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Papazoglou AS, Karagiannidis E, Liatsos A, Bompoti A, Moysidis DV, Arvanitidis C, Tsolaki F, Tsagkaropoulos S, Theocharis S, Tagarakis G, Michaelson JS, Herrmann MD. Volumetric Tissue Imaging of Surgical Tissue Specimens Using Micro-Computed Tomography: An Emerging Digital Pathology Modality for Nondestructive, Slide-Free Microscopy-Clinical Applications of Digital Pathology in 3 Dimensions. Am J Clin Pathol 2023; 159:242-254. [PMID: 36478204 DOI: 10.1093/ajcp/aqac143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/14/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Micro-computed tomography (micro-CT) is a novel, nondestructive, slide-free digital imaging modality that enables the acquisition of high-resolution, volumetric images of intact surgical tissue specimens. The aim of this systematic mapping review is to provide a comprehensive overview of the available literature on clinical applications of micro-CT tissue imaging and to assess its relevance and readiness for pathology practice. METHODS A computerized literature search was performed in the PubMed, Scopus, Web of Science, and CENTRAL databases. To gain insight into regulatory and financial considerations for performing and examining micro-CT imaging procedures in a clinical setting, additional searches were performed in medical device databases. RESULTS Our search identified 141 scientific articles published between 2000 and 2021 that described clinical applications of micro-CT tissue imaging. The number of relevant publications is progressively increasing, with the specialties of pulmonology, cardiology, otolaryngology, and oncology being most commonly concerned. The included studies were mostly performed in pathology departments. Current micro-CT devices have already been cleared for clinical use, and a Current Procedural Terminology (CPT) code exists for reimbursement of micro-CT imaging procedures. CONCLUSIONS Micro-CT tissue imaging enables accurate volumetric measurements and evaluations of entire surgical specimens at microscopic resolution across a wide range of clinical applications.
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Affiliation(s)
| | - Efstratios Karagiannidis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandros Liatsos
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreana Bompoti
- Diagnostic Imaging, Peterborough City Hospital, North West Anglia NHS Foundation Trust, Peterborough, UK
| | - Dimitrios V Moysidis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos Arvanitidis
- Institute of Marine Biology, Biotechnology and Aquaculture, Hellenic Centre for Marine Research, Heraklion, Crete, Greece.,LifeWatch ERIC, Sector II-II, Seville, Spain
| | - Fani Tsolaki
- Department of Cardiothoracic Surgery, AHEPA University Hospital, Thessaloniki, Greece
| | | | - Stamatios Theocharis
- First Department of Pathology, National and Kapoditrian University of Athens, Athens, Greece
| | - Georgios Tagarakis
- Department of Cardiothoracic Surgery, AHEPA University Hospital, Thessaloniki, Greece
| | - James S Michaelson
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Markus D Herrmann
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Beddok A, Chabi-Charvillat ML, Kennel T, de Wolf J, Pricopi C, Crequit P, Girard N, Otz J, Vallée A, Longchampt E, Sage E, Glorion M. Prospective Radiologic-Pathologic Correlation of Macroscopic Volume and Microscopic Extension of Nonsolid Lung Nodules on Thin-section CT Images for Sublobar Resection and Stereotactic Radiotherapy Planning. Clin Lung Cancer 2023; 24:98-106. [PMID: 36509664 DOI: 10.1016/j.cllc.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION The objective of this study was to determine whether computed tomography (CT) could be a useful tool for nonsolid lung nodule (NSN) treatment planning, surgery or stereotactic body radiation therapy (SBRT), by assessing the macroscopic and microscopic extension of these nodules. METHODS The study prospectively included 23 patients undergoing anatomic resection at the Foch Hospital in 2020/2021 for NSN with a ground-glass component of more than 50%. Firstly, for each patient, both the macroscopic dimensions of the NSN were assessed on CT and during pathologic analysis. Secondly, the microscopic extension was assessed during pathologic examination. Wilcoxon sign rank tests were used to compare these dimensions. Spearman correlation test and Bland-Altman analysis were used to evaluate the agreement between radiological and pathologic measurements. RESULTS On CT, the median largest diameter and volume of NSN were 21 mm and 3780 cc, while on pathologic analysis, they were 15 mm and 1800 cc, respectively. Therefore, the largest diameter and volume of the NSN were significantly higher on CT than on pathological analysis. For microscopic extension, the median largest diameter and volume of NSN were 17 mm and 2040 cc, respectively. No significant difference was observed between the macroscopic size and the microscopic extension assessed during pathologic analysis. Moreover, correlation analysis and Bland-Altman plots showed that radiological and pathologic measurements could provide equivalent precision. CONCLUSION Our study showed that CT did not underestimate the macroscopic size and microscopic extension of NSN and confirmed that CT can be used for NSN treatment planning.
