MSCT Analysis and Identification of Remarkable Anatomical Types of Segmental Bronchi in R   ight Middle Lobe: Based on Extensive Data

Purpose: To evaluate the various branching patterns of segmental bronchi in the right middle lobe and to survey the anatomical diversity and sex-related differences of these branches in a large sample of the study population. Materials: and Methods: In this retrospective board-approved study with informed consent, 10,000 participants (5428 males, mean age 50+/-13.5 years[SD] years; age range: 3-91 years) who underwent multi-slice CT scans from September 2019 to December 2021 were retrospectively included. The data were applied to generate 3D and virtual bronchoscopy (VB) simulations of a bronchial tree using the syngo.via post-processing workstation. The reconstructed images were then interpreted to locate and classify distinct bronchial patterns in right middle lobe. Cross-tabulation analysis and the Pearson chi-square test were used to calculate the constituent ratios of bronchial branch types and determine their significance between male and female groups. Results: : Our results revealed that the segmental bronchial ramifications of the right middle lobe were classified into two types mainly, i.e., bifurcation (B4, B5, 91.42%) and trifurcation (B4, B5, B*, 8.58%). There were no significant sex-related differences in the proportion of bronchial branches in RML ( P>0.05 ). Conclusion: The current study has confirmed the presence of segmental bronchial variations in the right middle lobe using 3D reconstruction and virtual bronchoscopy. These findings may have significant implications for the diagnosis of symptomatic patients and for carrying out specific procedures like bronchoscopy, endotracheal intubation, and lung resection.