Koray BİNGÖL, Hatice ÇAKIR
Advanced Radiology and Imaging - 2026;3(2):38-43
Objectives: To characterize the radiologic anatomy of tracheobronchial branching using computed tomography (CT)-based morphometric analysis and to evaluate the associations between branching angles and demographic variables, particularly age and sex, in pediatric and adult populations. Methods: This retrospective cross-sectional study included 712 individuals (310 pediatric and 402 adults) who underwent thoracic CT. Four tracheobronchial angles were measured on coronal 25-mm minimum intensity projection images: the right-left main bronchial angle, right upper lobe bronchus-bronchus intermedius angle, right middle lobe bronchus-right lower lobe bronchus angle, and left upper lobe bronchus-left lower lobe bronchus angle. Angle measurements were compared according to age group and sex, and correlations with age were assessed. Results: The mean right-left main bronchial angle was 70.1+/-13.1 derece. The right middle-lower bronchial angle was significantly greater in adults than in children (44.1+/-12.8 derece vs. 38.4+/-12.7 derece, p<0.001). In children, the right-left main angle was greater in boys than in girls (71.2+/-12.3 derece vs. 68.0+/-13.3 derece, p=0.029), whereas in adults it was greater in women than in men (72.4+/-14.0 derece vs. 68.7+/-12.3 derece, p=0.005). Age showed weak correlations with the right upper-intermedius angle (r=-0.102, p=0.006) and right middle-lower angle (r=0.159, p<0.001). Conclusion: CT-based morphometric evaluation demonstrated that tracheobronchial branching geometry exhibits branch-specific anatomical variation associated with age and sex. Although the main bronchial bifurcation angle remained relatively stable across pediatric and adult populations, distal branching angles showed significant demographic differences. These findings provide radiologic anatomical reference data that may facilitate individualized interpretation of thoracic CT examinations and contribute to the anatomical assessment of patients undergoing bronchoscopic and thoracic procedures.
