Research Article
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LUNG CONTUSION VOLUME: DO YOU REALLY KNOW?

Year 2023, Volume: 30 Issue: 3, 466 - 472, 23.09.2023
https://doi.org/10.17343/sdutfd.1339538

Abstract

Objective
Pulmonary contusion is one of the most common
complication of blunt chest trauma. It is sometimes
very difficult for a physician to determine the extent
and real amount of pulmonary contusion. The aim of
the study was to measure the accurate pulmonary
contusion volume on computed tomography images
by using the manual planimetry method with the
Cavalieri principle.
Material and Method
The study was performed on 76 patients who were
admitted to the Emergency Medicine Clinic with lung
contusion. Patient data were retrospectively screened
and computed-tomography images of patients with
lung contusion were examined to calculate lung
contusion volume. After measurement in all lung
sections, lung contusion volume was calculated in
6-8-10 sections by systemic randomized sampling.
The volume of the contusion was calculated by two
independent observers using the manual planimetry
method.
Results
The mean volume of contusion obtained from all
cross-section measurements was 34.23 ± 17.56%.
In 6 sections measurement, contusion volume was
27.98±15.05%, in 8 sections 30.66±16.07% and in 10
sections 32.47±16.97%. When we examined the Bland
Altman graphs, it is seen that the mean difference
obtained from the 10 sections is smaller than the 6
and 8 sections measurements and the confidence
interval is narrower. Therefore, we can say that the
10 sections measurement gives the closest evaluation
to all lung contusion measurements with about 95%
accuracy ratio.
Conclusion
Lung contusion volume can be objectively
evaluated using the manual planimetry method with
systematic random sampling without whole lung area
measurement on CT with high interobserver and
intraobserver agreement.

