Detection of Intrabronchial Lesions by Means of Virtual Bronchoscopy with
Submillimeter Collimation, Comparison with Flexible Optical Bronchoscopy
Mírka H.1, Ohlídalová K.1, Ferda J.1, Brůha F.2, Kos S.3, Houdek J.3
Radiodiagnostická klinika LF UK a FN, Plzeň1 přednosta doc. MUDr. B. Kreuzberg, CSc. Klinika tuberkulózy a respiračních nemocí LF UK a FN, Plzeň2 přednosta prof. MUDr. M. Pešek, CSc. Léčebna tuberkulózy a respiračních nemocí, Janov3 ředitel MUDr. S. Kos, CSc. |
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Summary:
The authors performed virtual bronchoscopy (VB) in 30 patients indicated to CT examination
of the chest for suspected tumor disease and subsequently compared the findings
with flexible bronchoscopy (FB). There were 22 patients with intrabronchial
lesion. Multiple intrabronchial lesions were present in 10 patients, their total number
being 38. The authors first evaluated precision of VB in relation to the patient. The
sensitivity of 100% and specificity of 87.5% were reached. Individual bronchi were
than divided in groups according to degree of damage (stenosis, occlusion) and caliber
(trachea and the main bronchi, lobar bronchi, segmental and subsegmental bronchi).
A statistically significant difference between the result of VB and FB was detected
only in the group of segmental and subsegmental bronchi, where five false cases
of positivity caused by bronchial secrete were detected. No statistically significant
difference was determined between the results of the two methods in the other
groups. The only false-negative result concerned a minute benign polyp, which was
detected in a patient with correctly determined tumor stenosis in other localization.
Therefore, in the evaluation related per patient it did not become manifest. In spite rekonof
the promising results VB with submillimeter collimation cannot be considered as
an equal alternative to FB. The impossibility to differentiate mucous lesion and sampling
of biological material are the main limitations. The method can be successfully
used in patients with contraindications to FB or in cases, where some areas, which
cannot be visualized by FB, should be evaluated (e.g. behind tight stenoses and occlusions).
Moreover, it can be applied in monitoring of bronchial anastomoses after lung
transplantation, evaluation of unobstructed stents and in planning of intervention
operations.
Key words:
multidetector computing tomography – bronchoscopy – virtual bronchoscopy
– respiratory pathways – bronchogenic cancer
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