Carignan S, Samson L, Lafontaine E, Cordeau M P
Département de Radiologie, Hôtel-Dieu de Montréal, Université de Montréal, Québec, Canada.
Ann Chir. 1994;48(8):777-84.
This study is based on the observations of 86 pleurodesis done by talc insufflation during thoracoscopy in 82 patients suffering from benign (8%) and malignant (92%) pleural effusions. Serial chest films were obtained on every patient. Chest computed tomography was obtained in ten patients. The most frequent finding seen in the early phase and one month later was the appearance of loculations (94%) in selective areas of the thorax. Occasionally they take the appearance of airfluid levels (22%). These loculations are characteristically located in the axillary (60%), intrafissural (30%) and paramediastinal (34%) areas of the chest. In the late phase with a mean evolution time of 6 months, these loculations evolve in 77% of patients in areas of pleural thickening. CT of the chest demonstrates the presence of characteristic pleural thickening in the form of coarse (5/12) and/or fine linear densities (7/12) corresponding to talc deposits, on the pleural surface. These modifications are shown by light microscopy examination of the pleural done at the autopsy.
本研究基于对82例患有良性(8%)和恶性(92%)胸腔积液的患者在胸腔镜检查期间通过滑石粉吹入法进行的86次胸膜固定术的观察。对每位患者均进行了系列胸部X线片检查。10例患者进行了胸部计算机断层扫描(CT)。在早期及1个月后最常见的表现是在胸部的特定区域出现分隔(94%)。偶尔会出现气液平面(22%)。这些分隔特征性地位于胸部的腋窝(60%)、叶间裂内(30%)和纵隔旁(34%)区域。在平均演变时间为6个月的后期,77%的患者这些分隔在胸膜增厚区域发生演变。胸部CT显示胸膜表面存在特征性的胸膜增厚,表现为对应滑石粉沉积的粗大(5/12)和/或细线性密度影(7/12)。这些改变通过尸检时胸膜的光镜检查得以证实。