References

  • 1. Wang S, Ruan Z, Zhang J, Jin W. The value of pulmonary contusion volume measurement with three-dimensional computed tomography in predicting acute respiratory distress syndrome development. Ann Thorac Surg 2011; 92: 1977–1983. doi: 10.1016/j.athoracsur.2011.05.020
  • 2. Cohn SM, Dubose JJ. Pulmonary contusion: an update on recent advances in clinical management. World J Surg 2010; 34: 1959–1970. doi: 10.1007/s00268-010-0599-9.
  • 3. Požgain Z, Kristek D, Lovrić I, Kondža G, Jelavić M, Kocur J, et al. Pulmonary contusions after blunt chest trauma: clinical significance and evaluation of patient management. Eur J Trauma Emerg Surg. 2018;44(5):773-777. doi:10.1007/s00068-017-0876-5
  • 4. Prunet B, Bourenne J, David JS, Bouzat P, Boutonnet M, Cordier PY, et al. Patterns of invasive mechanical ventilation in patients with severe blunt chest trauma and lung contusion: A French multicentric evaluation of practices. J Intensive Care Soc 2018; 20(1):46–52. doi: 10.1177/1751143718767060.
  • 5. Caironi P, Carlesso E, Gattinoni L. Radiological imaging in acute lung injury and acute respiratory distress syndrome. Semin Respir Crit Care Med 2006; 27:404 –15. doi: 10.1055/s-2006-948294.
  • 6. Ganie FA, Lone H, Lone GN, Wani ML, Singh S, Dar AM, et al. Lung Contusion: A Clinico-Pathological Entity with Unpredictable Clinical Course. Bull Emerg Trauma 2013; 1(1):7–16.
  • 7. Acer N, Sahin B, Usanmaz M, Tatoğlu H, Irmak Z. Comparison of point counting and planimetry methods for the assessment of cerebellar volume in human using magnetic resonance imaging: a stereological study. Surgical and Radiologic Anatomy 2008; 30(4):335-9. doi: 10.1007/s00276-008-0330-9.
  • 8. Kayipmaz S, Sezgin OS, Saricaoglu ST. The estimation of the volume of sheep mandibular defects using cone-beam computed tomography images and a stereological method. Dentomaxillofac Radiol 2011; 40(3): 165–169. doi: 10.1259/ dmfr/23067462.
  • 9. Mazonakis M, Sahin B, Pagonidis K. Assessment of left ventricular function and mass by MR imaging: a stereological study based on the systematic slice sampling procedure. Acad Radiol. 2011; 18(6): 738–744. doi: 10.1016/j.acra.2011.01.015.
  • 10. Cicchetti DV. Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychological Assessment 1994; 6(4):284–290. doi:10.1037/1040-3590.6.4.284
  • 11. Şahin B. Antropometry of the intracranial volume. e-book. In: Victor R. Preedy (Ed). Handbook of Antropometry. Newyork: Springer, 2012
  • 12. Acer N, Sahin B, Baş O, Ertekin T, Usanmaz M. Comparison of three methods for the estimation of total intracranial volume: stereologic, planimetric, and anthropometric approaches. Ann Plast Surg. 2007; 58(1):48-53. doi: 10.1097/01.sap.0000250653.77090.97.
  • 13. Miller PR, Croce MA, Bee TK, Qaisi WG, Smith CP, Collins GL, et al. ARDS after pulmonary contusion: accurate measurement of contusion volume identifies high-risk patients. J Trauma 2001; 51(2):223-230. doi:10.1097/00005373-200108000- 00003
  • 14. Strumwasser A, Chu E, Yeung L, Miraflor E, Sadjadi J, Victorino GP. A novel CT volume index score correlates with outcomes in polytrauma patients with pulmonary contusion. J Surg Res 2011; 170(2):280-285. doi: 10.1016/j.jss.2011.03.022
  • 15. Marini CP, Petrone P, Soto-Sánchez A, García-Santos E, Stoller C, Verde J. Predictors of mortality in patients with rib fractures. Eur J Trauma Emerg Surg. 2021 Oct;47(5):1527-1534. doi: 10.1007/s00068-019-01183-5.
  • 16. Ullman EA, Donley LP, Brady WJ. Pulmonary trauma emergency department evaluation and management. Emerg Med Clin N Am 2003; 21(2):291–313. doi: 10.1016/s0733-8627(03)00016-6.
  • 17. Kadish HA. Thoracic trauma. In: Fleisher GR, Ludwig S, Henretig FM, Ruddy RM, Silverman BK (eds). Textbook of pediatric emergency medicine. 6th edition. Lippincott Williams & Wilkins Hagerstown, Md, USA. 2010, pp:1458-1476.
  • 18. Yoruk O, Dane S, Ucuncu H, Aktan B, Can I. Stereological evaluation of laryngeal cancers using computed tomography via the Cavalieri method: correlation between tumor volume and number of neck lymph node metastases. J Craniofac Surg. 2009;20(5):1504-7. doi: 10.1097/SCS.0b013e3181b09bc3.
  • 19. Erić M, Anderla A, Stefanović D, Drapšin M. Breast volume estimation from systematic series of CT scans using the Cavalieri principle and 3D reconstruction. Int J Surg 2014; 12(9):912- 917. doi:10.1016/j.ijsu.2014.07.018
  • 20. Mazonakis M, Damilakis J, Mantatzis M, Prassopoulos P, Maris T, Varveris H, et al. Stereology versus planimetry to estimate the volume of malignant liver lesions on MR imaging. Magn Reson Imaging 2004;22(7):1011-6. doi: 10.1016/j.mri.2004.02.012
  • 21. Chang J, Zhang X, Zhang K, Pan Q. Three-dimensional reconstruction of medical images based on 3D slicer. Journal of Complexity in Health Sciences. 2019;30:2(1):1–12. doi: 10.21595/chs.2019.20724

AKCİĞER KONTÜZYON HACMİ: GERÇEKTEN BİLİYOR MUSUNUZ?

Year 2023, Volume: 30 Issue: 3, 466 - 472, 23.09.2023
https://doi.org/10.17343/sdutfd.1339538

