| Purpose：1.To determine the accuracy of CT scans to predictcompleteness of the pulmonary fissures,the indexes are as follows:sensitivity, particularity,positive predictive value,negative predictivevalue, and the accuracy.2.To assess incomplete interlobar fissurescomprehensively by calculating the frequency,designing the posit-ion, evaluating the percentage of the incomplete area,and confirmthe type classification.Methods：1.We obtained the completeness of pulmonary fiss-ures evaluated by direct observation during surgery by consulting t-he operation note from2013.6-2014.6.Preoperative CT scans wereindependently reviewed again by two dedicated thoracic radiologi-sts and the completeness of the fissures was recorded and then co-mpared to intraoperative findings.2.Retrospective assessment ofMDCT examinations of100patients who had been already design-ed to have incomplete fissures was performed.We assessed the lo-calization, extension,and attempt to make efficient classifications b-y varies bronchovascular structures associated with incomplete fis-sures. Criteria:Type I,the interlobar line is not observed,the zone isavascular or can be observed some small vessels in adjacent lobescross over the interlobar region;Type II,pulmonary vein can be obs-erved to penetrate the interlobar region;Type III,pulmonary artery,or associated with bronchus penetrate the interlobar region.TypeIV,complete fusion of the lobes with no evident fissure line.Results:1.The fissures of130patients were evaluated.182fis-sures were evaluated,132fissures were found to be incomplete. T-he frequency of incomplete fissures were18/37(48%) in the right u-pper fissure,and6/15(43%)in the right lower fissure,for the wholeright fissure,the frequency of incompleteness was25/30(82%);Thefrequency of incompleteness of the right minor fissure and left ma-jor fissure were45/52(86%),38/48(79%). Overall,The sensitivity, s-pecificity,positive predictive value and negativity predictive value ofCT scan to detect a incomplete fissure were0.92,0.80,0.90,0.85,respectively.So the accuracy of CT scan to predict a incomplete fi-ssure was0.88.2. Among the100patients who have incomplete fi-ssures,two right horizontal fissures were absent,thus298fissureswere observed,221fissures were incomplete among them:the con-stitute ratio is: incomplete right minor fissure is of the most,92/221(42%),followed by incomplete right major fissure,83/221(38%), a-nd the left major fissure,46/221(21%).On the left side,the discontin-uity was most present in the parahilar region,and the area of the in-completeness was most frequently between25%and50%.The rig-ht major fissure was incomplete most in parahilar region,with the m-ost frequent discontinuity below25%.The right minor fissure was i- ncomplete most in the middle1/3area,and with the most frequentdiscontinuity between76%and99%.For the types of the incompl-eteness of the fissure,In the right major fissure,the most frequenttype is type I(61),followed by type IV(18%),and type IV(51%) andtype II (34%) in the right minor fissure,in the left side,type II(46%)and type I(38%) was the most frequent.For all of the four types,typeI was75/221(34%),type II was64/221(29%),type IV was61/221(28%),and type III was21/221(10%).Conclusions:On the whole,with the high accuracy of MDCTscan to design the incomplete fissures,MDCT can be used topredict the interlobar fissure integrity.MDCT can assess theincompleteness of interlobar fissures comprehensively. |
PDF Full Text Request