Comparison of Left Ventricular Volume and Function between 16 Channel Multi-detector Computed Tomography (MDCT) and Echocardiography / 대한흉부외과학회지

BACKGROUND: Although echocardiography is usually used for quantitative assessment of left ventricular function, the recently developed 16-slice multidetector computed tomography (MDCT) is not only capable of evaluating the coronary arteries but also left ventricular function. Therefore, the objective of our study was to compare the values of left ventricular function quantified by MDCT to those by echocardiography for evaluation of its regards to clinical applications. MATERIAL AND METHOD: From 49 patients who underwent MDCT in our hospital from November 1, 2003 to January 31, 2005, we enrolled 26 patients who underwent echocardiography during the same period for this study. Left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), stroke volume index (SVI), left ventricular mass index (LVMI), and ejection fraction (EF) were analyzed. RESULT: Average LVEDVI (80.86+/-34.69 mL for MDCT vs 60.23+/-29.06 mL for Echocardiography, p<0.01), average LVESVI (37.96+/-24.52 mL for MDCT vs 25.68+/-16.57 mL for Echocardiography, p<0.01), average SVI (42.90+/-15.86 mL for MDCT vs 34.54+/-17.94 mL for Echocardiography, p<0.01), average LVMI (72.14+/-25.35 mL for MDCT vs 130.35+/-53.10 mL for Echocardiography, p<0.01), and average EF (55.63+/-12.91 mL for MDCT vs 59.95+/-12.75 mL for Echocardiography, p<0.05) showed significant difference between both groups. Average LVEDVI, average LVESVI, and average SVI were higher in MDCT, and average LVMI and average EF were higher in echocardiogram. Comparing correlation for each parameters between both groups, LVEDVI (r(2)=0.74, p<0.0001), LVESVI (r(2)=0.69, p<0.0001) and SVI (r(2)=0.55, p<0.0001) showed high relevance, LVMI (r(2)=0.84, p<0.0001) showed very high relevance, and EF (r(2)=0.45, p=0.0002) showed relatively high relevance. CONCLUSION: Quantitative assessment of left ventricular volume and function using 16-slice MDCT showed high relevance compared with echocardiography, therefore may be a feasible assessment method. However, because the average of each parameters showed significant difference, the absolute values between both studies may not be appropriate for clinical applications. Furthermore, considering the future development of MDCT, we expect to be able to easily evaluate the assessment of coronary artery stenosis along with left ventricular function in coronary artery disease patients.

Modified Thoracoscopic Bullectomy / 대한흉부외과학회지

BACKGROUND: Morbidity, the use of analgesics, the amount of postoperative drainage and the postoperative hospital stay were reduced in VATS for pneumothorax. However, some authors preferred minithoracotomy to VATS because the rate of recurrence after VATS were between 5% and 10%. Therefore, we present a modified thoracoscopic bullectomy (MTB) which we believe has the advantages of conventional VATS and minithoracotomy. MATERIAL AND METHOD: Sixty-six patients who received the operation from January 2002 to December 2002 were divided into 3 groups. Twenty-six patients were treated by axillary minithoracotomy and thirteen by conventional VATS and 18 by modified thoracoscopic bullectomy. The mean age was 21.9 years (range, 16~35 years) for minithoracotomy group, 20.6 years (range, 17~28 years) for conventional VATS group and 22.6 years (range, 16~39 years) for MTB group. The mean follow-ups were 11.4months for minithoracotomy group, 9.5 months for conventional VATS group and 4.7 months for MTB group. RESULT: The mean duration of operation was 55.79+/-23.35 minutes in MTB and 44.23+/-19.24 minutes in conventional VATS (p=0.333). The number of staplers being used was 1.63+/-0.76 in MTB, 1.41+/-0.64 in minithoracotomy (p=0.663), and 2.92+/-1.19 in conventional VATS (p<0.001). The duration of indwelling chest tube was 1.63+/-0.76 day in MTB, 4.07+/-1.41 day in minithoracotomy (p<0.001) and 4.46+/-2.33 day in conventional VATS (p<0.001). Hospital length of stay was 3.26+/-0.81 day in MTB, 6.04+/-2.21 day in minithoracotomy (p<0.001) and 6.69+/-3.33 day in conventional VATS (p<0.001). The number of postoperative complication and recurrence were 2 in minithoracotomy (7.4%), 5 in conventional VATS (38.5%) and 1 in MTB (5.6%). CONCLUSION: Modified thoracoscopic bullectomy is an effective procedure in the treatment of spontaneous pneumothorax.