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Affiliation(s)
- Arnaud Beddok
- Radiation Oncology Department, Proton Therapy Centre, Centre Universitaire, Institut Curie, PSL Research University, Orsay, France; Laboratory of Translational Imaging in Oncology (LITO), Institut Curie, PSL Research University, University Paris Saclay, Inserm, Orsay, France.
| | | | - Titouan Kennel
- Department of Epidemiology-Data-Biostatistics, Delegation of Clinical Research and Innovation (DRCI), Foch hospital, Suresnes, France
| | - Julien de Wolf
- Department of Thoracic Surgery, Hôpital Foch, Suresnes, France
| | - Ciprian Pricopi
- Department of Thoracic Oncology, Hôpital Foch, Suresnes, France
| | - Perrine Crequit
- Department of Epidemiology-Data-Biostatistics, Delegation of Clinical Research and Innovation (DRCI), Foch hospital, Suresnes, France
| | | | - Joelle Otz
- Radiation Oncology Department, Institut Curie, Saint-Cloud, France
| | - Alexandre Vallée
- Department of Epidemiology-Data-Biostatistics, Delegation of Clinical Research and Innovation (DRCI), Foch hospital, Suresnes, France
| | | | - Edouard Sage
- Department of Thoracic Surgery, Hôpital Foch, Suresnes, France
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He Z, Pan X, Li Z, Wang Q, Wang J, Wen W, Zhu Q, Wu W, Chen L. Individualized dorsal basal segment (S10) resection using intersegmental veins as the landmark. Interact Cardiovasc Thorac Surg 2021; 34:1071-1078. [PMID: 34931238 PMCID: PMC9214576 DOI: 10.1093/icvts/ivab358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/29/2021] [Accepted: 10/31/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Zhicheng He
- Department of Thoracic Surgery, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xianglong Pan
- Department of Thoracic Surgery, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhihua Li
- Department of Thoracic Surgery, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qi Wang
- Department of Thoracic Surgery, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jun Wang
- Department of Thoracic Surgery, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wei Wen
- Department of Thoracic Surgery, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Quan Zhu
- Department of Thoracic Surgery, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Weibing Wu
- Department of Thoracic Surgery, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Liang Chen
- Department of Thoracic Surgery, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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4
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Bompoti A, Papazoglou AS, Moysidis DV, Otountzidis N, Karagiannidis E, Stalikas N, Panteris E, Ganesh V, Sanctuary T, Arvanitidis C, Sianos G, Michaelson JS, Herrmann MD. Volumetric Imaging of Lung Tissue at Micrometer Resolution: Clinical Applications of Micro-CT for the Diagnosis of Pulmonary Diseases. Diagnostics (Basel) 2021; 11:diagnostics11112075. [PMID: 34829422 PMCID: PMC8625264 DOI: 10.3390/diagnostics11112075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 11/16/2022] Open
Abstract
Micro-computed tomography (micro-CT) is a promising novel medical imaging modality that allows for non-destructive volumetric imaging of surgical tissue specimens at high spatial resolution. The aim of this study is to provide a comprehensive assessment of the clinical applications of micro-CT for the tissue-based diagnosis of lung diseases. This scoping review was conducted in accordance with the PRISMA Extension for Scoping Reviews, aiming to include every clinical study reporting on micro-CT imaging of human lung tissues. A literature search yielded 570 candidate articles, out of which 37 were finally included in the review. Of the selected studies, 9 studies explored via micro-CT imaging the morphology and anatomy of normal human lung tissue; 21 studies investigated microanatomic pulmonary alterations due to obstructive or restrictive lung diseases, such as chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, and cystic fibrosis; and 7 studies examined the utility of micro-CT imaging in assessing lung cancer lesions (n = 4) or in transplantation-related pulmonary alterations (n = 3). The selected studies reported that micro-CT could successfully detect several lung diseases providing three-dimensional images of greater detail and resolution than routine optical slide microscopy, and could additionally provide valuable volumetric insight in both restrictive and obstructive lung diseases. In conclusion, micro-CT-based volumetric measurements and qualitative evaluations of pulmonary tissue structures can be utilized for the clinical management of a variety of lung diseases. With micro-CT devices becoming more accessible, the technology has the potential to establish itself as a core diagnostic imaging modality in pathology and to enable integrated histopathologic and radiologic assessment of lung cancer and other lung diseases.
