Watanabe Takuya, Suzuki Eriko, Yoshii Naoko, Tsuchida Hiroyuki, Yobita Shogo, Uchiyama Suiha, Iguchi Kensuke, Nakamura Minori, Endo Takumi, Tanahashi Masayuki
Division of Thoracic Surgery, Respiratory Disease Center, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
J Thorac Dis. 2023 Mar 31;15(3):1096-1105. doi: 10.21037/jtd-22-1226. Epub 2023 Mar 22.
To plan a surgical approach and predict the operative time or bleeding volume, it is important to determine the presence of pleural adhesions before surgery. Dynamic chest radiography (DCR) is a new modality that can dynamically capture X-rays, and we assessed the utility of DCR for detecting pleural adhesions preoperatively.
The subjects of this study were those who underwent DCR before surgery from January 2020 to May 2022. The preoperative evaluation was performed by three imaging analysis modes, and pleural adhesion was defined as the that spreading to more than 20% of the thoracic cavity and/or taking more than 5 minutes to dissect.
Of the 120 total patients, DCR was performed properly for 119 (99.2%). Accurate preoperative evaluations of pleural adhesions were confirmed in 101 patients (84.9%), with a sensitivity of 64.5%, specificity of 91.0%, positive predictive value of 74.1%, and negative predictive value of 88.0%.
DCR was very easy to perform in all preoperative patients with all manner of thoracic disease. We demonstrated the utility of DCR, showing its high specificity and negative predictive value. DCR has the potential to become a common preoperative examination for detecting pleural adhesions with further improvements in software programs.
为了规划手术入路并预测手术时间或出血量，术前确定胸膜粘连的存在很重要。动态胸部X线摄影（DCR）是一种能够动态采集X线的新方法，我们评估了DCR在术前检测胸膜粘连的效用。
本研究的对象是2020年1月至2022年5月期间术前接受DCR检查的患者。通过三种影像分析模式进行术前评估，胸膜粘连定义为蔓延至胸腔超过20%和/或分离耗时超过5分钟。
120例患者中，119例（99.2%）DCR检查执行得当。101例患者（84.9%）术前对胸膜粘连评估准确，灵敏度为64.5%，特异度为91.0%，阳性预测值为74.1%，阴性预测值为88.0%。
对于所有患有各种胸科疾病的术前患者，DCR操作非常简便。我们证明了DCR的效用，显示出其高特异度和阴性预测值。随着软件程序的进一步改进，DCR有可能成为检测胸膜粘连的常规术前检查。
