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Master Thesis

Détection de la ventilation collatérale avant réduction de volume par voie endoscopique de l'emphysème sévère : évaluation des scissures pulmonaires par tomodensitométrie

Abstract : In patients with severe emphysema, obtaining atelectasis to reduce pulmonary volume through implantation of endobronchial valves is a major goal to improve exercise tolerance and survival. In these patients, endoscopic measurement of collateral ventilation (CV) provides a good predictive value for obtaining atelectasis. In addition, the presence of a complete fissure on computed tomography (CT) is associated to greater reduction in pulmonary volume and significant improvement of FEV1. The aim of this study is to correlate the analysis of fissure integrity by CT with the presence of collateral ventilation measured endoscopically. 25 patients suffering from heterogeneous emphysema, with more than 50% of emphysema in a lobe, undergone CV measurement with a catheter trough an occlusive balloon within this target lobe, during flexible endoscopy. Two senior thoracic radiologists studied the fissures on thoracic CT. The fissures surrounding 37 targeted lobes were evaluated on CT. To detect collateral ventilation, the presence of a fissural defect presents a sensitivity, specificity, positive predictive value and negative predictive value of 95%, 44%, 69% and 88%, respectively. Prior to the insertion of bronchial valves, if thoracic CT does not reveal a fissural defect in contact with the target lobe, endoscopic measurement of collateral ventilation does not appear to be mandatory before endoscopic lung volume reduction with one-way valves.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00688462
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Submitted on : Tuesday, April 17, 2012 - 4:45:32 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:17 AM
Long-term archiving on: : Wednesday, July 18, 2012 - 2:38:24 AM

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  • HAL Id : dumas-00688462, version 1

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Emilie Reymond. Détection de la ventilation collatérale avant réduction de volume par voie endoscopique de l'emphysème sévère : évaluation des scissures pulmonaires par tomodensitométrie. Human health and pathology. 2012. ⟨dumas-00688462⟩

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