LUNG CONTUSION VOLUME: DO YOU REALLY KNOW?

Yıl 2023, Cilt: 30 Sayı: 3, 466 - 472, 23.09.2023

Cumhur Murat Tulay Ekim Sağlam Gürmen

https://doi.org/10.17343/sdutfd.1339538

Öz

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.

Anahtar Kelimeler

Computed tomography, contusion volume, lung contusion, planimetry method, trauma

AKCİĞER KONTÜZYON HACMİ: GERÇEKTEN BİLİYOR MUSUNUZ?

Öz

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.

Anahtar Kelimeler

Akciğer kontüzyonu, Bilgisayarlı tomografi, Kontüzyon hacmi, Planimetri yöntemi, Travma

Kaynakça

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