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Affiliation(s)
- Andreana Bompoti
- Department of Radiology, Peterborough City Hospital, Northwest Anglia NHS Foundation Trust, Peterborough PE3 9GZ, UK;
| | - Andreas S. Papazoglou
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636 Thessaloniki, Greece; (A.S.P.); (D.V.M.); (N.O.); (E.K.); (N.S.); (G.S.)
| | - Dimitrios V. Moysidis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636 Thessaloniki, Greece; (A.S.P.); (D.V.M.); (N.O.); (E.K.); (N.S.); (G.S.)
| | - Nikolaos Otountzidis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636 Thessaloniki, Greece; (A.S.P.); (D.V.M.); (N.O.); (E.K.); (N.S.); (G.S.)
| | - Efstratios Karagiannidis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636 Thessaloniki, Greece; (A.S.P.); (D.V.M.); (N.O.); (E.K.); (N.S.); (G.S.)
| | - Nikolaos Stalikas
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636 Thessaloniki, Greece; (A.S.P.); (D.V.M.); (N.O.); (E.K.); (N.S.); (G.S.)
| | - Eleftherios Panteris
- Biomic_AUTh, Center for Interdisciplinary Research and Innovation (CIRI-AUTH), Balkan Center B1.4, 10th km Thessaloniki-Thermi Rd., P.O. Box 8318, GR 57001 Thessaloniki, Greece;
| | | | - Thomas Sanctuary
- Respiratory Department, Medway NHS Foundation Trust, Kent ME7 5NY, UK;
| | - Christos Arvanitidis
- Hellenic Centre for Marine Research (HCMR), Institute of Marine Biology, Biotechnology and Aquaculture (IMBBC), 70013 Heraklion, Greece;
- LifeWatch ERIC, Sector II-II, Plaza de España, 41071 Seville, Spain
| | - Georgios Sianos
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636 Thessaloniki, Greece; (A.S.P.); (D.V.M.); (N.O.); (E.K.); (N.S.); (G.S.)
| | - James S. Michaelson
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA;
| | - Markus D. Herrmann
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA;
- Correspondence: ; Tel.: +6-17-724-1896
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Liu Y, Qiu B, Zhang S, Liu C, Yan M, Sun L, Gossot D, Homma T, Sheikh F, Kneuertz PJ. A simplified model for determining the cutting plane during thoracoscopic anatomical partial lobectomy of the right lower lobe. Transl Lung Cancer Res 2021; 10:3203-3212. [PMID: 34430358 PMCID: PMC8350089 DOI: 10.21037/tlcr-21-525] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/16/2021] [Indexed: 12/02/2022]
Abstract
Background Few studies have examined the use of two-dimensional computed tomography (2D CT) and three-dimensional (3D) reconstruction images to determine the intersegmental plane (ISP) for pulmonary segmentectomy, but a systematic approach and nomenclature are currently lacking. This current study used 3D reconstruction of CT imaging to analyze variations in the right lower lobe’s pulmonary ISP and created a simplified model to determine the optimum cutting plane (CP) for clinical application for operative planning and use during thoracoscopic anatomical partial lobectomy (APL). Methods Between January 2018 and October 2019, 325 patients with pulmonary lesions were identified who underwent thin-slice CT scans of the chest. The ISPs were identified by analyzing the 2D CT scans and 3D reconstruction images and the anatomical characteristics segmental boundary. The CP for the thoracoscopic procedure was then determined within the safe surgical margins, and a simplified CP model was created. Results The boundary between adjacent lung segment A and segment B was be expressed as “ISP: Sa-Sb”. The ISP was divided into venous ISP (VISP), arterial ISP (AISP), and bronchial ISP (BISP). The proposed model of the CP can be expressed as follows: CP (f) = (V/A/B) ISP (x) + (V/A/B) sub ISP (y) + (V/A/B) sub-sub ISP (z). Conclusions This report is a first attempt to provide a nomenclature for identifying the ISP, and create a simplified model for determining the CP for thoracoscopic partial lobectomy.
