airway collapse co-morbid with COPD diagnosed using 320-slice dynamic CT scanning technology.

a significant portion of patients suffering from chronic obstructive pulmonary disease (COPD). An 88-year-old man presented with a 2 day history of episodic dyspnoea, wheeze and non-productive cough, on a background of COPD. Despite treatment with oral steroids and short-acting bronchodilators the patient remained symptomatic. A 320-slice, dynamic CT scan of the patient’s upper airway revealed EDAC along the posterior intrathoracic tracheal wall (see figures 1 and 2): Continuous positive airways pressure (CPAP) was applied at 10 cm H2O in order to abolish the patient’s symptoms. Repeat 320-slice CT scan of the neck with CPAP in situ demonstrated amelioration of the EDAC (see figure 3 and figure 4). The reference gold standard for diagnosing tracheomalacia and EDAC is bronchoscopy, which is problematic during acute episodes of dyspnoea. Recent advances in technology have enabled dynamic cine viewing of the upper airway in a less Figure 1 Three-dimensional reconstruction demonstrating collapse of the posterior trachea on expiration.