Preoperative detection of pleural adhesions by respiratory dynamic computed tomography

World Journal of Surgical Oncology

Research

Ryota Sumitomo¹  Tsuyoshi Shoji¹  Yuichiro Ueda¹  Keiji Yamanashi¹  Junko Tokuno¹  Cheng-long Huang¹ 

[1] Department of Thoracic Surgery; Kitano Hospital, The Tazuke Kofukai Medical Institute, 530-8480, Osaka, Japan;

关键词: Pleural adhesion;    Dynamic CT;    Preoperative evaluation;    VATS;   

DOI  :  10.1186/s12957-017-1280-7

 received in 2017-04-28, accepted in 2017-11-20,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundVideo-assisted thoracic surgery (VATS) plays an important role in thoracic surgery because it is less invasive. However, the existence of severe pleural adhesions may make VATS difficult and complicated. The aim of this study was to assess the utility of inspiration and expiration computed tomography (respiratory dynamic CT (RD-CT)) in evaluation of pleural adhesions preoperatively.MethodsRD-CT was performed on 107 patients undergoing thoracotomies (both VATS and open). We assessed synchronous motion during respiration on RD-CT. Comparing the results of RD-CT and intraoperative findings, we assessed the utility of preoperative evaluation.ResultsA negative correlation between sliding score and adhesion grade was revealed. Sliding score in adhesion negative patients was significantly higher than that in adhesion positive patients (P < 0.0001). The sensitivity of RD-CT was 63.6%, specificity was 74.1%, and accuracy was 72%. Among 62 patients with a CT-Respiration Ratio of less than 0.65, the sensitivity of RD-CT was 77.8%, specificity was 86.8%, and accuracy was 85.5%.ConclusionsRD-CT may be clinically useful for detecting the presence of pleural adhesions. It can be adopted as one of the criteria for deciding the surgical approach.

【 授权许可】

CC BY   
© The Author(s). 2017