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At least 19 recordsLinked to original sources
PubMed2003

The use of selective bronchography in predicting reversal of neoplastic obstructive atelectasis.

OBJECTIVES: To assess the ability of selective bronchography to predict which patients with neoplastic postobstructive atelectasis will respond to interventional therapies directed at the reexpansion of the affected lung. Furthermore, to compare the utility of selective bronchography with the current predictive standard that reversal of postobstructive atelectasis is unlikely when it is > or = 4 weeks in duration (ie, the 4-week rule). DESIGN: A prospective observational study. SETTING: A tertiary care referral center/medical school. PATIENTS: Twenty-seven consecutive patients with advanced lung cancer or other malignancy, with documented neoplastic postobstructive atelectasis involving a total of 44 lobes. INTERVENTIONS: Lobar collapse was documented radiographically. The duration of atelectasis was investigated and quantified as accurately as possible. Prior to the use of interventional therapies, selective bronchography was performed on each collapsed lobe, and the results were documented. Bronchography results did not influence the decision to proceed with interventional therapies. Patients had each of their collapsed lobes manipulated by interventional techniques that were directed at reexpansion of the lung. One week after the patient underwent the intervention, the degree of reexpansion was assessed radiographically. RESULTS: Interventional therapies leading to significant reversal of airway narrowing were completed in all 44 lobes. These were successful in reexpanding 28 of 44 collapsed lobes (64%). Selective bronchography demonstrated the following two distinct patterns: an intact bronchial tree (ie, tree pattern); or the absence of a distinguishable, distal bronchial tree (ie, blush pattern). The sensitivity of selective bronchography to predict reexpansion is 1.00 (95% confidence interval [CI], 0.90 to 1.00), and its specificity is 0.56 (95% CI, 0.30 to 0.80). There were no complications attributable to selective bronchography. The sensitivity of the 4-week rule to predict reexpansion is 0.61 (95% CI, 0.41 to 0.78), and its specificity is 0.75 (95% CI, 0.48 to 0.93). The results of selective bronchography and use of the 4-week rule were significantly different in predicting which lobes would reexpand and which would not (p = 0.0026). Using selective bronchography to predict the reversal of lobar atelectasis, the positive predictive value of the tree pattern was 0.80 and the negative predictive value of the blush pattern was 1.00. The values for the 4-week rule are 0.81 and 0.52, respectively. CONCLUSIONS: Selective bronchography is a useful tool for predicting whether patients with neoplastic postobstructive atelectasis would benefit from interventional techniques that are directed at lobar reexpansion. Selective bronchography appears to be superior to the 4-week rule in this regard.

Aged↗
PubMed1993

[A new technique for evaluating the respiratory tract--digital subtraction bronchography (DSBG)].

Bronchography is essential for evaluation of morphological changes in the bronchial tree. However, conventional bronchography using Propyliodone (Dionosil) is extremely invasive, especially to those with pulmonary infections. In the present study, we developed a new less invasive method of bronchography with the aid of digital subtraction technique (DSBG), and evaluated its clinical benefits. Bronchography was performed by injecting contrast medium (Iopamidol: Iopamiron 300) via the lumen of the bronchoscope (Olympus Type 20), and image processing of the respiratory tract was performed using digital subtraction technique. From 1991 to 1992, DSBG was performed in 15 cases (8 bronchiectasis, 1 diffuse panbronchiolitis, 1 lung cancer, 1 pulmonary emphysema, and 4 others). DSBG clearly demonstrated the morphological changes of large and segmental bronchial lesions in cases of bronchiectasis and lung cancer, as well as conventional bronchography using Dionosil. In addition, it was possible to image the morphological changes of bronchiolar lesions in diffuse panbronchiolitis and pulmonary emphysema to the same detail as obtained using classical selective alveolo-bronchography (SAB). Since DSBG can provide enhanced images the bronchial tree without being affected by cardiac and respiratory movements, we could obtain detailed information on bronchial and/or bronchiolar lesions. With respect to side effects, Iopamiron was quickly drained and/or absorbed within 2 hours after injection. Pulmonary infection and bronchial bleeding, which are well known primary complications of classical bronchography using Dionosil, were not observed. We conclude that 1) DSBG is useful new technique for examining morphological changes of the respiratory tract, and 2) DSBG is less invasive than conventional bronchography.

