Accessory Cardiac Bronchus: Proposed Imaging Classification on Multidetector CT

Abstract

Purpose To propose the classification of accessory cardiac bronchus (ACB) based on imaging using multidetector computed tomography (MDCT), and evaluate follow-up changes of ACB.

Materials and Methods This study included 58 patients diagnosed as ACB since 9 years, using MDCT. We analyzed the types, division locations and division directions of ACB, and also evaluated changes on follow-up.

Results We identified two main types of ACB: blind-end (51.7%) and lobule (48.3%). The blind-end ACB was further classified into three subtypes: blunt (70%), pointy (23.3%) and saccular (6.7%). The lobule ACB was also further classified into three subtypes: complete (46.4%), incomplete (28.6%) and rudimentary (25%). Division location to the upper half bronchus intermedius (79.3%) and medial direction (60.3%) were the most common in all patients. The difference in division direction was statistically significant between the blind-end and lobule types (p = 0.019). Peribronchial soft tissue was found in five cases. One calcification case was identified in the lobule type. During follow-up, ACB had disappeared in two cases of the blind-end type and in one case of the rudimentary subtype.

Conclusion The proposed classification of ACB based on imaging, and the follow-up CT, helped us to understand the various imaging features of ACB.