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At least 145 records · Page 8Linked to original sources
PubMed1992

[MRI of the thorax; clinical application and efficacy in 100 thoracic diseases].

We carried out a retrospective analysis of about 100 surgical cases of mediastinal, pleural, chest wall and pulmonary disorders in order to determine the clinical application and efficacy of MRI (magnetic resonance imaging) of the thorax. Coronal and/or axial image of T1-weighted images were obtained in all cases, and T2-weighted or gadolinium-DTPA contrast-enhanced T1-weighted images were additionally obtained in several selected cases. All MR images were compared with findings of chest X-ray, CT and IVDSA (intravenous digital subtraction angiography) as appropriate. As a result, MR images were considered to provide additional information to that obtained by conventional techniques of chest X-ray and CT, in demonstrating chest wall invasion of pulmonary carcinoma, detecting hilar masses, which were difficult to distinguish from vessels, and in defining mediastinal masses. The anterior segment of the diaphragm is clearly depicted, aiding the differentiation of Morgagni hernia from other entities. Tuberculoma showed peripheral enhancement in Gd-enhanced T1 WI, which was distinctly different from the enhancing pattern of carcinomas. With the use of surface coil, the pleura and chest wall anatomy were clearly demonstrated. It is hoped that the wide application of this technique will increase the diagnostic accuracy of chest wall tumor invasion.

Adult↗
PubMed1996

[Use of a digital radiology system with phosphors in the assessment of thoracic diseases in bedside radiography].

We report our experience with a storage phosphor radiography system; to assess both the image resolution and the dynamic range of the system, a phantom simulating chest average density was used. Finally, we investigated the system impact on portable chest radiographs. The radiographs were taken on 35 x 43 cm phosphor plates, with 80 kV, 3 mAs and focus-film distance of 130 cm. The phosphor plates were scanned with a 75 microns laser beam, postprocessed with the system software and, finally, printed on a 20 x 25 cm film. As reported by other Authors, the storage phosphor system showed similar spatial resolution to conventional radiography (2.5 lp/mm for 35 x 43 cm films and 4.5 lp/mm for 20 x 25 cm films), a wide dynamic range always allowing correcting exposure, but increased noise; these features allow film density optimization even in such "critical" situations and bedside radiographs. Pneumonia, pneumothorax, emphysema, pleural effusions and catheters or tubes positioning were always easily depicted. In our experience, the phosphor plate storage system exhibits many advantages over conventional radiography, namely image postprocessing, the opportunity to choose between several sizes of laser films and finally, the possibility of linking the system to a network and possibly to a digital archive. The main drawbacks of the system are its increased noise and, at present, with the available hardware, slow plate reading.

Humans↗
PubMedDate not supplied

Use of radiography in combination with computed tomography for the assessment of noncardiac thoracic disease in the dog and cat.

Computed tomography (CT) of the thorax was performed in 28 dogs and five cats and findings were compared with previous thoracic radiographs. The sample population included all animals that had thoracic radiographs and a CT study within 5 days of each other, where the complete imaging studies were available for review. Thoracic radiographs were considered indeterminate in 31 patients and CT examinations were done to acquire additional information. The presence of additional information from CT relating to presence of pathology, location of pathology, extent of pathology, and involvement of mediastinal structures was recorded. Whether there was a change in diagnosis based on the CT findings was also recorded. In only 4/33 animals (all dogs) did CT fail to provide any new information for the parameters evaluated when compared with survey thoracic radiographs. Additional information about the pathology that was present was gained by CT in 5/5 cats and 21/ 28 dogs. New information on compartmental location of pathology was seen in 4/5 cats and 19/28 dogs. New information on pathology extent was noted in 5/5 cats and 20/28 dogs. Additional information regarding involvement of mediastinal structures was obtained in 2/5 cats and 10/28 dogs. A change in diagnosis was made in 3/5 cats and 13/28 dogs. In conclusion, CT is a valuable tool for evaluating intrathoracic disease. CT provides additional cross-sectional anatomic information that can aid in anatomic localization and evaluation of the extent of the pathology in question.

Animals↗
PubMed1975

[The value and use of percutaneous trans-thoracic needle biopsy in the diagnosis of intra-thoracic disease. Technique, indications, results and complications].

Between 1961 and 1974, 5,300 percutaneous, trans-thoracic needle biopsies under image intensifier control were carried out in the Karolinska Sjukhuset, Stockholm. These involved, 2,726 patients with localised intrathoracic disease. The indications, results and complications are discussed. Approximately 15% of cases were suspected of malignancy and showed peripheral infiltrates varying from 0.04 to 2 cm. diameter. Needle biopsy proved to be technically simple and relatively safe; it permits early diagnosis of bronchial carcinomas and solitary metastases with a high degree of accuracy and with few complications. It is assumed that, as a result, the prognosis in a large group of patients with bronchial carcinomas in the pre-clinical stage may be markedly improved.