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Affiliation(s)
- Yun Liu
- Department of Cardiothoracic Surgery, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China.,Department of Cardiothoracic Surgery, Yichang Central People's Hospital, Yichang, China
| | - Bin Qiu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Songlin Zhang
- Department of Cardiothoracic Surgery, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China.,Department of Cardiothoracic Surgery, Yichang Central People's Hospital, Yichang, China
| | - Chaobing Liu
- Department of Cardiothoracic Surgery, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China.,Department of Cardiothoracic Surgery, Yichang Central People's Hospital, Yichang, China
| | - Ming Yan
- Department of Cardiothoracic Surgery, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China.,Department of Cardiothoracic Surgery, Yichang Central People's Hospital, Yichang, China
| | - Lailong Sun
- Department of Cardiothoracic Surgery, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China.,Department of Cardiothoracic Surgery, Yichang Central People's Hospital, Yichang, China
| | - Dominique Gossot
- Thoracic Department, Curie-Montsouris Thorax Institute-Institut Mutualiste Montsouris, Paris, France
| | - Takahiro Homma
- Department of General Thoracic and Cardiovascular Surgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Fariha Sheikh
- Department of Surgery, Division of Trauma and Critical Care, Rutgers, New Jersey Medical School, Newark, New Jersey, USA
| | - Peter J Kneuertz
- Division of Thoracic Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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6
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Gao H, Liu C. Demarcation of arteriopulmonary segments: a novel and effective method for the identification of pulmonary segments. J Int Med Res 2021; 49:3000605211014383. [PMID: 33990153 PMCID: PMC8127771 DOI: 10.1177/03000605211014383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective Each pulmonary segment is an anatomical and functional unit. However, it is fundamentally difficult to precisely distinguish every pulmonary segment using the conventional pulmonary intersegmental planes from computed tomography images. Building arteriopulmonary segments is likely to be an effective way to identify pulmonary segments. Methods The thoracic computed tomography images of 40 patients were collected. The anatomic structures of interest were extracted in the transverse, sagittal, and coronal planes using the semi-automated segmentation tools provided by Amira software. The intrapulmonary vessels were subsequently segmented and reconstructed. The distributions of the pulmonary arteries, veins, and bronchi were observed. In patients with pulmonary masses, the mass was also reconstructed. Results The three-dimensional reconstructed images showed the branches of the pulmonary artery ramified up to their eighth order covering the entire lung as well as evident intersegmental gaps without pulmonary arteries. The segmental artery was closely accompanied by the segmental bronchi in 486 pulmonary segments (90% of total number of segments). The size and spatial location of the pulmonary mass within a pulmonary segment were also clearly visible. Conclusions Demarcation of arteriopulmonary segments can be used to precisely distinguish every pulmonary segment and provide its detailed anatomical structure before pulmonary segmentectomy.
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Affiliation(s)
- Huijie Gao
- College of Pharmacy, Jining Medical University, Rizhao, Shandong, China
| | - Chao Liu
- College of Pharmacy, Jining Medical University, Rizhao, Shandong, China
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Chen L, Ge M. [Advances in Identification of Intersegmental Plane during Pulmonary Segmentectomy]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2020; 23:818-823. [PMID: 32773009 PMCID: PMC7519953 DOI: 10.3779/j.issn.1009-3419.2020.101.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
With the popularity of computed tomography (CT) scan in recent years, early stage lung cancer has been discovered in large numbers of patients and pulmonary segmentectomy has been widely used clinically. Identification of the intersegmental plane is one of the key steps in pulmonary segmentectomy, and current methods for identifying the intersegmental plane are numerous and have their own advantages and disadvantages. We will review relevant methods to help the clinical practice.
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Affiliation(s)
- Liang Chen
- Department of Thoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Mingjian Ge
- Department of Thoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
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8
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Guan CS, Yan S, Lv ZB, Sun L, Ma DQ, Zhang YS, Xie RM, Chen BD. CT imaging and pathological basis of linear shadow connecting pulmonary segmental artery to horizontal fissure. Medicine (Baltimore) 2020; 99:e21239. [PMID: 32702901 PMCID: PMC7373523 DOI: 10.1097/md.0000000000021239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
To investigate the computed tomography (CT) imaging and pathological basis of the linear shadows connecting pulmonary segmental arteries to horizontal fissure (hereinafter referred to as "linear shadow") on thin-slice CT.Collect 127 clinical cases to analyze the display and morphology of linear shadows on the thin-slice CT and to measure their length, thickness, and angle. Collect 11 autopsy specimens of coal worker's pneumoconiosis to conduct an imaging and pathology basis control study for the linear shadows.There is no correlation between the linear shadow and gender, age, and smoking history. Linear shadows are observed in 54.33% of patients. 93.33% of those linear shadows are straight lines. Generally, the lengths are less than 10 mm, the thicknesses are around 1 mm, and the scopes of angles are wide, range from acute angles to obtuse angles. The linear shadow is a banded structure consisting of loose connective tissue, small blood vessels, and small lymphatic vessels due to the visceral pleura recessed and fused into the lung.Linear shadows are intrinsic to the lung. The linear shadows consist of loose connective tissue, small blood vessels, and small lymphatic vessels.
