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Katsuya Kato Kenichi Gemba Nobukazu Fujimoto Keisuke Aoe Yukio Takeshima Kouki Inai Takumi Kishimoto 《Japanese journal of radiology》2016,34(6):432-438
Purpose
The purpose of this study was to clarify the characteristic findings of mesothelioma at the time of diagnosis, and determine precautions and guidelines for diagnosing mesothelioma early in imaging studies.Materials and methods
Overall, 327 patients with pleural mesothelioma were selected from 6030 patients who died of mesothelioma between 2003 and 2008 in Japan. Their imaging findings were examined retrospectively.Results
Plaques were found in 35 % of computed tomography (CT) scans. Asbestosis, diffuse pleural thickening, and rounded atelectasis were found in only seven (2 %), five (2 %), and two cases (1 %), respectively. Pleural thickening findings on CT scans were classified into four stages: no irregularity, mild irregularity, high irregularity, and mass formation. Overall, 18 % of cases did not show a clear irregularity. Localized thickening was observed in the mediastinal (77 %) and basal (76 %) pleura and in the interlobar fissure (49 %). Eight percent of cases did not have any thickening in these three areas.Conclusions
Upon examination of the CT scans at diagnosis, 18 % of mesothelioma cases did not show a clear irregularity. When diagnosing pleural effusion of unknown etiology, it is necessary to consider the possibility of mesothelioma even when no plaque and pleural irregularity are observed.2.
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Factors influencing pneumothorax rate at lung biopsy: are dwell time and angle of pleural puncture contributing factors? 总被引:16,自引:0,他引:16
Ko JP Shepard JO Drucker EA Aquino SL Sharma A Sabloff B Halpern E McLoud TC 《Radiology》2001,218(2):491-496
PURPOSE: To study factors that may influence pneumothorax and chest tube placement rate, especially needle dwell time and pleural puncture angle. MATERIALS AND METHODS: In 159 patients, 160 coaxial computed tomography (CT)-guided lung biopsies were performed. Dwell time, the time between pleural puncture and needle removal, was calculated. The smallest angle of the needle with the pleura ("needle-pleural angle") was measured. These and other variables were correlated with pneumothorax and chest tube rates. RESULTS: One hundred fifty biopsies were included. There were 58 (39%) pneumothoraces (14 noted only at CT), with eight (5%) biopsies resulting in chest tube placement. Longer dwell times (mean, 29 minutes; range, 12-66 minutes) did not correlate with pneumothoraces (P =.81). Smaller needle-pleural angles (< 80 degrees) [corrected], decreased forced expiratory volume in 1 second to vital capacity ratio (<50%), lateral pleural puncture, and lesions along fissures were associated with higher [corrected] pneumothorax rates (P <.05). Emphysema along the needle path, pulmonary function tests showing ventilatory obstruction, and lesions along fissures predisposed patients to chest tube placement (P <.05). Pleural thickening and prior surgery were associated with lower pneumothorax rates (P <.05). CONCLUSION: Longer dwell times do not correlate with pneumothorax and should not influence the decision to obtain more biopsy samples. A shallow pleural puncture angle may increase the pneumothorax rate. 相似文献
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We present serial radiographic and CT findings of spontaneous reversibility of “pleural thickening” in a patient with proved
semi-invasive pulmonary aspergillosis who developed bilateral intracavitary aspergillomas. To the best of our knowledge, this
is the first report in the literature of this feature. Radiologists should be aware that pleural thickening in patients with
semi-invasive aspergillosis does not necessarily indicate irreversible pleural fibrosis.
Received: 16 February 1999; Revised: 22 June 1999; Accepted: 27 July 1999 相似文献
6.
ElShaimaa Mohamed Mohamed 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(2):346-351