Adult↗
PubMed1995

[Survey of the state of bronchography in Japan].

Bronchography is not routinely done. We analyzed the state of bronchography with questionnaires returned from 57 hospitals. Bronchography is now done at 30 hospitals. The number done in 1992 ranged from 1 to 27 (median 3). Peripheral lung cancer and bronchiectasis were the two most frequent diseases for which bronchography was done. In other hospitals, bronchography was once done, but had been stopped. Two reasons for discontinuation of bronchography are: recent progress in radiographic diagnostic techniques such as high resolution CT, and discomfort of the patient. Now that propyliodone is no longer available, some hospitals may use iopydol-iopydone or iopamidol instead. It is necessary to elucidate the true need for bronchography and for an appropriate contrast medium to take the place of propyliodone.

Bronchography↗
PubMed1987

[Bronchography during flexible bronchoscopy. Indications and results in bronchiectasis].

The radiological imaging of the respiratory tract by bronchography has apparently lost in importance since the introduction of newer imaging methods. Indications for and results of bronchography, performed after bronchoscopy with a flexible bronchoscope under local anesthesia, were analysed in 115 patients. In 68 the bronchography had been performed because of suspected bronchiectasis, in the others because of hemoptysis, cough or infiltration of unclear etiology. In 43% of patients who had undergone bronchography bronchiectasis was indeed found, in 47% there were isolated or additional changes in the bronchial system. In 70% the examination had furthered the diagnosis. The described method of bronchography was not significantly more uncomfortable than flexible bronchoscopy alone. Combined bronchoscopy and bronchography is thus a valuable procedure in the diagnosis of pneumonological abnormalities.

Adolescent↗
PubMed2000

Benign abnormalities and carcinoid tumors of the central airways: diagnostic impact of CT bronchography.

OBJECTIVE: The purpose of this retrospective study was to determine the added diagnostic value, if any, of CT bronchography for the detection and characterization of benign abnormalities and typical carcinoid tumors of the central airways. MATERIALS AND METHODS: We used bronchoscopy and helical CT to examine 238 bronchial sections in 28 patients with 32 bronchial abnormalities and in five patients with normal bronchoscopy results. Postprocessing consisted of CT bronchography based on surface rendering. Images were interpreted independently by two observers (a radiologist and a pneumonologist) who were not informed of the bronchoscopy results. After initial interpretation of axial CT scans, the observers analyzed the axial CT scans with CT bronchograms. Results were evaluated for gain in diagnostic accuracy and in confidence. RESULTS: Mean sensitivity for detection of abnormal bronchial sections was 89% (range, 87-90%) for axial CT and 92% (range, 90-94%) for axial CT with CT bronchography (not significant). Mean specificity of both approaches exceeded 99%. A correct diagnosis of the nature of the bronchial abnormalities was proposed for 68% of the cases in which axial CT was used alone and in 76% in which both axial CT and CT bronchography were used (not significant). The addition of CT bronchography significantly increased the confidence of the pneumonologist in the diagnoses. CONCLUSION: Axial CT remains the technique of choice to detect and characterize benign abnormalities of the airways. CT bronchography provides little diagnostic gain but increases the confidence of chest physicians in the interpretation of CT scans for the assessment of benign abnormalities and typical carcinoids of the central airways.

Adolescent↗
PubMedDate not supplied

Characteristics of tantalum dust and dust generator for bronchography.

The two tantalum powders, "5mu" and "1.4mu", available from Fansteel Metals, are characterized with respect to particle size. Results show that these powders cannot be used directly for tantalum bronchography, but require fractionation to achieve a range of sizes for effective use in tantalum bronchography. This task can be accomplished with the BAHCO Micro Particle Classifier. The powder designated "1.4mu" is superior to the "5mu" powder because about 60% by weight can be salvaged by separation for use in bronchography, compared to only 7% by weight of the "5mu" powder. Theoretical considerations of particle deposition in the human respiratory tract indicate that the material obtained with throttle 16 of the BAHCO is best suited for tantalum bronchography. The dust generator is a good tool to deliver a dust cloud into the lung. The generator can operate for approximately 2 1/2 hours before the brush of the brush feed must be replaced; a procedure taking about 10 min. Additional maintenance is unnecessary. The breathing resistance of 1.1 inch of water imposed by the generator system, and which has to be overcome by the patient, is judged acceptable. The bronchograms obtained by introducing tantalum dust for 10 min into an artificially ventilated dog lung were clear, with deposition heaviest at bifurcations. These results suggest that the generator should now be used for human bronchography.

