ABSTRACT
INTRODUCTION: There are no defined criteria for deciding to remove a non-functioning indwelling pleural catheter (IPC) when lung re-expansion on chest X-ray is incomplete. Chest computed tomography (chest CT) is usually used. The objective of this work is to validate the usefulness of chest ultrasound performed by a pulmonologist and by a radiologist compared to chest CT. PATIENTS AND METHODS: Prospective, descriptive, multidisciplinary and multicenter study including patients with malignant pleural effusion and non-functioning IPC without lung reexpansion. Decisions made on the basis of chest ultrasound performed by a pulmonologist, and performed by a radiologist, were compared with chest CT as the gold standard. RESULTS: 18 patients were analyzed, all of them underwent ultrasound by a pulmonologist and chest CT and in 11 of them also ultrasound by a radiologist. The ultrasound performed by the pulmonologist presents a sensitivity of 60%, specificity of 100%, PPV 100% and NPV 66% in the decision of the correct removal of the IPC. The concordance of both ultrasounds (pulmonologist and radiologist) was 100%, with a kappa index of 1. The 4 discordant cases were those in which the IPC was not located on the ultrasound. CONCLUSIONS: Thoracic ultrasound performed by an expert pulmonologist is a valid and simple tool to determine spontaneous pleurodesis and remove a non-functioning IPC, which would make it possible to avoid chest CT in those cases in which lung reexpansion is observed with ultrasonography.
Subject(s)
Pleural Effusion, Malignant , Humans , Pleural Effusion, Malignant/diagnostic imaging , Pleural Effusion, Malignant/therapy , Pleural Effusion, Malignant/pathology , Prospective Studies , Catheterization , Catheters, Indwelling , UltrasonographyABSTRACT
El secuestro pulmonar es una malformación congénita poco frecuente, generalmente asintomática hasta que la lesión se infecta, debutando entonces como infecciones respiratorias de repetición. El diagnóstico se confirma mediante pruebas de imagen que permitan objetivar el tejido pulmonar no funcionante irrigado por circulación sistémica. El tratamiento de elección es la resección quirúrgica con ligadura de los vasos nutricios
Pulmonary sequestration is a rare congenital abnormality. Most of them are asymptomatic but they can appear as recurrent respiratory infections. Radiological tests bring to light a non functioning mass of lung that receives its arterial blood supply from the systemic circulation. Treatment is made with a surgical resection by bonding the vascular supply
Subject(s)
Humans , Male , Adult , Bronchopulmonary Sequestration/complications , Respiratory Tract Infections/complications , Respiratory System Abnormalities/diagnostic imaging , Bronchopulmonary Sequestration/surgery , Pneumonectomy , Thoracic Surgery, Video-AssistedABSTRACT
La dilatación aneurismática de la arteria pulmonar es una patología rara y clínicamente inespecífica, por lo que el diagnóstico se basa en pruebas de imagen, como la TC o la angiorresonancia. Puede ser idiopática (menos frecuente) cuando la etiología es indeterminada o secundaria a diversas patologías, muchas de ellas identificables con técnicas de imagen complementarias, como el ecocardiograma. Debido a que la mayoría de los pacientes se diagnostican como hallazgo casual, están asintomáticos o estables, o tienen bajo riesgo de rotura, son muy pocos los que precisan de tratamiento quirúrgico
Aneurysm dilation of pulmonary artery is a very rare disease and the clinic is non-specific. Final diagnosis relies on imaging tests as computed tomography and nuclear magnetic resonance. They can be idiopathic (less frequent, when an indeterminate etiology occurs) or secondary to several pathologies, most of which can be identified with other imaging tests like echocardiogram. As in most patients the disease is a casual finding, are asymptomatic or with haemodynamic stability or have a low risk of rupture, only a few need surgery
Subject(s)
Humans , Male , Female , Middle Aged , Aortic Aneurysm, Thoracic/diagnosis , Pulmonary Embolism/diagnosis , Hypertension, Pulmonary/diagnosis , Echocardiography , Tomography, X-Ray ComputedABSTRACT
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