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Seminars in Roentgenology Oct 2023
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Medical Ultrasonography Dec 2014Pleural ultrasonography (US) represents nowadays a useful diagnostic tool in the management of pleural diseases. Detection and evaluation of pleural effusions,... (Review)
Review
Pleural ultrasonography (US) represents nowadays a useful diagnostic tool in the management of pleural diseases. Detection and evaluation of pleural effusions, pneumothorax and pleural-based lesions can be performed with US, which has the advantages of wide availability, low cost, absence of radiation exposure, and portability. It is the best method for guiding interventional procedures in the pleural space. It has also limitations, due to the interposition of bony parts of the thorax, subcutaneous emphysema and inability to visualize the mediastinal pleura. US of the thorax is an operator dependent technique demanding an experienced operator in order to obtain reliable results. This pictorial essay presents various ultrasound findings of the diseases which concern the pleura.
Topics: Humans; Pleura; Pleural Diseases; Ultrasonography
PubMed: 25463891
DOI: 10.11152/mu.201.3.2066.164.racc -
The European Respiratory Journal Mar 2021Thoracic ultrasound is increasingly considered to be an essential tool for the pulmonologist. It is used in diverse clinical scenarios, including as an adjunct to... (Review)
Review
Thoracic ultrasound is increasingly considered to be an essential tool for the pulmonologist. It is used in diverse clinical scenarios, including as an adjunct to clinical decision making for diagnosis, a real-time guide to procedures and a predictor or measurement of treatment response. The aim of this European Respiratory Society task force was to produce a statement on thoracic ultrasound for pulmonologists using thoracic ultrasound within the field of respiratory medicine. The multidisciplinary panel performed a review of the literature, addressing major areas of thoracic ultrasound practice and application. The selected major areas include equipment and technique, assessment of the chest wall, parietal pleura, pleural effusion, pneumothorax, interstitial syndrome, lung consolidation, diaphragm assessment, intervention guidance, training and the patient perspective. Despite the growing evidence supporting the use of thoracic ultrasound, the published literature still contains a paucity of data in some important fields. Key research questions for each of the major areas were identified, which serve to facilitate future multicentre collaborations and research to further consolidate an evidence-based use of thoracic ultrasound, for the benefit of the many patients being exposed to clinicians using thoracic ultrasound.
Topics: Humans; Lung Diseases; Pleura; Pleural Effusion; Pneumothorax; Ultrasonography
PubMed: 33033148
DOI: 10.1183/13993003.01519-2020 -
Thoracic Surgery Clinics Feb 2017Despite the increasing knowledge about the pleural physiology after lung resection, most practices around chest tube removal are dictated by personal preferences and... (Review)
Review
Despite the increasing knowledge about the pleural physiology after lung resection, most practices around chest tube removal are dictated by personal preferences and experience. This article discusses recently published data on the topic and suggests opportunities for further investigation and future improvements.
Topics: Chest Tubes; Device Removal; Drainage; Humans; Pleura; Pneumonectomy; Pneumothorax; Postoperative Care
PubMed: 27865326
DOI: 10.1016/j.thorsurg.2016.08.007 -
PloS One 2022Thoracic endometriosis-related pneumothorax is a secondary spontaneous pneumothorax caused by thoracic endometriosis. Diaphragmatic endometriosis is well-studied, but...
BACKGROUND
Thoracic endometriosis-related pneumothorax is a secondary spontaneous pneumothorax caused by thoracic endometriosis. Diaphragmatic endometriosis is well-studied, but visceral and/or parietal pleural lesions are not. Although surgery is an effective treatment, postoperative recurrence rates are unsatisfactory probably due to inadequate understanding of underlying pathophysiology. We aimed to clarify the clinicopathological features of thoracic endometriosis.
METHODS
In total, 160 patients who underwent thoracoscopic surgery from a single institution with histopathologically proven thoracic endometriosis from January 2015 to December 2019 were included. Clinicopathological characteristics and surgical outcomes were assessed retrospectively.
