Estimation of 3D tracheal volume using regression analysis on multidetector computed tomography and quantitative deviation analysis at two different anatomical levels.

PURPOSE: This study sought to streamline 3D tracheal volume (3D TV) assessment using routine multidetector computed tomography (MDCT) based estimation rather than time-consuming segmentation, while defining regional deviation dynamics for clinical planning.

METHODS

3D Slicer software was used to analyze thoracic multidetector computed tomography (MDCT) images from 147 healthy adults (71 women, 76 men) aged 18-83 years. The researchers measured tracheal length (TL), anterior-posterior diameter (TAPD), transverse diameter (TTD), subcarinal (SCA) and interbronchial (IBA) angles, and 3D TV. The magnitude of deviation was calculated in millimeters at the subcricoid (cervical) and carina (thoracic) levels.

RESULTS

3D TV (males: 34.39 ± 7.15cm³, females: 23.89 ± 7.10cm³), TL (males: 11.03 ± 1.12cm, females: 9.82 ± 1.41cm), TAPD (males: 20.89 ± 3.22mm, females: 16.49 ± 3.08mm), and TTD (males: median 16.97mm, females: median 14.00mm) were significantly higher in males (p < 0.001). Conversely, SCA was wider in females (85.98° ± 13.41°) than males (79.66° ± 12.33°) (p = 0.004). Age had no significant effect on 3D TV and deviation (p > 0.05). Rightward thoracic deviation predominated (70.75%), being significantly greater than cervical deviation (median 4.20mm, Z = -9.25, p < 0.001). Horseshoe-shaped morphology correlated positively with thoracic deviation (r = 0.300, p = 0.019). The developed multiple linear regression model including age, sex, TL and TAPD explains 53.5% of the variance of 3D TV, with TL, sex and TAPD as significant predictors (adjusted R² = 0.535, p < 0.001).

CONCLUSION

This model allows for personalized airway assessment via two routine linear measurements and sex without requiring volumetric segmentation. The age-independent rightward thoracic deviation represents a frequently observed anatomical orientation, and these objective morphometric baseline data may inform procedural planning during invasive airway interventions.