Objective. To determine the opportunities of low-dose digital fluorography (LDDF) in differential diagnosis of phenotypic variants of chronic obstructive pulmonary disease (COPD).Material and methods. There were 107 patients with clinically diagnosed COPD of varying severity examined. The average age of the patients was 51.8±1.5 years (46–59 years). All patients for LDDF of the chest in the frontal projection in the inspiratory and expiratory phase of respiration were undergone.Results. The electron optical density of the lungs was determined in the upper, middle and lower zones of both lungs. As a result in patients with a predominance of emphysematous variant of COPD (n=15) the most characteristic radiological symptom was lung hyperventilation (14% of 107 patients) and inspiratory electron optical density value was 748.18±4.72 optical density units (ODU). In patients with a predominance of bronchitic variant of COPD (n=43) the most common radiological symptom was the presence of symptom amplification and deformation of lung pattern (40% of 107 patients) and inspiratory electron optical density value was 668.04±12.26 ODU. For patients with mixed phenotypic variant of COPD (n=49) it was characterized by a combination of X-ray symptom amplification and deformation of lung pattern with lung emphysema (46% of 107 patients); the average value of inspiratory electron optical density value was 815.24±17.25 ODU.Conclusion. The technique of LDDF can detect X-ray symptoms and determine inspiratory and expiratory electron optical density of the lungs in patients with COPD that allows optimizing the differential diagnosis of phenotypic variants of chronic obstructive pulmonary disease.
The article describes a rare case of metastatic pulmonary choriocarcinoma manifested with hemoptysis. Obstacles and pitfalls of the diagnosis of uterine choriocarcinoma with atypical manifestation were discussed. The patterns of pulmonary metastases of uterine choriocarcinoma and contribution of cross-sectional imaging modalities to diagnostic work-up were described. For the first time diffusion weighted magnetic resonance imaging of the chest was used for the follow-up examination and diagnosis of the recurrence of the disease.This case is of interest due to unusual clinical and radiological presentation of uterine choriocarcinoma. The article is aimed to radiologists to be familiar with this disease to provide its early diagnosis and timely treatment.
The purpose of the study – to examine the capabilities of the method of digital chest fluorography in diagnosis of chronic obstructive pulmonary disease (COPD) of different stages. By chest digital fluorography 247 patients with clinically diagnosed COPD stage I–III were examined. The average age of the patients was (55.3 1.7) years (16 to 88 years), forced expiration volume for the first second (FEV1) was (59.17 16.28) %. It was shown that for patients with COPD stage I most characteristic radiographic symptom was emphysema of the lung in the upper regions (26 (48%) of 54 patients); the mean values of the inspiratory lung optical density (ILOD) ranged from (703.48 2.15) to (807.47 5.61) optical density units (ODU), the expiratory lung optical density (ELOD) – from (786.05 6.15) to (830.23 4.71) ODU. For patients with COPD stage II the most common radiographic sign was the presence of amplification and deformation pulmonary pattern (95 (89%) of 107 patients); the mean values of ILOD ranged from (646.20 4.94) to (791.38 2.81) ODU, ELOD – from (677.34 9.91) to (813.91 3.29) ODU. Patients with COPD stage III were characterized by a combination of amplification and deformation pulmonary pattern (77 (90%) of 86 patients) with lung emphysema (51 (59%) of 86 patients); the mean values of the inspiratory lung optical density ranged from (765.93 16.4) to (863.37 15.83) ODU, expiratory lung optical density – from (826.80 11.64) to (881.37 4.29) ODU. Thus, we concluded that the method of digital chest fluorography, possessing low dose burden to the patient, can detect the characteristic radiological symptoms and determine the stage of the disease up to the values of the lung optical density in patients with COPD.
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