RESULTS
The cohort median age was 41 (range 22-53) years. Pneumothorax was right-sided in 159 (99.4%) and left-sided in only 1 (0.6%) case. Visceral and parietal pleural lesions were diagnosed in 79 (49.4%) and 71 (44.4%) patients, respectively. In total, 104 visceral pleural lesions and 101 parietal pleural lesions were detected. The S4 region and the dorsal 6th intercostal space contained the largest number of visceral pleural (66 lesions) and parietal pleural lesions (25 lesions), respectively. Histopathological evaluation revealed endometriotic tissues, existing in the outer external elastic layer in all lesions, were localized or invaded deeply. The median follow-up period was 370 (range, 6-1824) days. The Kaplan-Meier method revealed that the 1- and 2-year postoperative recurrence rates were 13.8% and 19.3%, respectively.
CONCLUSIONS
Visceral pleural endometriotic lesions may be disseminated from the visceral pleural surface and infiltrate into the pleura. Intraoperatively, careful observation of the specific sites, such as the visceral pleura of S4 and the parietal pleura of 6th intercostal space, is important to reduce postoperative recurrence.
Topics: Adult; Chest Pain; Endometriosis; Female; Humans; Middle Aged; Pleura; Pleural Cavity; Pneumothorax; Retrospective Studies; Thoracic Surgery, Video-Assisted; Young Adult
PubMed: 35544515
DOI: 10.1371/journal.pone.0268299 -
Medical Ultrasonography Aug 2021Ultrasound (US) is an ideal diagnostic tool for paediatric patients owning to its high spatial and temporal resolution, real-time imaging, and lack of ionizing radiation... (Review)
Review
Ultrasound (US) is an ideal diagnostic tool for paediatric patients owning to its high spatial and temporal resolution, real-time imaging, and lack of ionizing radiation and bedside availability. The lack of superficial adipose tissue and favorable acoustic windows in children makes US the first line of investigation for the evaluation of pleural and chest wall abnormali-ties. Lung parenchyma was previously thought to be inaccessible to ultrasound due to the presence of the air and bony thorax. The change in attitude and growing awareness of the diagnostic possibilities has led to lung ultrasound (LUS) being accepted as a valuable point of care method. In addition, the application of LUS has widened with improvements in technology such as higher resolution transducers, harmonic imaging and contrast-enhanced ultrasound. In the current World Federation of Societies for Ultrasound in Medicine and Biology (WFUMB) paper series the topic will be introduced, the technical requirements explained and the use of ultrasound in the lung and pleura in pediatric patients are discussed.
Topics: Child; Humans; Lung; Pleura; Point-of-Care Systems; Ultrasonography
PubMed: 33626123
DOI: 10.11152/mu-3058 -
Respiratory Medicine Jan 2022Pleuroparenchymal fibroelastosis (PPFE) is a rare, generally idiopathic form of interstitial pneumonia with unique clinical, radiological and histopathological features.... (Review)
Review
Pleuroparenchymal fibroelastosis (PPFE) is a rare, generally idiopathic form of interstitial pneumonia with unique clinical, radiological and histopathological features. It is named after the presence of upper lobe pleural and subjacent parenchymal fibrosis, with accompanying elastic fibers. Although it is usually an idiopathic disease, it has been linked to other co-existent diseases. Diagnostic suspicion of PPFE is based on the identification of typical abnormalities on chest CT scan, which are prevailingly located in the upper lobes, adjacent to the apex of the lungs. Diagnosis can be confirmed by histological analysis, although biopsy is not always feasible. The disease is generally progressive, but not uniformly. The course of the disease is frequently slow and involves a progressive loss of upper lobe volume, which results in platythorax, associated with a significant reduction of body mass. PPFE concomitant to other interstitial lung diseases is associated with a poorer prognosis. The disease occasionally progresses rapidly causing irreversible respiratory insufficiency, which leads to death. Currently, there is no effective pharmacological therapy available, and lung transplantation is the best therapeutic option. The purpose of this review is to draw the attention to PPFE, describe its clinical, radiological and histopathological features, analyze its diagnostic criteria, and provide an update on the management of the disease.
