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PubMedDate not supplied

[Ultrasound guided diagnostic procedures in the thorax].

Fluid in the pleural cavity, parenchyma masses and consolidation provide excellent sonographic windows for scanning. Ultrasound has proven extremely useful in directing interventional procedures in the pleural space, pulmonary parenchyma and mediastinum. Ultrasound offers a number of advantages over other imaging methods, the most important being the capability to monitor continuously the interventional procedures, thus assuring maximum safety and benefit. We will discuss the indications, technique, performances and complications of ultrasound guided thoracic puncture in the pleural space, pulmonary parenchyma and mediastinum.

Biopsy↗
PubMed2006

Comparative analysis of 99mTc-depreotide and 99mTc-EDDA/HYNIC-TOC thorax scintigrams acquired for the purpose of differential diagnosis of solitary pulmonary nodules.

BACKGROUND: Aiming at comparison of diagnostic efficacy of 2 radiopharmaceuticals: 99mTc-depreotide (Neospect, Amersham) and 99mTc-EDDA/HYNIC-Tyr3-octreotide (Tektrotyd, Polatom), in differentiation between malignant and benign etiology of solitary pulmonary nodules (SPNs), radionuclide studies with 2 radiotracers were performed in 18 patients. MATERIAL AND METHODS: For both radiopharmaceuticals the same acquisition and processing protocols were applied. Studies were acquired with SPECT technique, after administration of 740 MBq of activity. Scintigrams were assessed visually, as: positive (+), equivocal (+/-) and negative (-). Additionally, uptake intensity of both radiotracers in nodules was assessed semiquantitatively, using a tumour-to-background ratio. Verification of scintigraphic results was based in 14 cases upon a pathological examination of tumour samples (histopathology) and in the remaining 4 - on clinical observation and bacteriological studies. RESULTS: Normal scintigrams obtained with both radiopharmaceuticals differed significantly. 99mTc-depreotide was markedly accumulated in spine, sternum, ribs and lungs (mean lung/heart ratio = 2.2). This accumulation was not observed on 99mTc- -EDDA/HYNIC-TOC scintigrams (mean lung/heart ratio = 0.7). In 6 patients a malignant etiology--lung cancer--was revealed (5--adenocarcinoma, 1--squamous cell) and the other 12 cases turned out to be benign (4 hamartomas, 3 tuberculomas, a tuberculous infiltrate, an alien body with inflammatory reaction, a hyperplasia of lymphatic tissue and 2 cases of unknown etiology, from which one had a stable size and the other resolved during a 6 month observation period). In all 6 cases of lung cancer positive results were obtained with both tracers. Moreover, in 2 patients metastases in mediastinum could be observed on scintigrams obtained with both radiopharmaceuticals. From among 12 cases of benign etiology 6 99mTc-depreotide scintigrams were true negative, 1--equivocal and 5--false positive, whereas 6 99mTc-EDDA/HYNIC-TOC scintigrams were true negative, 4--equivocal and 2 false positive. Moreover, 99mTc-depreotide additionally revealed mediastinal and hilar lesions in 9 patients with benign lesions and 99mTc-EDDA/HYNIC-TOC - in 8. A visual comparison of scintigrams revealed a higher quality of 99mTc-Depreotide images in comparison with 99mTc-EDDA/HYNIC-TOC ones. 99mTc-Depreotide showed a higher than 99mTc-EDDA/HYNIC-TOC accumulation in lung tumours compared with blood pool (heart) - 4.5 (s.d. 1.05) and 1.8 (s.d. 0.29), respectively (p < 0.05). However, mean values of tumour-to-lung-background ratio were equal for both radiotracers (2.2 in malignant and 1.4 in benign lesions, respectively). A statistically significantly higher non-uniformity of counts inside lung background regions was found on 99mTc-EDDA/HYNIC-TOC scintigrams than on 99mTc-depreotide ones (16.4% vs. 11.4%; p < 0.01). CONCLUSIONS: Although both radiopharmaceuticals show similar diagnostic efficacy in differentiation of SPNs, a tendency toward a higher number of false positive results on 99mTc-depreotide scintigrams probably leads to a lower specificity. Better statistical quality of 99mTc-depreotide scintigrams facilitates their interpretation and a distinct outline of lungs simplify localization of lesions. A substantial number of false positive lesions in mediastinal and hilar regions in patients without a neoplastic process hamper the usefulness of both radiotracers for effective detection of lung cancer metastases to lymph nodes.

Adult↗
PubMed1991

[Anatomic markers of the thorax and mediastinum].

A basic Survey of thoracic gross anatomy is given. The particular importance of the spacial relationship of the organs (Thymus, esophagus, heart, lungs), the tubular systems (vessels, bronchi) and their variations is stressed. The lymphatic pathways of the lungs and their surroundings are analyzed. Selected axial cuts illustrate the topographic peculiarities of mediastinum and pleural spaces.

Humans↗
PubMed1990

[The effect of the age of the child at the time of surgery for pectus excavatum on respiratory function and anthropometric parameters of the thorax].

Respiratory function and anthropometric parameters of the chest were studied in two groups of children aged 15, undergoing pectus excavatum repair before and after the age of 12, respectively. Mean values of static and dynamic functional respiratory parameters were significantly lower in children operated before the age of 12. Sagital diameters of the chest determined at the level of sternal angle and costal arch intersection were significantly shorter in children operated before the age of 12. Restricted respiratory motility of the chest and shorter sagital diameters are very likely caused by the damage of active ossification centers in the sternum of children. The results support the indications for pectus excavatum repair beyond the age of 12.

Adolescent↗