Learning objectives To review surgical or bronchoscopic treatment for severe emphysema. To describe preoperative characterization of emphysema by HRCT and to define the specific abnormalities that guide the choice of optimal procedure. To show the regular morphological changes that follow the procedures and to describe the complications as detected by chest x-ray and HRCT. Background COPD is characterized by incompletely reversible expiratory airflow obstruction, and its severity is rated according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, which defines four stages of disease, according to the post-bronchodilator airflow limitation. HRCT allows the categorization of COPD patients into subtypes that are distinguished accordingly to different structural and functional alterations [1]. Findings and procedure details 1. Lung volume reduction surgery (LVRS) The surgical removal of emphysematous tissue has the purpose of revert ventilation in residual healthy parenchyma [2], specifically in patients suffering from upper-lobes predominant emphysema (Fig. 1); therefore, the pre-operative assessment of emphysema through visual scoring or by quantitative analysis of CT images is needed; the latter precisely calculates the percentage of emphysematous tissue, thus guiding the correct strategy [3]. Conclusion Radiologists should be familiar with HRCT imaging aspects related to this noninvasive treatment option for pulmonary emphysema, which are being increasingly performed in referral centers.

Treatment of emphysema: procedure planning and follow-up by HRCT / Milanese, Gianluca; Silva, Mario; Borghesi, Andrea; Bezzi, Michela; Bonifazi, Martina; Novali, Mauro; Sverzellati, Nicola. - ELETTRONICO. - (2016). (Intervento presentato al convegno European Congress of Radiology tenutosi a Vienna (AT) nel March 2-6, 2016) [10.1594/ecr2016/C-1796].

Treatment of emphysema: procedure planning and follow-up by HRCT

MILANESE, Gianluca;SILVA, Mario;SVERZELLATI, Nicola
2016-01-01

Abstract

Learning objectives To review surgical or bronchoscopic treatment for severe emphysema. To describe preoperative characterization of emphysema by HRCT and to define the specific abnormalities that guide the choice of optimal procedure. To show the regular morphological changes that follow the procedures and to describe the complications as detected by chest x-ray and HRCT. Background COPD is characterized by incompletely reversible expiratory airflow obstruction, and its severity is rated according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, which defines four stages of disease, according to the post-bronchodilator airflow limitation. HRCT allows the categorization of COPD patients into subtypes that are distinguished accordingly to different structural and functional alterations [1]. Findings and procedure details 1. Lung volume reduction surgery (LVRS) The surgical removal of emphysematous tissue has the purpose of revert ventilation in residual healthy parenchyma [2], specifically in patients suffering from upper-lobes predominant emphysema (Fig. 1); therefore, the pre-operative assessment of emphysema through visual scoring or by quantitative analysis of CT images is needed; the latter precisely calculates the percentage of emphysematous tissue, thus guiding the correct strategy [3]. Conclusion Radiologists should be familiar with HRCT imaging aspects related to this noninvasive treatment option for pulmonary emphysema, which are being increasingly performed in referral centers.
2016
Treatment of emphysema: procedure planning and follow-up by HRCT / Milanese, Gianluca; Silva, Mario; Borghesi, Andrea; Bezzi, Michela; Bonifazi, Martina; Novali, Mauro; Sverzellati, Nicola. - ELETTRONICO. - (2016). (Intervento presentato al convegno European Congress of Radiology tenutosi a Vienna (AT) nel March 2-6, 2016) [10.1594/ecr2016/C-1796].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11381/2809686
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