Topics: Humans; Lung; Lung Diseases, Interstitial; Lung Transplantation; Pleura; Tomography, X-Ray Computed
PubMed: 33992495
DOI: 10.1016/j.rmed.2021.106437 -
La Revue Du Praticien Jun 2019
Topics: Humans; Neurilemmoma; Pleura; Pleural Neoplasms
PubMed: 31626423
DOI: No ID Found -
Der Radiologe Feb 2022In the case of lesions of the pleura, the thoracic wall and the diaphragm, chest x‑ray is of great relevance in everyday clinical practice. In many clinical... (Review)
Review
In the case of lesions of the pleura, the thoracic wall and the diaphragm, chest x‑ray is of great relevance in everyday clinical practice. In many clinical situations, it is already sufficient for the initial diagnosis or for monitoring the course of the disease; these include, for example, pleural effusion and pneumothorax. In some cases, however, supplementary cross-sectional imaging may be necessary, e.g., if there is a possible pleural empyema or if the soft tissues of the mediastinum and pleural wall are also affected. Further diagnostic workup is also necessary for more advanced questions such as staging or surgical planning. This article is intended to provide an overview of the most common diseases of the pleura, thoracic wall, and diaphragm with their typical appearances on radiographs and, at the same time, to demonstrate the importance and limitations of conventional diagnostics.
Topics: Diaphragm; Humans; Pleura; Pleural Effusion; Thoracic Wall; Tomography, X-Ray Computed
PubMed: 35029724
DOI: 10.1007/s00117-021-00958-5 -
Medicina (Kaunas, Lithuania) Dec 2022: This study was designed to evaluate platelet-rich plasma (PRP) as a method of pleurodesis in a rabbit model. Pleurodesis with PRP was compared against the...
: This study was designed to evaluate platelet-rich plasma (PRP) as a method of pleurodesis in a rabbit model. Pleurodesis with PRP was compared against the gold-standard use of talc. The secondary evaluation assessed the ideal time for achieving pleurodesis. : 25 healthy New Zealand white rabbits were assigned to three groups, as follows: 12 animals in the first and second groups, as well as one animal with no intervention in the final group, which was used as a control. The talc pleurodesis group (baseline) underwent pleurodesis with sterile talc, which is the gold-standard sclerosing agent used for pleurodesis. The PRP group underwent pleurodesis using autologous PRP. The last group had one rabbit with no intervention. A total of 12 rabbits ( = 6 for the talc pleurodesis group and = 6 for the PRP group) were sacrificed 3 days (72 h) after the intervention, and 12 rabbits ( = 6 for the talc pleurodesis group and = 6 for the PRP group) were sacrificed 6 days (144 h) after the intervention. In both the talc and PRP group, FBC and CRP were measured before the intervention and in 3 or 6 days afterwards, respectively. The pleura and the lungs were evaluated histopathologically. : Macroscopically, there were no statistically significant differences between the two groups. In terms of microscopic findings, there were no statistically significant differences in inflammatory reactions provoked in the visceral and parietal pleura between the PRP and talc. In addition, with talc pleurodesis, a foreign-body reaction was observed in about 50% of the cases, which was not observed with PRP. In terms of inflammation between 3 and 6 days, there were no statistically significant differences with PRP, there was only a statistically significant difference between 3 and 6 days regarding the parietal pleura in the talc group. : The instillation of autologous PRP in the pleural cavity shows promise in achieving pleurodesis. The efficacy of PRP as a pleurodesis agent should be examined further.
Topics: Rabbits; Animals; Pleurodesis; Talc; Pleura; Lung; Platelet-Rich Plasma
PubMed: 36557044
DOI: 10.3390/medicina58121842