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1.
Dtsch Med Wochenschr ; 146(13-14): 927-932, 2021 Jul.
Article in German | MEDLINE | ID: mdl-34256411

ABSTRACT

Acute COVID-19 pneumonia may result in persistent changes with various imaging and histopathological patterns, including organizing pneumonia and pulmonary fibrosis. In addition, SARS-CoV-2 infection is associated with increased risk of pulmonary vascular endothelialitis and thrombosis. Herein, current findings on pulmonary consequences of COVID-19 with implications for clinical management are summarized based on a selective literature review.


Subject(s)
COVID-19/complications , Cryptogenic Organizing Pneumonia/complications , Pneumonia, Viral/complications , Pulmonary Fibrosis/complications , Acute Disease , COVID-19/diagnostic imaging , COVID-19/therapy , Cryptogenic Organizing Pneumonia/diagnostic imaging , Cryptogenic Organizing Pneumonia/therapy , Follow-Up Studies , Humans , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/therapy , Pulmonary Fibrosis/diagnostic imaging , Pulmonary Fibrosis/therapy
2.
Rofo ; 192(1): 65-73, 2020 Jan.
Article in English | MEDLINE | ID: mdl-31370088

ABSTRACT

PURPOSE: To assess the sensitivity of radiologists and a CAD system for the detection of lung metastases on thin-section computed tomographic (CT) scans prior to pulmonary metastasectomy. MATERIALS AND METHODS: All patients scheduled for resection of lung metastases were eligible for this prospective single-center trial. 95 patients with 115 surgical procedures (pulmonary metastasectomy using thoracotomy) were included. An experienced radiologist examined the CT scans for pulmonary metastases and documented his findings. A commercial CAD system was used as a second reader; additional CAD findings were recorded. A comparison of the sensitivity of the radiologist alone and with CAD was performed. Intraoperatively surgeons tried to identify the documented lesions and resected them as well as additionally palpable lesions. The standard of reference consisted of surgery and histopathology. Follow-up information for radiologically detected lesions missed during surgery was sought. RESULTS: 693 lesions (262 metastases) were detected radiologically or surgically, 646 of them were resected. The sensitivity of radiologists without CAD was 67.5 % for all lesions (87.4 % for metastases). CAD highly significantly (p < 0.001) increased the sensitivity to 77.9 % (92.7 %). During surgery, 143 additional lesions (19 metastases) were detected. 49 radiologically detected lesions were not palpable during surgery: 4 metastases, 5 benign lesions, and 40 lesions of an unknown nature. CONCLUSION: CAD provides significant additional sensitivity for detecting lung metastases using MDCT compared to the performance of a radiologist alone. CT reveals a relevant number of non-palpable pulmonary lesions. KEY POINTS: · CAD significantly increased the sensitivity for the detection of lung metastases on CT.. · Surgical palpation of the lungs missed 8.5 % of all radiologically detected lesions.. · CT with CAD may increase the chance for complete metastasectomy.. CITATION FORMAT: · Meybaum C, Graff M, Fallenberg EM et al. Contribution of CAD to the Sensitivity for Detecting Lung Metastases on Thin-Section CT - A Prospective Study with Surgical and Histopathological Correlation. Fortschr Röntgenstr 2020; 192: 65 - 73.


Subject(s)
Diagnosis, Computer-Assisted/methods , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/secondary , Tomography, X-Ray Computed/methods , Adolescent , Adult , Aged , Aged, 80 and over , Correlation of Data , Female , Humans , Lung/diagnostic imaging , Lung/pathology , Lung/surgery , Lung Neoplasms/pathology , Lung Neoplasms/surgery , Male , Middle Aged , Observer Variation , Prospective Studies , Sensitivity and Specificity , Young Adult
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