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Hunter diagnosis of pure destructive diseases of lung and pleura

Author:Biophilia  UpdateTime:2020-04-16

     Traditional roentgenologic methods still remain the basic in diagnostics of pulmonary organs diseases, but non-linear diagnostic research (NLS) of thorax organs opens conceptually new prospects for evaluation of lungs and pleura changes. Information about a pathological process is presented in a form of three-dimensional image with strict differentiation of various in spectral properties biological structures, at the same time application of ultramicroscopic scanning makes possible to study researched object in every detail. The study is not related to radiation exposure, it does not require expenses for additional equipment if a standard set of NLS-diagnostic devices is available. That is why at the present moment it finds more extensive application in diagnostics of lungs and pleura diseases and with increasing frequency becomes a topic of scientific works.

    horax research was carried out using “Metatron”-4025 system with 4.9GHz high-frequency sensors in accordance with procedure created in the hospital. At visualization of pathological neoplasms we defined their localization, size, chromogeneity, spectral structure; applying spectral-entropic analysis (SEA) we evaluated changes of NLS-picture in dynamics. When there were pleural fluids we evaluated amount and structure of a fluid content with study of all inclusions (suspensions, threads) and condition of pleura. According to results of ultramicroscanning we judged about diagnostic value of each of mentioned criteria.
     At the initial stage NLS-study of thorax was carried out after roentgenography with following comparison of results. Further on both diagnostic methods were applied simultaneously, but frequently NLS-study preceded roentgenography or replaced some part of it.
    Macroscopic basis of an early stage was a large cavity of destruction with insufficient spontaneous drainage, indistinctly separated from surrounding lung tissue and filled with purulent exudate with sequesters. On NLS-graphy early stage was characterized by a neoplasm with heterogeneous structure due to diffuse distribution of lesser achromogenic areas of air beads against the background of prevailing isochromogenic content with heterogeneous suspensions and presence of large hypochromogenic< sequesters. Walls were not visualized, abscess was separated by lung tissue.
    At the advanced stage we detected cavity of destruction with solid walls, properly drained by bronchi and containing mainly air, sequesters and small amount of purulent exudate . On NLS-graphy it was characterized by heterogeneous neoplasm with prevailing long achromogenic objects with small amount of fluid in lower parts. Also homogeneous moderately chromogenic abscess wall of equal thickness with distinct external and indistinct internal walls was visualized.
    Acute purulent processes are characterized by smaller than gangrenous abscesses size, often insufficient spontaneous drainage with heterogeneous diffuse distribution of achromogenic inclusions of air against isochromogenic background, absence of walls and sequesters. At adequate treatment we detected a positive dynamics in form of abscess cavity decreasing with simultaneous decreasing of fluid content amount and replacing by air. Further on a cicatrix was formed at the spot.
    Chronic lung abscesses are characterized by the same regularities of NLS-picture as acute ones. Diagnostic criteria are the quantitative ratio of purulent exudate and achromogenic air inclusions and their spatial distribution in a cavity. We singled out 4 types of chronic abscess depending on efficiency of its spontaneous drainage through bronchi: without access to bronchi (pseudo-tumorous), with insufficient spontaneous drainage, with free spontaneous drainage and an abscess with air pocket.
The main difference between chronic abscess and acute one was a presence of moderately chromogenic wall which was more distinctly visualized at the level of air content in the upper part of a cavity and less distinctly – in the lower part against the background of hyperchromogenic purulent exudate with suspensions. A wall had homogeneous chromogenic structure (4 points at Fleindler’s scale), even thickness (up to 8 mm), distinct external and indistinct internal contours.
    The greatest diagnostic difficulty was represented by pseudo-tumorous form of chronic abscess, which had, as a rule, homogeneous hyperchromogenic structure because of dense purulent content and distinct contour imitating peripheral lung cancer. Etiology of a nidus was defined by SEA results and confirmed by puncture biopsy.
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