Sonoda Akinaga, Jeudy Jean, White Charles S, Kligerman Seth J, Nitta Norihisa, Lempel Jason, Frazier Aletta Ann
Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 22 S. Greene Street, Baltimore, MD, 21201, USA,
Jpn J Radiol. 2015 May;33(5):241-5. doi: 10.1007/s11604-015-0412-7. Epub 2015 Mar 20.
Pleurodesis is frequently performed to prevent recurrence of pneumothorax or recurrent pleural effusion in benign or malignant conditions. In essence, it involves producing an area of adhesion between the parietal and the visceral layers of the pleura. The approach to this procedure can be divided into chemical and mechanical methods. Chemical pleurodesis is performed by introducing various substances such as talc, bleomycin, povidone iodine or other chemicals into the pleural space typically using a pleural catheter. The instilled substances cause inflammation of the parietal and the visceral layers of the pleura and leads to adhesion of the pleural surfaces, preventing further fluid or air accumulation. Mechanical pleurodesis, which is performed with thoracotomy or thoracoscopy, involves mechanical irritation of the pleura or removal of parietal pleura. It is important for the radiologist to develop an understanding of the clinical indications for pleurodesis, methods for the procedure and post-procedure imaging appearance so the radiologist can provide a correct interpretation and avoid misdiagnosis of the radiologic appearance as chronic infection, tumor or other entities with a similar appearance. Thus, the aim of this article is to review the indications, techniques and post-procedural appearances of pleurodesis from an imaging perspective.
胸膜固定术常用于预防良性或恶性疾病导致的气胸复发或反复胸腔积液。本质上，它涉及在胸膜的壁层和脏层之间形成粘连区域。该手术方法可分为化学法和机械法。化学性胸膜固定术通常通过胸膜导管将滑石粉、博来霉素、聚维酮碘等各种物质注入胸膜腔来实施。注入的物质会引起胸膜壁层和脏层的炎症，导致胸膜表面粘连，防止液体或气体进一步积聚。通过开胸手术或胸腔镜进行的机械性胸膜固定术，包括对胸膜的机械刺激或切除壁层胸膜。放射科医生了解胸膜固定术的临床适应证、手术方法以及术后影像学表现非常重要，这样放射科医生才能做出正确的解读，避免将影像学表现误诊为慢性感染、肿瘤或其他外观相似的疾病。因此，本文旨在从影像学角度综述胸膜固定术的适应证、技术及术后表现。
