PubMed · 3905341
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C R Stock. 1985. Esophagoscopy.. https://pubmed.ncbi.nlm.nih.gov/3905341/
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PURPOSE: The technical conditions, the optimized scanning protocols and the facilities of virtual endoscopy (VE) are presented in an overview. METHODS: Phantom studies showed that, for a single-row-detector helical CT, collimation of 3.0 mm combined with pitch of 1.5 provided an optimal compromise between image quality and the scan duration per breath-hold. A multi-row-detector helical CT requires only a fraction of the scanning time. This is especially important for patients with dyspnea. RESULTS: The threshold-dependent virtual endoscopic surface rendering is a reliable and rapidly practicable reconstruction algorithm for the imaging of the upper airway. CONCLUSIONS: The VE technique is suitable for the imaging of space-occupying tumors and restricted stenoses. With VE follow-up examinations can be performed non-invasively and interventional procedures can be prepared in an optimal way. Because of the computed tomographic data acquisition the structure of the mucosa is not assessable and there is no opportunity to obtain a biopsy specimen.
Bedside fiberoptic bronchoscopy is a valuable tool in the diagnosis and treatment of various respiratory conditions in critically ill patients. The fiberoptic bronchoscope allows direct airway inspection, facilitating the diagnosis of benign and malignant airway lesions. In addition, pulmonary secretions or tissue samples can be collected using the bronchoscope and techniques that allow sampling of the lower airways with minimal or no upper airway contamination. Collection of lower airway samples is important in the diagnosis of pulmonary infiltrates in immunocompromised patients, in many patients with ventilator-associated pneumonia, and in selected patients with CAP. The fiberoptic bronchoscope can be used for therapeutic interventions, such as insertion of an endotracheal tube, removal of an aspirated foreign body, clearance of tenacious secretions, promotion of hemostasis in patients with hemoptysis, instillation of drugs, and assistance in the placement of tracheobronchial prostheses (i.e., airway stents). If proper preprocedural training and planning are done and the patient is monitored carefully during the procedure, fiberoptic bronchoscopy can be performed quickly and safely at the bedside in most critically ill patients.
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