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Title: A diagnostic yield of high resolution computed tomography in targeting lung biopsy performed by videothoracoscopy in diagnostics of diffuse parenchymal lung diseases

Abstract:

The aim of the study was: 1/ to evaluate the usefulness of HRCT-score as a guide method in selection of the most reliable lung region for VATS biopsy in DPLD, 2/ to examine the correlation between HRCT-score and semi-quantitative histopathological results in idiopathic interstitial pneumonias (IIPs) based on HP-score, 3/ to evaluate the homogeneity of fibrosis by estimation of cytological and immunological results of TGF-ß1, MMP-9, PGE2 and PGD2 in double BAL from two different lung segments: with the most and with the least extensive involvement estimated by HRCT-score. Examined group consisted of 31 patients in whom diagnosis of DPLD was not established by clinical, radiological, physiological and non-invasive methods. The two different lung segments were indicated by HRCT-score for BAL and VATS biopsy. Regarding as histopathological results there were 17 IIPs and 14 granulomatous diseases (GDs). Twenty eight of patients showed nonhomogenous distribution of HRCT changes, with a predominance of linear opacities in IIPs in lower lobes (p = 0,05279) and higher HRCT-score in IIPs in lower lobes (p < 0,01). In IIPs the odds ratio for obtaining better histopathological result was 12,5-times higher depending on higher activity in HRCT-score, also confirmed by logit model (p = 0,0609). In GDs the histopathological result was obtained in 84,62%, independently of HRCT-score and with no predilection for any lobe. A semi-quantitative histopathological result in IIPs is correlated only with few parameters of HRCT; a fibrosis-score with linear opacities (χ2 p = 0,042) and a cellularity-score with intensity of changes (χ2 p = 0,0192) and ground-glass opacities (χ2 p = 0,026). There was not found any correlation between total HRCT-score and HP-score. A higher amount of neutrophils and eosinophils and a higher concentration of TGF-ß1, MMP-9 and PGD2 in BAL may occur good markers of fibrosis in IIPs, but only the higher concentration of TGF-ß1 (p = 0,018) and the higher amount of eosinophils (p = 0,016, ANOVA) are significantly correlated with HRCT-score.

Level of degree:

2 - studia doktoranckie

Degree discipline:

radiologia ; pulmonologia

Degree grantor:

Wydział Lekarski

Promoter:

Krzysztof Sładek

Date issued:

2008

Format:

application/pdf

Identifier:

oai:dl.cm-uj.krakow.pl:1046

Call number:

ZB-108268

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Access rights:

tylko w bibliotece

Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego - Collegium Medicum

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Last modified:

Feb 12, 2020

In our library since:

Nov 21, 2012

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2

All available object's versions:

http://dl.cm-uj.krakow.pl:8080/publication/1046

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ZB-108268 Feb 12, 2020
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