Animals↗
PubMed1990

Comparison of thin section computed tomography with bronchography for identifying bronchiectatic segments in patients with chronic sputum production.

Computed tomography is widely used in the investigation of patients in whom bronchiectasis is suspected, despite considerable variation in its reported sensitivity and specificity. The findings with 3 mm high resolution computed tomography were compared at segmental level with bronchography by two radiologists independently in 27 patients (aged 20-67 years) undergoing investigation of chronic sputum production. Fifteen patients were found to have bronchiectasis by both investigations. Five were identified by computed tomography alone, including two in whom disease was revealed in segments underfilled at bronchography. The sensitivity of computed tomography compared with bronchography in the diagnosis of bronchiectasis at segmental level was 84% and the specificity 82%. The predictive value of computed tomography in the diagnosis of bronchiectasis was 38% overall, but increased to 75% when only those segmental bronchi moderately or severely dilated on the computed tomography scan were considered. There was no relation between the degree of bronchial wall thickening on the computed tomogram and the diagnosis of bronchiectasis by bronchography. Bronchography may be avoided in patients being considered for surgical resection of their bronchiectasis in whom computed tomography shows diffuse disease.

Adult↗
PubMed1990

Suitability of and tolerance to Iotrolan 300 in bronchography via the fibreoptic bronchoscope.

The contrast agent Iotrolan 300 has potential advantages for bronchography over previous agents in that it can be injected directly through the bronchoscope and it does not obscure bronchoscopic vision or interfere with further bronchoscopic procedures. It was used for selective bronchography in 20 patients with suspected bronchiectasis. Side effects and change in FEV1 and in arterial oxygen saturation were compared in these patients and in 14 patients undergoing bronchoscopy for suspected carcinoma. Thirteen of the 20 patients undergoing bronchography had side effects, mainly headache, nausea, and a feeling of heat or flushing. The fall in FEV1 at four hours (0.3 l) did not differ from the fall in the control group (0.1 l). The fall in arterial oxygen saturation (SaO2) during bronchography (9.4%) did not differ significantly from the fall during bronchoscopy in the control group (6.1%). Iotrolan gave good quality bronchograms, which in all cases provided a diagnosis. Iotrolan appears to be suitable for bronchography by fibreoptic bronchoscope and to be well tolerated.

Bronchiectasis↗
PubMed1994

Central bronchiectasis in allergic bronchopulmonary aspergillosis: comparative evaluation of computed tomography of the thorax with bronchography.

Demonstration of central bronchiectasis (CB) with normal peripheral bronchi is an essential requirement for the diagnosis of allergic bronchopulmonary aspergillosis (ABPA). Although the results of bronchography remain the gold standard for demonstration of central bronchiectasis they are not always diagnostic. Moreover, it is an unpleasant invasive procedure which may be difficult to perform in a patient of allergic bronchopulmonary aspergillosis with acute severe asthma. In an attempt to find a safe and effective alternative to demonstrate central bronchiectasis computed tomography (CT) of the thorax was evaluated against bronchography. Twenty one patients with allergic bronchopulmonary aspergillosis underwent computed tomography of the thorax followed by bronchography. Of the 378 bronchopulmonary segments available for analysis, 42 had to be excluded because of consolidation or non-filling of the contrast dye, leaving 336 segments for evaluation. CB was identified on CT in all 21 patients. Detailed analysis of the visualized segments revealed that computed tomography (using 8 mm contiguous scans) identified 146 of the 212 segments showing central bronchiectasis on bronchography (sensitivity 70%) and 114 of the 124, read as normal on bronchography (specificity 92%). Supplemental 4 mm scans, used in 8 out of 21 patients improved the overall sensitivity of computed tomography to 83%, whilst the specificity remained unchanged at 92%. Thus, computed tomography of the thorax, being more acceptable to the patient, has the potential of being the investigation of choice for the demonstration of central bronchiectasis in patients with allergic bronchopulmonary aspergillosis.

Adolescent↗
PubMed1989

[Bronchography in children. Methodologic, statistical and functional findings].

