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Background: Echographic vertical artifacts (B-lines) in chest ultrasonography have often been associated with pathological patterns. A scientifically sound explanation of these artifacts has not yet been proposed.
Objectives: The 'spongy' nature of the lung in its liquid and solid components and the changes that take place in peripheral airspace (PAS) geometry might be the key point to understanding these phenomena.
Methods: Six excised right rabbit lungs were obtained. Each lung underwent direct ultrasound evaluation in two different conditions: at complete tissue elastic recoil volume and at pulmonary expansion volume achieved by applying a constant positive pressure of 12 cm H2O. Lung volumes and densities were reported in both conditions. Histological examination was performed on three naturally collapsed lungs and on three lungs under positive pressure inflation after having been fixed in formalin solution.
Results: Mean volumes of naturally collapsed lungs and fixed expanded lungs were 11.2 ± 0.36 and 44.83 ± 3.03 ml, respectively. Mean densities were 0.622 ± 0.016 and 0.155 ± 0.007 g/ml, respectively. Ultrasound evaluation of collapsed lungs showed dense vertical artifacts and a 'white lung' pattern, while the evaluation of expanded lungs showed hyperechoic line and horizontal artifacts of reflection. Histological evaluation showed a different PAS geometry in collapsed lungs caused by alveolar size reduction and shape changes with unfolded and closed units modifying the peripheral porosity of the frothy nature of the lung.
Conclusions: Airspace geometry, frothy nature and porosity are the determinants of the different behavior of ultrasound interacting with the subpleural lung parenchyma. Chest ultrasound may thus be interpreted as an indirect 'estimator' of lung porosity.
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http://dx.doi.org/10.1159/000368086 | DOI Listing |
BMC Med Imaging
December 2024
Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, Yangfangdian Tieyiyuan Road No.10, Haidian District, Beijing, 100038, China.
Objectives: To investigate the diagnostic value of CT lymphangiography (CTL) and non-contrast MR lymphangiography (MRL) in lymphatic plastic bronchitis.
Materials And Methods: The clinical and imaging data of 31 patients with lymphatic plastic bronchitis diagnosed by clinical, imaging and pathological results were retrospectively analyzed. All patients underwent CTL and MRL.
Clin Pract Cases Emerg Med
November 2024
Atrium Health's Carolinas Medical Center, Department of Emergency Medicine, Division of Medical Toxicology, Charlotte, North Carolina.
Introduction: Metallic luster dusts are decorative agents for cakes and other confections. While some powders are labeled "non-edible," they are also marketed as "non-toxic." We present a case of a child who developed acute metal pneumonitis after accidental aspiration of metallic luster dust.
View Article and Find Full Text PDFJ Bronchology Interv Pulmonol
January 2025
Department of Surgery, Inova Schar Cancer Institute, Inova Fairfax Hospital.
Background: Bronchoscopic lung volume reduction (BLVR) is a minimally invasive procedure used to reduce shortness of breath and improve functionality in some patients with emphysema. While BLVR is often effective for improving dyspnea by causing target lobe atelectasis, the treatment effect can sometimes be lost. This study reviews the incidence of revision bronchoscopies in patients who lost or never achieved target lobe atelectasis following BLVR.
View Article and Find Full Text PDFAnn Am Thorac Soc
December 2024
UZ Leuven, Department of Pediatric Pulmonology, Leuven, Vlaams-Brabant, Belgium;
RATIONALE+OBJECTIVE/ Cystic fibrosis (CF) is characterized by bronchiectasis on imaging, while functionally evolving towards obstructive impairment. Despite its assumed importance in CF, small airway remodeling and its relation to bronchiectasis, is still poorly understood. METHOD/ On high-resolution computed tomography (HRCT, 600µm, CF=21, control=6) and micro-computed tomography (µCT, 150µm, CF=3, control=1) scans of inflated explant lungs, AV% (airway/total lung volume) was calculated as marker for bronchiectasis, while airway segmentation was used for generation analysis.
View Article and Find Full Text PDFBMC Anesthesiol
December 2024
Department of Anesthesiology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana-cho, Chuo-ku, Chiba, 260-8670, Japan.
Background: Bleeding are common in cardiac surgery, with significant impacts on transfusion-related complications and patient prognosis. This study aimed to determine the differences in perioperative blood loss, transfusion rates, and the incidence of postoperative pulmonary complications (PPCs) with and without the use of positive end-expiratory pressure (PEEP) in patients undergoing off-pump coronary artery bypass graft surgery (OPCAB).
Methods: This single-center, retrospective study included 106 adult patients undergoing coronary artery bypass surgery without cardiopulmonary bypass from January 2018 to March 2022.
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