Dynamic Digital Radiography for Functional Assessment of Unilateral Main Bronchial Stenosis Before and After Treatment: A Case Report.

Functional assessment of unilateral main bronchial stenosis is challenging because conventional pulmonary function tests and morphological imaging may not adequately reflect side-specific ventilation abnormalities. Dynamic digital radiography (DDR) enables visualization of respiratory dynamics throughout the breathing cycle. A 75-year-old woman presented with cough and dyspnea on exertion was found to have a nodular lesion causing near-complete obstruction of the left main bronchus. Bronchoscopic snare resection was performed, and histopathological examination confirmed mucoepidermoid carcinoma without metastatic disease. DDR performed before treatment demonstrated marked left-right asymmetry, reduced expansion of the affected lung during inspiration, and mediastinal shift during expiration. After intervention, DDR showed restoration of lung expansion, resolution of mediastinal shift, and improved respiratory synchrony between the two lungs. Pulmonary function testing also improved after treatment. These findings suggest that DDR can provide direct visualization of functional respiratory abnormalities and their resolution after bronchoscopic intervention in unilateral main bronchial stenosis.