Abstract

Amaç
Pulmoner kontüzyon, künt göğüs travmasının en yaygın
komplikasyonlarından biridir. Bir hekimin pulmoner
kontüzyonun boyutunu ve gerçek miktarını belirlemesi
bazen çok zordur. Çalışmanın amacı bilgisayarlı
tomografi görüntüleri üzerinde Cavalieri prensibi ile
manuel planimetri yöntemini kullanarak doğru pulmoner
kontüzyon hacmini ölçmektir.
Gereç ve Yöntem
Çalışma “Acil Tıp Kliniğine”, akciğer kontüzyonu ile
başvuran 76 hasta üzerinde yapıldı. Hasta verileri retrospektif
olarak tarandı ve akciğer kontüzyonu olan
hastaların bilgisayarlı tomografi görüntüleri akciğer
kontüzyon hacmini hesaplamak için incelendi. Tüm
akciğer kesitlerinde ölçüm yapıldıktan sonra, sistemik
randomize örnekleme ile 6-8-10 kesitte akciğer
kontüzyon hacmi hesaplandı. Kontüzyon hacmi iki
bağımsız gözlemci tarafından manuel planimetri yöntemi
kullanılarak hesaplandı.
Bulgular
Tüm kesit ölçümlerinden elde edilen ortalama kontüzyon
hacmi %34.23 ± 17.56 idi. Kontüzyon hacmi 6 kesit
ölçümünde %27,98±15,05, 8 kesitte %30,66±16,07
ve 10 kesitte %32,47±16,97 idi. Bland Altman grafiklerini
incelediğimizde 10 kesitten elde edilen ortalama
farkın 6 ve 8 kesit ölçümlerine göre daha küçük olduğu
ve güven aralığının daha dar olduğu görülmektedir.
Dolayısıyla 10 kesit ölçümünün yaklaşık %95 doğruluk
oranı ile tüm akciğer kontüzyon ölçümlerine en
yakın değerlendirmeyi verdiğini söyleyebiliriz.
Sonuç
Akciğer kontüzyon hacmi, BT'de tüm akciğer alanı
ölçümü olmaksızın sistematik rastgele örnekleme ile
manuel planimetri yöntemi kullanılarak yüksek gözlemciler
arası ve gözlemci içi uyum ile objektif olarak
değerlendirilebilir.

