ISSN:0883-5993    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Metastasis along the needle track (NTM) after a transthoracic needle biopsy (TNB) is considered a very rare complication. A survey of the membership of the Society of Thoracic Radiology and a review of the English-language literature were conducted to assess the incidence of this complication and its predisposing factors and natural history. A questionnaire was sent to all radiology departments in the United States and Canada that had a senior member of the Society of Thoracic Radiology. The total number of TNB between 1978 and 1993 and occurrences of NTM were elicited. If an NTM was encountered, information on the size of the nodule, proximity to the pleura, histology, size of the biopsy needle, and the interval between biopsy and NTM and outcome of the patient was elicited. The incidence of NTM was estimated using binomial proportions. Results of the literature survey were tabulated to provide similar information. One hundred sixty-five questionnaires were mailed and 75 responses were received. Approximately 68,346 TNB were reported. Five departments reported a total of eight NTM, resulting in an incidence of 0.012%. The average interval between TNB and NTM was 2.6 months. There were no predictable risk factors. The outcome was known in only 11 patients; 4 patients died by the time of reporting (2 after 14 months and 1 each after 6 and 9 months). From the results of this survey, the incidence of NTM after TNB is approximately 0.012%. This small risk is random and unavoidable

ISSN:0883-5993    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The authors attempted to determine whether the anatomic characteristics of thoracic lesions and the surrounding lung field, as assessed by the preprocedure chest computed tomography (CT) scan, can assist in predicting the yield of complications or positive results of pathologic examination resulting from percutaneous core-needle biopsies (PCNB). The pathologic diagnoses and procedural complications of 50 consecutive thoracic PCNBs (43 men, age range 19–81 years) performed under the guidance of a single operator (J.A.M.) were recorded. Prebiopsy chest CT findings, including the size, depth, location, and border appearance of the lesion, as well as presence or absence of adjacent emphysema, interstitial fibrosis, bullae, pleural effusions, and the age and smoking history of the patient were correlated with the biopsy results and any ensuing complications. The pathologic analysis in 42 patients (84%) was specific enough to positively impact patient management, with 29 malignant and 13 benign entities. The imaging variables that predicted obtaining adequate tissue for pathologic diagnosis were most importantly large size (especially >35 mm), although irregular lesion margins and increased depth were significant as well. Seven patients (14%) experienced a pneumothorax, only one of which (2%) was symptomatic and required thoracostomy. All patients experiencing a pneumothorax had CT evidence of emphysema or interstitial fibrosis and all biopsied masses in these individuals had spiculated borders, with six (86%) in an anterior location and only one involving the pleural surface. We conclude that the preprocedure CT scan can delineate several characteristics of both the patient and the lesion to be biopsied that can assist in predicting the rates of successful tissue retrieval or pneumothorax during PCNBs.

ISSN:0883-5993    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0883-5993    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

On computed tomography (CT), neurilemomas have generically been described as well-defined, round masses with heterogeneous contrast enhancement. The CT scans of 38 surgically proven thoracic neurilemomas in 36 patients were reviewed to characterize further the CT features of this tumor, with an emphasis on different enhancement patterns. Unenhanced CT was available in 32 patients; 10 tumors appeared isodense, and 22 tumors appeared slightly hypodense compared with chest wall muscle. Except for an intraosseous neurilemoma of the T8 vertebral body, which mimicked bone metastasis, the tumors could be categorized into five different patterns on CT after contrast enhancement. Twenty tumors (54.1%) revealed diffuse, but amorphous and inhomogeneous enhancement. Seventeen (45.9%) tumors appeared as masses with multiple hypodense or cystic areas. Of these 17, the pattern was somewhat radial enhancement (n = 6, 16.2%), peripheral enhancement with a large central hypodense area (n = 5, 13.5%), homogeneous hypodensity (n = 5, 13.5%), and central enhancement with peripheral hypodensity (n = 1, 2.7%). Appreciation of various CT manifestations is important in the diagnosis of this tumor.

ISSN:0883-5993    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Solitary fibrous tumor of the pleura (previously known as benign fibrous mesothelioma or pleural fibroma) can have a wide variety of appearances on imaging examinations. This essay reviews some of the lesion's more dramatic features.

ISSN:0883-5993    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Patients with severe, diffuse emphysema may be candidates for pneumectomy (lung-volume reduction surgery, LVRS) to improve lung and respiratory muscle function. To identify candidates who might benefit from this surgery, it is necessary to understand how lung volumes and respiratory function are effected. In this article, the authors demonstrate a significant difference in lung size on chest radiographs obtained before and after surgery. Thirty-five of 71 consecutive patients undergoing LVRS had both preoperative and postoperative chest radiographs and pulmonary function tests available for retrospective review. Preoperative and postoperative measurements of lung height, transthoracic diameters, mediastinal width, heart size, diaphragmatic arc, and intercostal spaces were compared using paired r-tests. Radiographic measurements where also correlated with changes in lung volumes as measured by pulmonary function tests. Lung heights (right, left, mean lateral) and coronal diameter at the aortic arch were reduced after surgery (all p < 0.05). Forced vital capacity, forced expiratory volume in 1 second (FEV1), and vital capacity increased, and total lung capacity and residual volume decreased after surgery (all p < 0.05). Left lung height showed a significant correlation (p = 0.025) with FEV1; all other correlations between radiographic changes and pulmonary function test changes were not significant. The explanation for improved lung function in patients after LVRS is not completely clear and is probably multifactorial. Radiologic alterations reflect anatomic changes caused by surgery and support the theory that modifications of chest wall configuration occur and are likely responsible, in part, for improved symptomatology and respiratory function.

ISSN:0883-5993    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

In a patient with lung torsion, computed tomography demonstrated an occluded right upper lobe bronchus with opacified posterior lung. A pulmonary angiogram demonstrated the right upper lobe artery to be posteriorly and inferiorly displaced into the consolidated lung. In selected cases, computed tomography and angiography can help to confirm a torsed lung.

ISSN:0883-5993    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

A case is reported of a 79-year-old man with rapid onset of superior vena cava syndrome caused by an epithelioid hemangioendothelioma. Contrast-enhanced helical computed tomography showed a soft-tissue mass with punctate calcifications obstructing the superior vena cava and infiltrating adjacent fat. Epithelioid hemangioendothelioma is a very rare primary mesenchymal tumor of the superior vena cava that often presents with calcifications. It should to be added to the differential diagnosis of tumors of the anterior mediastinum

ISSN:0883-5993    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Pulmonary capillary hemangiomatosis is a rare disorder that is characterized pathologically by formation of capillaries along alveolar walls that may ultimately invade the pulmonary parenchyma and pulmonary arteries. The clinic presentation overlaps that of primary pulmonary hypertension, but the natural history of pulmonary capillary hemangiomatosis is one of rapid deterioration. The typical radiographic appearance is a diffuse bilateral reticulonodular pattern associated with enlarged central pulmonary arteries.

ISSN:0883-5993    

出版商:OVID    

年代:1998

数据来源: OVID