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Affiliation(s)
| | | | | | - Lei Sun
- Department of Pathology, Beijing Ditan Hospital
| | - Da-Qing Ma
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University
| | - Yan-Song Zhang
- Department of Pathology, National Research Center for Occupational Safety and Health, Beijing, China
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9
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Guan CS, Lv ZB, Xie RM, Liang CJ, Ma DQ. Linear shadows that connect oblique fissures and costal pleurae on the superior segments of lower lobes: evaluating the imaging findings on thin-slice lung CT. Jpn J Radiol 2018; 36:603-610. [PMID: 30047033 DOI: 10.1007/s11604-018-0762-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 07/19/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To retrospectively analyse the imaging findings of the linear shadows that connect the oblique fissures and the costal pleurae on the superior segments of the lower lobes on thin-slice lung CT. MATERIALS AND METHODS Thin-slice CT scans of 221 cases of normal lungs and 86 abnormal lungs were collected. The parameters of the imaging observations included the existence of the superior segmental linear shadow, its morphology, length, and starting position, bird-beak sign, and adjacent structures on the pleural end. RESULTS The linear shadows were more common on the left lower lobe (43.44%) than on the right side (19.46%). The pleural origins of the linear shadows were mainly located above the carina (69.78%); the adjacent structure on the left lung was the descending aorta (70.83%), and for the right lung, it was next to the thoracic vertebrae (60.47%). In the presence of pulmonary lobectomy or atelectasis, the linear shadows could be extended, which could pull the oblique fissures and costal pleurae to form the bird-beak sign. CONCLUSION The linear shadows on the superior segments of the lower lobes are common structures fixing the oblique fissures. Recognition of the linear shadows can help radiologists distinguish normal structures from abnormal ones.
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Affiliation(s)
- Chun-Shuang Guan
- Department of Radiology, Beijing Ditan Hospital, Capital Medical University, No. 8 Jingshun East Street, Chaoyang District, Beijing, China
| | - Zhi-Bin Lv
- Department of Radiology, Beijing Ditan Hospital, Capital Medical University, No. 8 Jingshun East Street, Chaoyang District, Beijing, China
| | - Ru-Ming Xie
- Department of Radiology, Beijing Ditan Hospital, Capital Medical University, No. 8 Jingshun East Street, Chaoyang District, Beijing, China
| | - Chun-Jie Liang
- Department of Radiology, Beijing Fengtai Hospital, No. 1 Xi'an Street, Fengtai District, Beijing, China
| | - Da-Qing Ma
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong'an Road, Xicheng District, Beijing, China.
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Short linear shadows connecting pulmonary segmental arteries to oblique fissures in volumetric thin-section CT images: comparing CT, micro-CT and histopathology. Eur Radiol 2015; 26:2740-8. [DOI: 10.1007/s00330-015-4107-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 11/02/2015] [Accepted: 11/10/2015] [Indexed: 11/26/2022]
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11
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Zuo Y, Li L, Liu S. Kohn's pores are not responsible for collateral ventilation between inflated and deflated segments: a microscopic study of pulmonary intersegmental septa in the human lung. J Anat 2015; 226:381-5. [PMID: 25832125 DOI: 10.1111/joa.12288] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2015] [Indexed: 11/26/2022] Open
Abstract
The composition of the pulmonary intersegmental septum has not been clearly identified by thoracic surgeons who regard Kohn's pores as the main channel that causes air leakage when determining the intersegmental septum by segmental ventilation. In this study, we aimed to examine this possible misinterpretation by focusing on a detailed description of the microscopic anatomy of the intersegmental septum. To accomplish this aim, 50 lung samples of the intersegmental septum from fresh cadavers without emphysema were studied by histological and electron microscopy. The findings of light microscopy and electron microscopy showed that the intersegmental septum is composed of three layers. The alveolar walls of adjacent segments serve as the superficial layer. They are integral, and no Kohn's pores were identified. The deep layer contains collagen fibres. As shown by our findings, Kohn's pores are absent within the intersegmental septum. Therefore, they could not be the main channel for the collateral ventilation between inflated and deflated lung segments during a pulmonary segmentectomy.
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Affiliation(s)
- Yizhi Zuo
- Department of Anatomy, Nanjing Medical University, Nanjing, China
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12
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Hochhegger B, Irion K, Hochhegger DR, Rodrigues R, Sartori A, Marchiori E. Anterior Segment and Medial Segment of the Left Lower Lobe: A New and Unknown Nomenclature. Radiology 2013; 269:310-1. [DOI: 10.1148/radiol.13130771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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