Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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CT Follow-Up of Postoperative Bronchopleural Fistula: Risk Factors for Progression to Chronic Complicated Infection

수술 후 기관지 흉막루의 전산화단층촬영 추적 검사: 만성 복합성 감염 진행의 위험인자 분석

  • Ji-Yeon Han (Department of Radiology, Respiratory Medicine, Inje University College of Medicine, Busan Paik Hospital) ;
  • Ki-Nam Lee (Department of Radiology, Dong-A University College of Medicine) ;
  • Yoo Sang Yoon (Department of Thoracic Surgery, Respiratory Medicine, Inje University College of Medicine, Busan Paik Hospital) ;
  • Jihyun Lee (Department of Radiology, Dongnam Institute of Radiological & Medical Sciences Cancer Center) ;
  • Hongyeul Lee (Department of Internal Medicine, Respiratory Medicine, Inje University College of Medicine, Busan Paik Hospital) ;
  • Seok Jin Choi (Department of Radiology, Respiratory Medicine, Inje University College of Medicine, Busan Paik Hospital) ;
  • Hye Jung Choo (Department of Radiology, Respiratory Medicine, Inje University College of Medicine, Busan Paik Hospital) ;
  • Jin Wook Baek (Department of Radiology, Respiratory Medicine, Inje University College of Medicine, Busan Paik Hospital) ;
  • Young Jin Heo (Department of Radiology, Respiratory Medicine, Inje University College of Medicine, Busan Paik Hospital) ;
  • Gi Won Shin (Department of Radiology, Respiratory Medicine, Inje University College of Medicine, Busan Paik Hospital) ;
  • Jinyoung Park (Department of Radiology, Respiratory Medicine, Inje University College of Medicine, Busan Paik Hospital) ;
  • Dasom Kim (Department of Radiology, Respiratory Medicine, Inje University College of Medicine, Busan Paik Hospital)
  • 한지연 (인제대학교 의과대학 부산백병원 영상의학과) ;
  • 이기남 (동아대학교 의과대학 영상의학과) ;
  • 윤유상 (인제대학교 의과대학 부산백병원 흉부외과) ;
  • 이지현 (동남권원자력의학원 영상의학과) ;
  • 이홍열 (인제대학교 의과대학 부산백병원 호흡기내과) ;
  • 최석진 (인제대학교 의과대학 부산백병원 영상의학과) ;
  • 추혜정 (인제대학교 의과대학 부산백병원 영상의학과) ;
  • 백진욱 (인제대학교 의과대학 부산백병원 영상의학과) ;
  • 허영진 (인제대학교 의과대학 부산백병원 영상의학과) ;
  • 신기원 (인제대학교 의과대학 부산백병원 영상의학과) ;
  • 박진영 (인제대학교 의과대학 부산백병원 영상의학과) ;
  • 김다솜 (인제대학교 의과대학 부산백병원 영상의학과)
  • Received : 2020.01.23
  • Accepted : 2020.06.11
  • Published : 2021.01.01
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Abstract

Purpose We evaluated the risk factors for progression to chronic complicated bronchopleural fistula (BPF) after pulmonary resection using follow-up CT. Materials and Methods We retrospectively reviewed 45 cases with BPF that had undergone pulmonary resection during 2010-2018. We compared the clinical and radiological characteristics of those with complicated BPF (n = 24) and those without complicated (sterilized) BPF (n = 21). The clinical and radiological risk factors for progression to chronic complicated BPF were examined by logistic regression analysis. Results The thickness of the pleural cavity wall (p = 0.022), the size of the pleural cavity (p = 0.029), and the size increase of BPF on follow-up (p = 0.012) were significantly different between the two groups. The risk factors for progression to chronic complicated BPF were age > 70 years (odds ratio, 6.43; 95% confidence interval, 1.2-33.7), the thickness of the cavity wall > 5 mm (odds ratio, 52.5; 95% confidence interval, 5.1-545.4), and an increase in the size of the pleural cavity on follow-up CT (odds ratio, 12.5; 95% confidence interval, 2.1-73.5), only in the univariate analysis. Conclusion The risk factors for progression to chronic complicated BPF can be evaluated using follow-up CT.

목적 수술 후 발생한 기관지 흉막루에서 만성 복합성 형태로 진행하는 위험인자를 추적 전산화단층촬영 검사에서 평가하고자 한다. 대상과 방법 2010~2018년 동안 수술 후 발생한 기관지 흉막루 45예의 추적 전산화단층촬영 검사와 의무기록을 후향적으로 평가하였다. 합병된 기관지 흉막루(n = 24)와 합병되지 않은 기관지 흉막루(n = 21)의 임상적 영상의학적 특징을 비교하였다. 만성 복합성 기관지 흉막루로의 진행 위험인자는 로지스틱 회귀분석으로 분석하였다. 결과 흉강 벽 두께(p = 0.022), 흉강 크기(p = 0.029) 그리고 추적검사에서 흉강의 크기 증가(p = 0.012)에서 두 집단 간의 차이를 보였다. 만성 복합성 기관지 흉막루로의 진행 위험인자는 단일 변량 회귀 분석에서 70세 이상 고령(odds ratio, 6.43; 95% confidence interval, 1.2~33.7), 5 mm 이상의 흉벽 두께(odds ratio, 52.5; 95% confidence interval, 5.1~545.4), 추적 전산화단층촬영에서 흉강의 크기 증가(odds ratio, 12.5; 95% confidence interval, 2.1~73.5)로 나타났다. 결론 수술 후 발생한 기관지 흉막루에서 만성 복합성 형태로의 진행 위험인자를 추적 전산화 단층촬영검사에서 평가할 수 있다.

Keywords

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