[Virtual pleuroscopy of diaphragmatic pleura: myth or reality?].
OBJECTIVE
Evaluate the feasibility of the virtual pleuroscopy (VP) in the detection of the pleural plaques.


METHODS
Twenty consecutive patients, having asbestos exposure, explored by unenhanced multidetector CT-scan (Siemens, Sensation 16). The imaging parameters were as follows: beam width, 12 mm; beam pitch, 1; and reconstruction thickness, 1mm every 0.8mm at 120 kV and 180 mA. The image display used a surface-rendering algorithm and produced perspective red-scale images with a matrix of 512 x 512. Each VP image simulated a coned-down view, with a variable cone angle to explore the diaphragmatic pleura. The camera was placed 1 to 2 cm above the diaphragmatic dome. Four views are studied by diaphragm: crâniocaudal, lateral tangential, anterior and posterior. The observed virtual pleura aspect was classified in 5 groups (gr): gr 1: Rib band, gr 2: lobulated pleural thickening, gr 3: spicular, gr 4: plaques and gr 5: nodules. The results were compared to the other MDCT images using multiplanar reformatting.


RESULTS
The visualization of each diaphragm was optimal (35/40; 87.5%), limited (3/40; round atelectasis and asbestosis) or impossible (2/40; asbestosis). The classifications of the studied 38 diaphragmatic pleura were: gr 1 (n=15), gr 2 (n=5), gr 3 (n=11), gr 4 (n=7), gr 5 (n=0). The MDCT analysis showed normal pleura for both gr 1 and gr 2, a confirmed or beginning of fibrosis for gr 3 and confirmed the presence of pleural plaques on the diaphragmatic pleura in all cases of gr 4.


CONCLUSIONS
The virtual pleuroscopy is a reality. It is a feasible technique. Other studies are necessary to confirm these preliminary results.
Carette
M-F
MF
Service de radiologie, Hôpital Tenon (AP-HP), 4 rue de la Chine, Paris cedex 20, France. marie-france.carette@tnn.aphp.fr
Chabchoub
H
H
Tassart
M
M
Korzec
J
J
Marsault
C
C
Khalil
A
A
D000328:Adult; D000368:Aged; D001195:Asbestosis / Q000000981:diagnostic imaging; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000000981:diagnostic imaging*; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*