Intrathoracic tumors in contact with the chest wall--ultrasonographic and computed tomography comparative evaluation

A comparative evaluation of lung lesions in contact with the thoracic wall by transthoracic ultrasonography (US) and computed tomography (CT).

A retrospective analysis of the US and CT results was performed in 131 patients with thoracic masses. In all of these cases the histological diagnosis was established after a US guided transthoracic biopsy. A comparative analysis of the two methods was realized regarding the following items: lesion dimensions, presence of tumoral wall invasion, peritumoral atelectasis, presence of pleural effusion and incidence of post-biopsy complications.

A number of 17 patients from the study group were diagnosed with benign lesions and 114 (87%) with malignancies. US showed signs of wall invasion in 78 patients (68.42%), whereas CT revealed it in 83 of the patients (72.8%) from the malignancies group. Intratumoral necrosis was diagnosed by US in 100 patients (87.71%) and by CT in 83 patients (72,8%), also from the 114 patients with malignant lesions. US found peritumoral atelectasis in 33 cases and CT in 38 cases. All parameters had good and very good correlation indexes between the methods (kappa = 0,8; 0,6; 0,72; p < 0,001 in all cases).

In patients with thoracic masses in contact with the thoracic wall there is an overlap in the diagnosis performances of US and CT. The sensitivity and specificity of US in diagnosing wall invasion of malignant lesions is superior to that of CT.