adiological methods in diagnosis, evaluation of the lung resection volume, planning of thoracoplasty and efficacy monitoring of the surgical treatment of expanded destructive pulmonary multi-drug resistant (MDR) tuberculosis

Giller D.B., Ratobylsky G.V., Nikitin M.M., Koroev V.V., Frolova O.P., Shekhter A.I., Ots O.N., Grigoriev Yu.G., Lavrov V.N.

 

Purpose. Demonstration of various radiological methods possibilities in diagnosis, evaluation of the lung resection volume, planning of thoracoplasty and efficacy monitoring of the surgi-cal treatment of destructive pulmonary multi-drug resistant (MDR) tuberculosis (TB). Results. Plain chest film revealed a widespread pulmonary tuberculosis inflamma-tion. With CT application, the nature and prevalence of pulmonary parenchymal involvement was clarified, indications and volume of complex surgical intervention were determined, and surgical treatment efficacy was controlled. Digital tomosynthesis application determined the state of the lung tissue after resection and the volume of the planned postponed thoracoplas-ty. Discussion. Taking into account the incidence of pulmonary tuberculosis in our country, the similarity of its clinical and radiological picture with a number of other patholog-ical processes, as well as the polymorphism of alterations, it is necessary to know the patho-morphological, clinical and radiological manifestations of this disorder. A reliable assessment of the respiratory organs state according to the radiography data has objective limits due to the presence of a cumulative effect and other factors. So, CT is the priority method in diagno-sis, evaluation of lung resection volume, planning of thoracoplasty, and monitoring of surgi-cal treatment efficacy. Due to layer-by-layer visualization, the method of digital tomosynthesis makes it possible to obtain additional information, in comparison with radiographic data, in pulmonary parenchyma state assessment at pre- and postoperative stages, which indicates the prospects of its application in solving this tasks. Conclusion. Due to modern radiological methods in the study of respiratory organs TB, the question of the expediency of surgical treatment or refusal in favor of conservative thera-py is solved, which is of particular relevance in patients with MDR TB. Accurate determina-tion of lung resection and thoracoplasty volume significantly reduces the risk of postoperative complications, which contributes to improving the quality of life of the patient. A correct con-trol of respiratory TB surgical treatment efficacy with CT application allows estimating the state of the zone of interest, and timely reveal the relapse of a specific process.
1 - I.M. Sechenov First Moscow State Medical University (Sechenov Uni-versity).
2 - FSBI «SMIC FTI» Ministry of Healthcare. Moscow, Russia.
3 - A.I. Evdokimov Moscow State University of Medicine and Stomatology. 4 - Central Research Insti-tute of Tuberculosis. Moscow, Russia.



 

Keywords: CT, digital tomosynthesis, pulmonary tuberculosis, lung resection, thoracoplasty.

 

Corresponding author: Ratobylsky G.V., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Giller D.B., Ratobylsky G.V., Nikitin M.M., Koroev V.V., Frolova O.P., Shekhter A.I., Ots O.N., Grigoriev Yu.G., Lavrov V.N. Radiological methods in diagnosis, evaluation of the lung resection volume, planning of thoracoplasty and efficacy monitoring of the surgical treat-ment of expanded destructive pulmonary multi-drug resistant (MDR) tuberculosis.. REJR 2018; 8 (3):249-258. DOI:10.21569/2222-7415-2018-8-3-249-258.

Received:10.06.18Accepted:06.07.18