Literature DB >> 25795703

CT findings after lipiodol marking performed before video-assisted thoracoscopic surgery for small pulmonary nodules.

Hiroshi Miura1, Takuji Yamagami2, Osamu Tanaka3, Rika Yoshimatsu4, Yusuke Ichijo3, Daishiro Kato5, Junichi Shimada5.   

Abstract

BACKGROUND: In preoperative lipiodol marking for small pulmonary nodules, lipiodol has a potential risk of distribution in the surrounding lung structure. There are no reports about the detailed accumulation and distribution of lipiodol.
PURPOSE: To evaluate computed tomography (CT) findings after lipiodol marking before thoracoscopic surgery for pulmonary nodules.
MATERIAL AND METHODS: Sixty-four consecutive CT-guided lipiodol markings for 103 nodules were performed in 55 patients. Lipiodol (0.2-0.4 mL) was injected using a 21-gauge needle near the nodule. The appearance of lipiodol spots was classified into the following three types on CT: type 1, dense; type 2, punctate; and type 3, unclear. The distribution of lipiodol was also investigated. Statistical analyses were performed on the accumulation and distribution related to nodule factors. Incidences of complications were also investigated.
RESULTS: A total of 110 markings were performed because of seven additional procedures due to insufficient marking. All nodules were successfully resected on the same day. The appearances of the lipiodol spots were type 1 (82%), type 2 (11%), and type 3 (7.3%). The areas of distribution were lung parenchyma (54%), central bronchus (39%), peripheral bronchovascular bundle (24%), needle tract (20%), pleural space (19%), another segment of ipsilateral lung (5.5%), and contralateral lung (0.9%). Distribution into pleural space and central bronchus was frequently seen in the shallow nodules (P < 0.05). Complications were pneumothorax (61%) and pulmonary hemorrhage (35%). There were no serious symptoms.
CONCLUSION: The appearance of the lipiodol spot was dense in most cases, despite frequent distribution in the surrounding lung structures without serious complications. © The Foundation Acta Radiologica 2015.

Entities:  

Keywords:  Localization; interventional; lung

Mesh:

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Year:  2015        PMID: 25795703     DOI: 10.1177/0284185115576047

Source DB:  PubMed          Journal:  Acta Radiol        ISSN: 0284-1851            Impact factor:   1.990


  17 in total

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