The value of bronchography in the various respiratory diseases of childhood is examined. After a brief critical review of the historical development of bronchography, 10 cases encountered in the Pneumology Unit of Regina Margherita Children's Hospital, Turin are examined in order to compare the indications to and results of bronchography. In the light of the results obtained guidelines for the selection of bronchography as a diagnostic procedure are presented, specifying the situations in which stratigraphy, CAT scans or NMR are not adequate substitutes and suggesting what should be the current role of bronchography in paediatrics.

Bronchial Diseases↗
PubMed1985

Does bronchography have a role in the assessment of patients with haemoptysis?

The results of bronchography in 96 consecutive patients investigated for haemoptysis at Papworth Hospital from 1975 to 1983 were reviewed. None of the patients included in this study gave a history suggestive of bronchiectasis and neither chest radiography nor fibreoptic bronchoscopy had shown a cause for the bleeding. Bronchography was performed through the fibreoptic bronchoscope and all included in the study showed both lungs adequately. The chest radiographic appearances were compared with the bronchographic findings. Seven of 12 patients with appearances suggesting old fibrosis showed bronchiectasis, as did eight of 10 with radiographic appearances suggestive of bronchiectasis. Eleven out of 74 patients with normal chest radiographs, however, also showed bronchiectasis. This group of 11 was compared with the other 63 but no clinical feature was found to be significantly associated with the presence of bronchiectasis. Although bronchography is now rarely used in the investigation of haemoptysis, this high yield (15%) of bronchiectasis indicates that its use should be reappraised. Follow up of the patients indicated that bronchography was not reliable at diagnosing peripheral bronchial carcinomas, which became evident later in two cases, and that asthma was present in 15 (24%) of the 63 patients with both normal chest radiographs and normal bronchograms.

Adolescent↗
PubMed1985

Bronchography in patients with persistent cough.

Bronchography was performed together with a fibre-optic bronchoscopic study in 98 patients with persistent cough, 33 of whom also had haemoptysis. Finally there were chronic bronchitis in 62 patients, bronchiectasis in 21, subacute bronchitis in 9, inflammatory residuals in 3, pulmonary tuberculosis in 2 patients and metastases in one. In chronic bronchitis, the value of plain chest radiography was low. It was normal in 34 of 62 cases (55%), bronchography in 12 cases (19%). Mild cases of bronchitis were more numerous in bronchography than seen by scopist. Bronchiectasis was found in 21 patients, four of these unexpectedly (two in a tbc scar). Additionally, three cases were overdiagnosed by the radiologist on chest films and eight cases by the scopist with bronchoscopy. In patients with persistent cough and haemoptysis, bronchography mainly revealed alterations of bronchitis.

Adolescent↗
PubMed1983

Bronchial drainage prior to bronchography--a possible modification.

Bronchography results were studied in 110 cases between the ages of 14 and 68 years. In each case the mucolytic agent Carbocysteine was used to increase the effectiveness of postural drainage prior to bronchography. Insufficient filling of the bronchial tree occurred in only one case. These results suggest that Carbocysteine increases the effectiveness of postural drainage prior to bronchography and indicates the need for further careful controlled studies.

Adolescent↗
PubMed1982

Clinical bronchography in the horse: development of a method using barium sulphate powder.

A method for performing bronchography in standing nonanaesthetized horses was developed. Bronchography was performed by insufflating the previously intubated trachea with a mixture of 120 to 200 g of finely powdered barium sulphate mixed with 3 to 7 g of powdered methyl cellulose. The mixture was delivered from an ether vaporiser into which compressed air was blown. Premedication with atropine sulphate immediately before insufflation minimised bronchoconstriction. Satisfactory bronchograms with contrast visible down to the seventh and eighth bronchial divisions were obtained in 80 per cent of the 26 horses tested. Poor results were obtained if there were delays in taking exposures. Total clearance of the barium sulphate from the lung fields was extremely rapid, averaging 4 h. No significant clinical side effects were noted and histology of the lungs, in animals sacrificed sequentially over a period of 2 weeks, demonstrated a minimal cellular response. In one clinical case, with chronic bronchitis, loss of parallelism of the bronchial walls and moderate bronchial dilatation between branches was demonstrated. It was concluded that although the value of bronchography as a diagnostic procedure in equine radiology has yet to be proven, the method of powder insufflation with barium sulphate provides a safe and accurate means of investigating bronchial conditions in the horse.

Animals↗