BACKGROUND: With the extensive application of segmental lung resection in the treatment of early-stage lung cancer, how to complete segmentectomy more accurately and minimally invasively has become a research hotspot. The aim of this study is to explore the application of three-dimensional computed tomography bronchography and angiography (3D-CTBA) combined with perfusion area recognition technique in single-hole thoracoscopic complex segmentectomy. METHODS: From January 2021 to January 2022, the clinical data of 112 consecutive patients undergoing single-port thoracoscopic complex segmentectomy in the Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University were retrospectively analyzed. The three-dimensional reconstruction combined with perfusion area identification technique was used to perform the operation and the clinical data were analyzed. RESULTS: The average operation time was (141.1±35.4) min; the initial time of intersegmental plane display was (12.5±1.7) s; the maintenance time of intersegmental plane was (114.3±10.9) s; the intersegmental plane was clearly displayed (100%); the amount of bleeding was [10 (10, 20)] mL; the total postoperative drainage volume was (380.5±139.7) mL; the postoperative extubation time was (3.9±1.2) d; and the postoperative hospitalization time was (5.2±1.6) d. Postoperative complications occurred in 8 cases. CONCLUSIONS The advantages of 3D-CTBA combined with perfusion area recognition technique are fast, accurate and safe in identifying intersegmental boundary in single-port thoracoscopic complex segmentectomy, which could provide guidances for accuratding resection of tumors, shortening operation time and reducing surgical complications.
Humans ; Lung Neoplasms/pathology* ; Bronchography ; Pneumonectomy/methods* ; Retrospective Studies ; Thoracic Surgery, Video-Assisted/methods* ; Tomography, X-Ray Computed ; Angiography/methods* ; Perfusion

OBJECTIVE: The aim of this study was to evaluate whether the difference in the degree of collateral ventilation between canine and swine models of bronchial obstruction could be detected by using xenon-enhanced dynamic dual-energy CT. MATERIALS AND METHODS: Eight mongrel dogs and six pigs underwent dynamic dual-energy scanning of 64-slice dual-source CT at 12-second interval for 2-minute wash-in period (60% xenon) and at 24-second interval for 3-minute wash-out period with segmental bronchus occluded. Ventilation parameters of magnitude (A value), maximal slope, velocity (K value), and time-to-peak (TTP) enhancement were calculated from dynamic xenon maps using exponential function of Kety model. RESULTS: A larger difference in A value between parenchyma was observed in pigs than in dogs (absolute difference, -33.0 +/- 5.0 Hounsfield units [HU] vs. -2.8 +/- 7.1 HU, p = 0.001; normalized percentage difference, -79.8 +/- 1.8% vs. -5.4 +/- 16.4%, p = 0.0007). Mean maximal slopes in both periods in the occluded parenchyma only decreased in pigs (all p < 0.05). K values of both periods were not different (p = 0.892) in dogs. However, a significant (p = 0.027) difference was found in pigs in the wash-in period. TTP was delayed in the occluded parenchyma in pigs (p = 0.013) but not in dogs (p = 0.892). CONCLUSION: Xenon-ventilation CT allows the quantification of collateral ventilation and detection of differences between canine and swine models of bronchial obstruction.
Airway Obstruction/*radiography ; Animals ; Bronchial Diseases/*radiography ; Bronchography/*methods ; Disease Models, Animal ; Dogs ; Pulmonary Ventilation/*physiology ; Respiration ; Swine ; Tomography, Spiral Computed/*methods ; Xenon

BACKGROUND AND OBJECTIVEAir bronchogram were visible in endobronchial ultrasound images of benign and malignant lesions. The aim of this study is to analyze the endobronchial ultrasound images of different characteristics of air bronchogram and clinical significance combined with pathologic section.

METHODSFrom June 1, 2005 to December 30, 2008, 92 patients were found pulmonary peripheral lesions by X-ray and CT examinations, and confirmed that lesions were located lower to the segmental bronchial orifice by flexible bronchoscopy examinations. These patients were examined by radial endobronchial ultrasound probe afterwards.

RESULTSSeventy-eight patients clarified with benign or malignant diagnosis of lesions were analyzed, among whom, 22 of 47 (46.8%) were of malignant lesion without air bronchogram, 22 patients in 25 of lesions without air bronchogram were confirmed malignant (88%), among whom, 66.7% (2/3), were of small cell lung cancer, 43.9% (18/41) were of non-small cell lung cancer, and 50% (5/10) were of poorly differentiated adenocarcinoma, no sign of air bronchogram was found in corresponding pathological sections. Among those patients with malignant lesion, 51.1% (24/47) were of irregular air bronchogram. For patients with malignant lesions, irregular air bronchogram was most commonly found in adenocarcinoma, 55.2% (16/29) of pathological sections showed signs of air bronchogram, similar sign was also found in 2 patients with moderately differentiated adenocarcinoma and 1 patient with poorly differentiated adenocarcinoma. The total percentage of patients without air bronchogram and with irregular air bronchogram was 97.9% (46/47), only one of them (with medium differentiated adenocarcinoma) showed regular air bronchogram (1.3%). 80.6% (25/31) patients with benign lesion showed regular sign of air bronchogram distributed in the shape of concentric circles, the percentage of patients without air bronchogram or with irregular air bronchogram was both 3.8% (3/31).

CONCLUSIONWhen there's no air bronchogram, or irregular air bronchogram sign found by endobronchial ultrasound examination, it is highly indicated that there is a malignant lesion, while there's regular sign of air bronchogram distributed in the shape of concentric circles, it is likely to be a benign lesion.

Adult ; Aged ; Aged, 80 and over ; Bronchi ; diagnostic imaging ; Bronchography ; Endosonography ; methods ; Female ; Humans ; Lung Neoplasms ; diagnostic imaging ; pathology ; Male ; Middle Aged