Dijagnostička vrijednost ultrazvučnoga pregleda prsnoga koša u razlikovanju pleuralnih izljeva maligne i nemaligne etiologije

doctoral thesis

• Title (english): Diagnostic validity of thoracic ultrasound in distinguishing malignant and nonmalignant pleural effusions
• Author: Nevenka Piskač Živković
• Mentor: Neven Tudorić (mentor)
• Committee member: nije dostupno (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2019-10-22, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences
• Universal decimal classification (UDC): 61 - Medical sciences

Abstract

Ultrazvuk prsnog koša je dijagnostička metoda koja se koristi u predikciji etiologije pleuralnog izljeva. Analizom ultrazvučnih karakteristika pleuralnog izljeva, visceralne i parijetalne pleure, najbolji rezultati u predikciji malignog pleuralnog izljeva (MPI) dobiveni su za nodularnost pleure (osjetljivost 76,19 %, specifičnost 71,43 %, točnost 73,81 %). Kombinacijom ultrazvučnih i makroskopskih karakteristika koje su tipične za MPI: 1) nodularnost i hemoragično/sangvinolentni izljev, 2)... More nodularnost i odsutnost fibrina, 3) zadebljanje pleure >10 mm i hemoragično/sangvinolentni izljev, točnost u predikciji MPI se povećava na 82,50 %. Integralnom statističkom analizom ultrazvučnih, makroskopskih i biokemijskih parametara metodom logističke regresije dobivena su tri parametra (nodularnost pleure, odsutnost fibrina, koncentracija proteina u serumu) koji daju najbolje rezultate u predikciji MPI (osjetljivost 81,58 %, specifičnost 76,09 %, točnost 89,64 %). Ultrazvučna karakteristika koja daje najbolju predikciju nemalignog limfocitnog pleuralnog izljeva (NMPI) je fibrinska pregradnja (osjetljivost 45,24 %, specifičnost 90,48 %, točnost 67,86 %). Kombinacijom ultrazvučnih i makroskopskih karakteristika koje su tipične za NMPI: 1) nehemoragičan (bistri/serozni) i fibrinom pregrađen izljev, 2) fibrinom pregrađen izljev bez nodularnosti pleure, 3) fibrinom pregrađen izljev bez zadebljanja pleure >10 mm, točnost u predikciji NMPI povećana je na 88,24 %. Temeljem navedenih rezultata predložen je Algoritam dijagnostičkih pretraga za limfocitne pleuralne izljeve. Less

Abstract (english)

Thoracic ultrasound is a diagnostic procedure that may help in the prediction of the pleural effusion etiology. Analyzing the ultrasound characteristics of pleural effusion, visceral and parietal pleura, the best predicting parameters for malignant pleural effusion (MPI) were pleural nodularity (sensitivity of 76,19 %, specificity of 71,43 %, accuracy of 73,81 %). Using various combinations of ultrasound and macroscopic characteristics of typical MPI (nodular pleura together with... More hemorrhagic/sanguinolent effusion; nodular pleura together with the fibrin absence in pleural effusion; pleural thickness over 10 mm together with hemorrhagic/sanguinolent effusion) finding accuracy in prediction of MPI increased up to 82,50 %. Using integrated statistical analyses of ultrasound, macroscopic and biochemical parameters (logistic regression), the three parameters were obtained (pleural nodularity, fibrin absence, serum proteins) which were the best predictors for MPI (sensitivity of 81,58 %, specificity of 76,09 %, accuracy of 89,64 %). The best single predicting parameter for non-malignant pleural effusion (NMPI) was the fibrinous remodeling (sensitivity of 45,24 %, specificity of 90,48 %, accuracy of 67,86 %). Using various combinations of ultrasound and macroscopic characteristics of typical NMPI (clear/serous pleural effusion together with fibrinous remodeling; pleural effusion fibrinous remodeling together with absent pleural nodularity; pleural effusion fibrinous remodeling together with pleural thickness less than 10 mm), finding accuracy in prediction of NMPI increased up to 88,24 %. Based on these findings, together with results of previous studies, a simple diagnostic algorithm for lymphocytic pleural effusions was proposed. Less

• Keywords: medicina
• Keywords (english): medicine
• Language: croatian
• URN:NBN: urn:nbn:hr:105:351350
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstva (doktor/doktorica znanosti, područje biomedicine i zdravstva)
• Type of resource: Text
• Extent: 93 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-05-05 08:34:59