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An increase in micro-vessels beneath the pleural surface on computed tomography as a preoperative predictor of
Tomoyuki Kawamura1, Naohiro Kobayashi2, Takahiro Yanagihara1
1Department of Thoracic Surgery, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan.
Purpose:
Pleural adhesions, which may be present in varying degrees and involve blood vessels, often complicate thoracic surgery. The blood flow within pleural adhesions can be identified on computed tomography (CT) as micro-vessels beneath the pleural surface (MVBP). We conducted a prospective study to assess if MVBP can be detected on preoperative CT to predict intraoperative pleural adhesions.
Methods:
This prospective study investigated the preoperative CT images of patients scheduled to undergo surgery for lung tumors. MVBP was defined as positive when lung vessels were identified below the pleura on CT. MVBP was evaluated for each lung segment, and intraoperative findings of pleural adhesions on the segments were then recorded.
Results:
This study included 173 patients, with 1532 segments evaluated. Pleural adhesions were found in 51 patients and confirmed in 92 segments. The number of segments evaluated preoperatively as MVBP-positive was 134 (9%), of which 36 (26.9%) had pleural adhesions. Multivariable analysis identified that MVBP was an independent significant predictor (odds ratio = 2.29, 95% confidence interval 1.09-4.80, P = 0.028) of pleural adhesions on a per-patient basis.
Conclusions:
MVBP is a valuable predictor of pleural adhesions. The method is useful in clinical practice because it does not require additional examinations and is easy to assess.
Insights
Micro-vessels beneath the pleural surface (MVBP) seen on CT scans can predict pleural adhesions. This imaging finding helps anticipate surgical complications in thoracic procedures.
Area of Science:
- Thoracic Surgery
- Radiology
- Pulmonary Medicine
Background:
- Pleural adhesions frequently complicate thoracic surgery.
- Identifying these adhesions preoperatively is crucial for surgical planning.
- Micro-vessels beneath the pleural surface (MVBP) on CT scans may indicate adhesions.
Purpose of the Study:
- To prospectively evaluate if MVBP detected on preoperative computed tomography (CT) can predict intraoperative pleural adhesions.
- To assess the diagnostic value of MVBP in patients undergoing thoracic surgery for lung tumors.
Main Methods:
- Prospective study of 173 patients scheduled for lung tumor surgery.
- Preoperative CT scans were analyzed for MVBP in each lung segment.
- Intraoperative findings of pleural adhesions were recorded and correlated with CT findings.
Main Results:
- Out of 1532 evaluated segments, 134 (9%) were MVBP-positive.
- Pleural adhesions were confirmed in 36 of the 134 MVBP-positive segments (26.9%).
- MVBP was an independent significant predictor of pleural adhesions (OR=2.29, P=0.028).
Conclusions:
- MVBP identified on preoperative CT is a valuable predictor of intraoperative pleural adhesions.
- This non-invasive imaging marker aids in surgical risk assessment for thoracic procedures.
- The assessment of MVBP is practical for routine clinical use.
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