Adenocarcinoma↗
PubMed2006

Respiratory muscle training in restrictive thoracic disease: a randomized controlled trial.

OBJECTIVE: To investigate the effects of respiratory muscle training (RMT) in patients with restrictive thoracic disorders and intermittent noninvasive positive-pressure ventilation (NPPV). DESIGN: Prospective randomized controlled trial. SETTING: Home-based RMT, with assessment in a primary care pulmonary center. PARTICIPANTS: Thirty patients with restrictive thoracic disorders; 28 patients completed the trial. INTERVENTION: Three months of RMT by isocapnic hyperpnea or sham training. MAIN OUTCOME MEASURES: Respiratory muscle strength and endurance, lung function, exercise performance, and health-related quality of life (HRQOL). RESULTS: After RMT, maximal inspiratory mouth pressure was increased (27.6%+/-36.5%, P=.013). In patients who could perform cycle ergometer testing (n=17), peak oxygen consumption (2.24+/-3.39mLxkg(-1).min(-1) vs -1.71+/-2.54mLxkg(-1).min(-1), P=.014) and maximal work rate (9.4+/-14.8W vs -5.1+/-10.8W, P=.043) increased relative to a control group. Similar differences occurred regarding changes of HRQOL (physical performance, 3.3+/-11.4 score vs -6.6+/-9.0 score; P=.012) and time of ventilator use (-0.6+/-1.2h/d vs 0.4+/-0.5h/d, P=.010). Lung volumes, 12-second maximum voluntary ventilation, 6-minute walking distance, and blood gases were unchanged. CONCLUSIONS: In patients with restrictive thoracic disorders and NPPV, RMT improved inspiratory muscle strength. Exercise performance and HRQOL were improved when the 2 groups were compared. RMT was practicable and safe despite severe respiratory impairment. Further evaluation, including different training intensities and modalities, seems warranted.

Breathing Exercises↗
PubMed2003

The role of mediastinoscopy in the evaluation of thoracic disease and lung cancer.

BACKGROUND: Mediastinoscopy is a widely used technique in the diagnosis of mediastinal disease and the staging of bronchogenic carcinoma. Its efficacy in the preoperative staging of lung cancer is well-established, with a procedural sensitivity of greater than 90% and specificity of 100%. Mediastinoscopy can also establish the diagnosis in greater than 90% of mediastinal disease. We conducted a retrospective study of mediastinoscopy performed at our institution between 1998 and 2001 to evaluate the safety and efficacy of mediastinoscopy. METHODS: We collected 100 consecutive mediastinoscopies performed in Thoracic Division of Taipei Veterans General Hospital between 1998 and 2001. The indications for mediastinoscopy included mediastinal mass or lymphadenopathy and the staging of lung cancer. Some patients had the undetermined lung mass with enlarged mediastinal lymph node. RESULTS: There were 69 men and 31 women aged from 13 to 87 (mean 60.9). Sixty-seven patients had mediastinoscopy for the staging of lung cancer, 29 patients for diagnosis of mediastinal mass or lymphadenopathy, and 4 patients for undetermined lung mass with mediastinal lymphadenopathy. Among the patients with mediastinal disease, sarcoidosis was diagnosed in 13 patients, and lymphoma in 5 patients. N2 or N3 nodal metastasis was revealed in 38 of 67 patients who had lung cancer. Fifteen patients with negative mediastinoscopy proceeded to thoracotomy for tumor resection. Seventeen patients received neoadjuvant chemotherapy followed by resection. There were three complications, all due to bleeding, and no mortality. CONCLUSIONS: Mediastinoscopy is a safe and effective procedure for the diagnosis of mediastinal disease and the staging of lung cancer. In cases of lung cancer, mediastinoscopy can provide more accurate evaluation of mediastinal lymph node metastasis than conventional diagnostic tools like computed scan or magnetic resonance image with low morbidity and mortality.

Adolescent↗
PubMed1993

Polycystic hepatic disease, thoracic granular cell tumor and secondary hypertrophic osteopathy in a horse.

A 13-year-old American Saddlebred mare was presented with a 4-day history of anorexia. Physical examination revealed increased inspiratory effort and bony enlargement of the distal limbs. Radiographs indicated a thoracic mass and periosteal proliferations on the distal limbs consistent with hypertrophic osteopathy. Gastric endoscopy revealed distal esophageal and gastric ulceration, and functional pyloric stenosis. Abdominal ultrasonographic examination revealed multiple large, cystic structures associated with the liver. A percutaneous biopsy indicated the thoracic mass to be a granular cell tumor. At necropsy, a large mass consisting of intercommunicating cystic structures was present confluent with the right caudal edge of the liver. Histologically these hepatic lesions were consistent with cystic hepatic disease, which has not previously been reported in the horse.

