| Computed Tomographic Pulmonary Angiography for Diagnosis of Invasive Mold Diseases in Patients With Hematological Malignancies. | |
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MedLine Citation:
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PMID: 22173235 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background. Invasive mold diseases (IMDs) of the lung remain a challenge for immunocompromised patients. Although timely diagnosis and treatment are crucial for the outcome of the infection, the poor sensitivity of microbiological techniques and the limited specificity of chest high-resolution computed tomography (HRCT) often delay definitive diagnosis of these infections.Methods. To explore the diagnostic utility of computed tomographic pulmonary angiography (CTPA) for detecting angioinvasive patterns of pulmonary infection, we performed a single-center, prospective, nonrandomized trial involving 36 patients with hematological malignancies who had clinical suspicion of IMD, as defined by European Organization for Research and Treatment of Cancer/Mycosis Study Group diagnostic criteria.Results. We found that 5 of 5 patients with proven IMD had CTPA-positive findings consistent with interruption of the arterial vessels (concordance, 100%). CTPA findings were positive in 5 of 7 patients with probable IMD (findings for 2 were considered false negative because lesions were too small or not evaluable). In 15 of 24 patients with a final diagnosis of possible IMD, CTPA findings were negative for 14 patients and were positive for 1 patient, who had septic emboli associated with Staphylococcus aureus bacteremia. CTPA findings were positive in the remaining 9 patients with a final diagnosis of possible IMD at the end of the study.Conclusions. We conclude that CTPA appears to be a promising tool to exclude the diagnosis of IMD in high-risk patients without specific findings on HRCT scans, and it is most useful in the presence of well-circumscribed lesions in which there is suspicion for IMD. |
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Authors:
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Marta Stanzani; Giuseppe Battista; Claudia Sassi; Russell E Lewis; Giulia Tolomelli; Cristina Clissa; Rayka Femia; Alberto Bazzocchi; Fabio Tumietto; Pierluigi Viale; Simone Ambretti; Michele Baccarani; Nicola Vianelli |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-14 |
Journal Detail:
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Title: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America Volume: - ISSN: 1537-6591 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9203213 Medline TA: Clin Infect Dis Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Institute of Hematology "Lorenzo e Ariosto Seràgnoli," Department of Hematology and Oncology. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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