1986
DOI: 10.1055/s-2007-1022188 View full text |Buy / Rent full text
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Abstract: The operative findings at 27 thoracotomies in 24 patients were compared with the results of chest X-rays, computerized tomographies and conventional tomographies. Radiological and operative findings corresponded in 15 of 27 cases. The computerized tomography proved to be the most sensitive method for the estimation of the number of metastases. The foci often located close to the pleura repeatedly cause an exudative reaction of the visceral pleura and thus mark the interlobular septa. These changes were most di… Show more

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“…The problems involved in diagnosing pulmonary metastases include both detection and characterisation. Although chest X-rays were once used, it has long been demonstrated that CT, including conventional CT, is far superior [4,19], yielding a sensitivity of 68%-78% as opposed to 44%-56% for chest X-rays [3,5,6]. This superiority is attributable to the greater contrast resolution between the nodule and the lung parenchyma and easier detection of lesions, thanks to elimination of the superimposition of structures such as the chest wall, mediastinum, diaphragm and vessels [20].…”
Section: Discussionementioning
“…In passato a tal fine veniva utilizzata la radiografia del torace, ma già da anni è stata dimostrata la superiorità della TC [4,19], anche se di tipo convenzionale, con risultati di sensibilità segnalati in letteratura del 44%-56% per la radiografia del torace e del 68%-78% per la TC [3,5,6]. La superiorità della TC è in rapporto ad una maggiore risoluzione di contrasto tra nodulo e parenchima polmonare ed ad un più agevole riconoscimento delle lesioni in assenza di sovrapposizione di strutture quali parete toracica, mediastino, diaframma e vasi [20].…”
Section: Discussioneunclassified
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“…La mayoría de los cirujanos de tórax prefiere la toracotomía, dado que por la vía toracoscópica no se estaría cumpliendo el segundo criterio básico y único factor pronóstico validado universalmente, la resección de todas las lesiones 15 . Esto se basa en que las imágenes preoperatorias son fundamentales para programar la resección y se ha visto que la TAC subestima lesiones hasta en un 27-40% de las veces [15][16][17] . Por esto habría que palpar directamente la superficie pulmonar buscando lesiones no diagnosticadas, e incluso en forma bilateral, a pesar que las imágenes nos revelen compromiso unilateral.…”
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