Animals↗
PubMed1978

[Recent results of intraoperative cytodiagnosis in thoracic diseases (author's transl)].

The intraoperative cytological quick-examinations and quick-tests may influence way and type of the operation in cases of uncertain nature. They may lead to the fact that the original schedule of operation is kept to or changed. Thus, the operation is performed according to the situation, and lung tissue may be saved. Therefore, the possibility of a rapid diagnosis during the operation is of great importance. It is, however, often difficult or risky due to a potential tumour transplantation or due to other complications, to obtain respective tissue material for histological examination, above all, in such cases where the foci are located very deeply in the lung parenchyma. Therefore, the authors deal with the cytological examinations of 216 tissue samples taken from 187 patients intraoperatively (obtained by thoracotomy: 119 cases, by mediastinoscopy: 57 cases, by various surgical interventions: 20 cases). In 155 cases (82 per cent) the findings proved to be rightly positive or negative with regard to their malignity. The histological type diagnosis was correct in 79 per cent of all tumours. In 94 per cent of the nonmalignant processes the cytological finding was negative; besides, the authors point to the histological diagnosis of several types of benign tumours, Boeck-sarcoidoses, tuberculoses, other granulomatoses etc.

Adult↗
PubMed2002

Endovascular treatment of thoracic disease: patient selection and a proposal of a risk score.

BACKGROUND: Although selection criteria and subgroup analysis are still in the early developmental stages, endovascular treatment of aortic disease has become an alternative to surgery for many patients. METHODS: From November 1996 to November 1999, 49 patients were treated with a self-expandable endoprosthesis at our institution. Most patients had acute aortic dissections. Thirteen of these patients did not follow the anatomic selection protocol. We retrospectively analyzed these patients to compare our numerical risk score (which includes clinical and anatomic criteria) between groups with or without success and between groups that followed the anatomic protocol (P) or did not follow the anatomic protocol (E [exception]). RESULTS: Success rates were similar in groups P and E, although mortality rates were higher in group E. Patients from group E had longer procedures and required multiple stents more frequently. The proposed risk score was able to differentiate between groups with or without success, as well as between groups P and E. CONCLUSIONS: In order to reduce mortality and morbidity rates, careful selection criteria must be followed when treating patients endovascularly. Although it is time-consuming, using objective criteria can help select patients for endovascular treatment. We propose that patients with a risk score higher than 11 should only undergo percutaneous treatment when they have an unacceptably high surgical risk, and even so only after a detailed discussion of the risks.

Adolescent↗
PubMed2003

Prenatal ultrasound guided percutaneous shunts for obstructive uropathy and thoracic disease.

The authors reviewed the status of closed ultrasound-guided fetal therapy using a pigtail shunt to create vesicoamniotic or thoracoamniotic decompression of the fluid-filled space. This review includes published and textbook reports of in utero therapy for bladder obstruction, pleural effusion, and macrocystic adenomatoid malformation from 1985 through 2002. For fetuses affected by lower urinary tract obstruction, the key component is identifying those fetuses that have retained renal function and are most likely to benefit from in utero shunting. This good prognosis group has been shown to have improved survival rate and a lower incidence of renal failure. Complications of fetal loss are estimated at 5% owing to the shunt procedure, and the risk of shunt displacement varies from 30% to 50%. Hydrops secondary to primary PE has been shown to be associated with low fetal and neonatal survival at 21% to 23%. Treatment by thoracoamniotic shunting increases survival rate to 75%. The fetus with a macrocystic CCAM and secondary hydrops should be considered a candidate for thoracoamniotic shunt to decrease CCAM volume, reverse hydrops, and improve survival rate. Thoracoamniotic shunt and thoracocentesis pregnancy loss risks for pleural effusion (PE) and macrocystic adenomatoid malformation of the lung (CCAM) are 5% and 0.5% to 1.0%, respectively.

Cystic Adenomatoid Malformation of Lung, Congenita↗
PubMed1989

Computed tomography in the diagnosis of asbestos-related thoracic disease.

High-resolution computed tomography (HRCT) has improved the radiologist's ability to detect and potentially quantify the abnormalities of asbestos exposure. It has proved to be more sensitive than chest radiography for detecting pleural plaques and for discriminating between pleural fibrosis and extrapleural fat. HRCT is also more sensitive than chest radiography or conventional CT for detecting parenchymal abnormalities in asbestos-exposed persons. The HRCT findings that correlate with other parameters of asbestosis include (1) septal and centrilobular thickening, (2) parenchymal fibrous bands, (3) honeycomb patterns, (4) subpleural density persisting in the prone position, and (5) subpleural curvilinear lines that persist in the prone position. CT has an important role in evaluating benign and malignant lung and pleural masses in asbestosis.

Asbestosis↗