Abstract
Electrical impedance tomography (EIT) is a radiation-free technique generating cross-sectional images of the lung. EIT visualizes global and regional ventilation by illustrating the distribution of electrical bioimpedance. With an electrode belt around the patient’s thorax, rotating injection-couples of a harmless alternating current allow voltage measurement of the remaining electrodes. This enables the reconstruction of a tomogram with highly dynamic changes within ventilation. We report on a female six-year-old patient with cystic fibrosis and complete destruction of the upper and middle lobe of the right lung. Lobectomy, a rare therapeutic option in patients with cystic fibrosis that needs to be considered in cases of severe localized destruction, was performed. We show a pre- and postoperative documentation of static (radiology) and dynamic investigation tools (spirometry) in correlation with EIT as a new non-invasive and radiation-free diagnostic tool for this patient group.
References
[1] Aurora P, Gustafsson P, Bush A, et al. Multiple breath inert gas washout as a measure of ventilation distribution in children with cystic fibrosis. Thorax 2004; 59: 1068–1073.10.1136/thx.2004.022590Search in Google Scholar PubMed PubMed Central
[2] Camargos P, Le Bourgeois M, Revillon Y, et al. Lung resection in cystic fibrosis: a survival analysis. Pediatr Pulmonol 2008; 43: 72–76.10.1002/ppul.20742Search in Google Scholar PubMed
[3] Costa LVE, Gonzalez Lima R, Amato BPM. Electrical impedance tomography. Curr Opin Crit Care 2009; 15: 18–24.10.1097/MCC.0b013e3283220e8cSearch in Google Scholar
[4] Eichinger M, Optazaite DE, Kopp-Schneider A, et al. Morphologic and functional scoring of cystic fibrosis lung disease using MRI. Eur J Radiol 2012; 81: 1321–1329.10.1016/j.ejrad.2011.02.045Search in Google Scholar PubMed
[5] Gattinoni L, Caironi P, Valenza F, Carlesso E. The role of CT-scan studies for the diagnosis and therapy of acute respiratory distress syndrome. Clin Chest Med 2006; 27: 559–570.10.1016/j.ccm.2006.06.002Search in Google Scholar PubMed
[6] Leonhardt S, Lachmann B. Electrical impedance tomography: the holy grail of ventilation and perfusion monitoring? Intensive Care Med 2012; 38: 1917–1929.10.1007/s00134-012-2684-zSearch in Google Scholar PubMed
[7] Mallory GB, Spray TL. Paediatric lung transplantation. Eur Respir J 2004; 24: 839–845.10.1183/09031936.04.00064804Search in Google Scholar PubMed
[8] Mearns MB, Hodson CJ, Jackson AD, et al. Pulmonary resection in cystic fibrosis. Results in 23 cases. Arch Dis Child 1972; 47: 499–508.10.1136/adc.47.254.499Search in Google Scholar PubMed PubMed Central
[9] Meier T, Gehring H, Leonhardt S, et al., Assessment of regional lung recruitment and derecruitment during a PEEP trial based on electrical impedance tomography. Intensive Care Med 2008, 34: 543–550.10.1007/s00134-007-0786-9Search in Google Scholar PubMed
[10] Miller MR, Hankinson J, Brusasco V, et al. Standardization of Spirometry. Eur Respir J 2005; 26: 319–338.10.1183/09031936.05.00034805Search in Google Scholar PubMed
[11] Pikkemaat R, Tenbrock K, Lehmann S, Leonhardt S. Electrical impedance tomography: New diagnositic possibilities using regional time constant maps. Appl Cardiopul P (ACP) 2012; 16: 212–225.Search in Google Scholar
[12] Vogt B, Pulletz S, Elke G, et al. Spatial and temporal heterogeneity of regional lung ventilation determined by electrical impedance tomography during pulmonary function testing. J Appl Physiol 2012; 16: 1154–1161.10.1152/japplphysiol.01630.2011Search in Google Scholar PubMed
[13] Zhao Z, Fischer R, Frerichs I, Müller-Lisse U, Möller K. Regional ventilation in cystic fibrosis measured by electrical impedance tomography. J Cyst Fibros 2012; 11: 412–418.10.1016/j.jcf.2012.03.011Search in Google Scholar PubMed
[14] Zhao Z, Müller-Lisse U, Frerichs I, Fischer R, Möller K. Regional airway obstruction in cystic fibrosis determined by electrical impedance tomography in comparison with high resolution CT. Physiol Meas 2013; 34: 107–114.10.1088/0967-3334/34/11/N107Search in Google Scholar PubMed
©2014 by De Gruyter
