RESUMO
The usefulness of routine overhead views in the double-contrast investigation of the stomach and duodenum was evaluated. In this series, overhead views missed 26% of the lesions diagnosed and diagnosed no lesion not also seen on spot films. The authors could thus find no indication for the routine use of overhead views. It is concluded that overhead projections add no information to the examination, are not cost-effective, and can be eliminated without detriment to the patient.
Assuntos
Duodeno/diagnóstico por imagem , Radiografia/economia , Estômago/diagnóstico por imagem , Análise Custo-Benefício , Úlcera Duodenal/diagnóstico por imagem , Estudos de Avaliação como Assunto , Hérnia Hiatal/diagnóstico por imagem , Humanos , Radiografia/métodos , Gastropatias/diagnóstico por imagemRESUMO
A total of 164 consecutive patients were studied prospectively in the hope of increasing the accuracy of a negative prediction of transthoracic thin-needle biopsy. The protocol included pre-biopsy imaging with conventional and computed tomography, repeated sampling if no malignant cells were found, and specialized staining and culture methods. Forty-four patients with no evidence of malignant cells were divided into "benign specific" [25] and "benign nonspecific" groups [19]. A variety of bacterial and fungal infections, benign tumors, and other benign specific diagnoses were made. The accuracy of a negative prediction for the benign specific group was found to be 1.00 (100%), while that for the benign nonspecific group varied from 84% to 95% depending on whether the 2 patients lost to follow-up had benign disease.
Assuntos
Biópsia por Agulha/métodos , Pneumopatias/patologia , Neoplasias Pulmonares/patologia , Humanos , Pneumopatias/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Estudos Prospectivos , Coloração e Rotulagem , Tomografia Computadorizada por Raios XRESUMO
A protocol designed to overcome the inherent limitations of fluoroscopically guided thin-needle aspiration biopsy of central hilar and mediastinal lesions, involving addition of computed tomography to classical plain radiography and tomography, was applied prospectively for 24 months. The same protocol was applied to all referred patients regardless of the compartmental location of the lesion. Experience to date with 17 patients has yielded extremely accurate results. Representative tissue was obtained in each case, and all 11 malignant lesions were distinguished from the 6 benign ones. A lesion smaller than 1.5 cm, not visible on the lateral chest radiograph, was successfully sampled. A variety of malignant mediastinal tumors were diagnosed, as well as tuberculosis and cryptococcosis.