References

  • 1. Wang S, Ruan Z, Zhang J, Jin W. The value of pulmonary contusion volume measurement with three-dimensional computed tomography in predicting acute respiratory distress syndrome development. Ann Thorac Surg 2011; 92: 1977–1983. doi: 10.1016/j.athoracsur.2011.05.020
  • 2. Cohn SM, Dubose JJ. Pulmonary contusion: an update on recent advances in clinical management. World J Surg 2010; 34: 1959–1970. doi: 10.1007/s00268-010-0599-9.
  • 3. Požgain Z, Kristek D, Lovrić I, Kondža G, Jelavić M, Kocur J, et al. Pulmonary contusions after blunt chest trauma: clinical significance and evaluation of patient management. Eur J Trauma Emerg Surg. 2018;44(5):773-777. doi:10.1007/s00068-017-0876-5
  • 4. Prunet B, Bourenne J, David JS, Bouzat P, Boutonnet M, Cordier PY, et al. Patterns of invasive mechanical ventilation in patients with severe blunt chest trauma and lung contusion: A French multicentric evaluation of practices. J Intensive Care Soc 2018; 20(1):46–52. doi: 10.1177/1751143718767060.
  • 5. Caironi P, Carlesso E, Gattinoni L. Radiological imaging in acute lung injury and acute respiratory distress syndrome. Semin Respir Crit Care Med 2006; 27:404 –15. doi: 10.1055/s-2006-948294.
  • 6. Ganie FA, Lone H, Lone GN, Wani ML, Singh S, Dar AM, et al. Lung Contusion: A Clinico-Pathological Entity with Unpredictable Clinical Course. Bull Emerg Trauma 2013; 1(1):7–16.
  • 7. Acer N, Sahin B, Usanmaz M, Tatoğlu H, Irmak Z. Comparison of point counting and planimetry methods for the assessment of cerebellar volume in human using magnetic resonance imaging: a stereological study. Surgical and Radiologic Anatomy 2008; 30(4):335-9. doi: 10.1007/s00276-008-0330-9.
  • 8. Kayipmaz S, Sezgin OS, Saricaoglu ST. The estimation of the volume of sheep mandibular defects using cone-beam computed tomography images and a stereological method. Dentomaxillofac Radiol 2011; 40(3): 165–169. doi: 10.1259/ dmfr/23067462.
  • 9. Mazonakis M, Sahin B, Pagonidis K. Assessment of left ventricular function and mass by MR imaging: a stereological study based on the systematic slice sampling procedure. Acad Radiol. 2011; 18(6): 738–744. doi: 10.1016/j.acra.2011.01.015.
  • 10. Cicchetti DV. Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychological Assessment 1994; 6(4):284–290. doi:10.1037/1040-3590.6.4.284
  • 11. Şahin B. Antropometry of the intracranial volume. e-book. In: Victor R. Preedy (Ed). Handbook of Antropometry. Newyork: Springer, 2012
  • 12. Acer N, Sahin B, Baş O, Ertekin T, Usanmaz M. Comparison of three methods for the estimation of total intracranial volume: stereologic, planimetric, and anthropometric approaches. Ann Plast Surg. 2007; 58(1):48-53. doi: 10.1097/01.sap.0000250653.77090.97.
  • 13. Miller PR, Croce MA, Bee TK, Qaisi WG, Smith CP, Collins GL, et al. ARDS after pulmonary contusion: accurate measurement of contusion volume identifies high-risk patients. J Trauma 2001; 51(2):223-230. doi:10.1097/00005373-200108000- 00003
  • 14. Strumwasser A, Chu E, Yeung L, Miraflor E, Sadjadi J, Victorino GP. A novel CT volume index score correlates with outcomes in polytrauma patients with pulmonary contusion. J Surg Res 2011; 170(2):280-285. doi: 10.1016/j.jss.2011.03.022
  • 15. Marini CP, Petrone P, Soto-Sánchez A, García-Santos E, Stoller C, Verde J. Predictors of mortality in patients with rib fractures. Eur J Trauma Emerg Surg. 2021 Oct;47(5):1527-1534. doi: 10.1007/s00068-019-01183-5.
  • 16. Ullman EA, Donley LP, Brady WJ. Pulmonary trauma emergency department evaluation and management. Emerg Med Clin N Am 2003; 21(2):291–313. doi: 10.1016/s0733-8627(03)00016-6.
  • 17. Kadish HA. Thoracic trauma. In: Fleisher GR, Ludwig S, Henretig FM, Ruddy RM, Silverman BK (eds). Textbook of pediatric emergency medicine. 6th edition. Lippincott Williams & Wilkins Hagerstown, Md, USA. 2010, pp:1458-1476.
  • 18. Yoruk O, Dane S, Ucuncu H, Aktan B, Can I. Stereological evaluation of laryngeal cancers using computed tomography via the Cavalieri method: correlation between tumor volume and number of neck lymph node metastases. J Craniofac Surg. 2009;20(5):1504-7. doi: 10.1097/SCS.0b013e3181b09bc3.
  • 19. Erić M, Anderla A, Stefanović D, Drapšin M. Breast volume estimation from systematic series of CT scans using the Cavalieri principle and 3D reconstruction. Int J Surg 2014; 12(9):912- 917. doi:10.1016/j.ijsu.2014.07.018
  • 20. Mazonakis M, Damilakis J, Mantatzis M, Prassopoulos P, Maris T, Varveris H, et al. Stereology versus planimetry to estimate the volume of malignant liver lesions on MR imaging. Magn Reson Imaging 2004;22(7):1011-6. doi: 10.1016/j.mri.2004.02.012
  • 21. Chang J, Zhang X, Zhang K, Pan Q. Three-dimensional reconstruction of medical images based on 3D slicer. Journal of Complexity in Health Sciences. 2019;30:2(1):1–12. doi: 10.21595/chs.2019.20724
There are 21 citations in total.

Details

Primary Language Turkish
Subjects Thoracic Surgery
Journal Section Research Articles
Authors

Cumhur Murat Tulay 0000-0001-8593-9233

Ekim Sağlam Gürmen 0000-0002-8672-6181

Publication Date September 23, 2023
Submission Date August 8, 2023
Acceptance Date August 25, 2023
Published in Issue Year 2023 Volume: 30 Issue: 3

Cite

Vancouver Tulay CM, Sağlam Gürmen E. AKCİĞER KONTÜZYON HACMİ: GERÇEKTEN BİLİYOR MUSUNUZ?. Med J SDU. 2023;30(3):466-72.

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