Chest standard texts

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CTPA

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Report:
Scan quality: [Good/Adequate/Poor/Non-diagnostic.].
Pulmonary emboli? [Yes/No.]
Location: [Saddle/Main left/Main right/Segmental left/Segmental right/Subsegmental left/Subsegmental right/Multiple]
Features of right heart strain/raised pulmonary artery pressure: [Straightening/reverse bowing of interventricular septum/Pulmonary artery enlargement/Reflux of contrast into hepatic veins]
Lymphadenopathy: [Axillary/Hilar/Mediastinal]
Lung parenchyma: []
Pleural disease: []
Pulmonary nodules: []
Upper abdominal organs: []
Bones: []
Vasculature including coronary arteries: []

Explanatory notes 
Heading Options Reason
Clinical details:
Technique: CTPA
Scan quality: Good/Adequate/Poor/Non-diagnostic.
Pulmonary emboli? Yes/No.
Location Saddle/Main left/Main right/Segmental left/Segmental right/Subsegmental left/Subsegmental right/Multiple
Features of right heart strain/raised pulmonary artery pressure Straightening/reverse bowing of interventricular septum/Pulmonary artery enlargement/Reflux of contrast into hepatic veins
Lymphadenopathy: Axillary/Hilar/Mediastinal
Lung parenchyma:
Pleural disease:
Pulmonary nodules:
Upper abdominal organs:
Bones
Vasculature including coronary arteries

Nodule follow up CT

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Report:
Comparison is made with the previous scan(s) dated [].
The time after baseline is: []
The nodule volume on [date] was: [] mm3.
The nodule volume now is: [] mm3.
This gives a volume doubling time of: [] days.
According to BTS guidelines [CT in 2 years/Discharge/consider discharge or follow up depending on patient preference/consider biopsy or surveillance based on patient preference/further workup and consideration of definitive management] is advised

References:
1. Callister MEJ, Baldwin DR, Akram AR on behalf of the British Thoracic Society Standards of Care Committee, et alBritish Thoracic Society guidelines for the investigation and management of pulmonary nodules: accredited by NICEThorax 2015;70:ii1-ii54.

Pectus excavatum pre-surgery

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Report:
Haller index: [widest measurement/smallest AP spine to sternum].
Correction index: [(largest anterior spine to anterior most part of chest (rib) - anterior spine to posterior sternum)/largest anterior spine to anterior most part of chest (rib)]
Asymmetry index: [largest AP posterior rib to anterior on left/largest on right]
Sternal torsion angle: [Angle of sternum to horizontal]
Depression index: [Sternal depression at level of mid sternum as measured from a line across the anterior ribs to the sternum/vertebral body width at that point]
Lungs: []
Lymphadenopathy: [Yes/No.]
Soft tissue and other organ abnormalities: [Present/Absent.]

References:
A novel measure for pectus excavatum: the correction index St. Peter, Shawn D. et al. Journal of Pediatric Surgery , Volume 46 , Issue 12 , 2270 - 2273
Classification of Pectus Excavatum According to Objective Parameters From Chest Computed Tomography Choi, Jin-Ho et al. The Annals of Thoracic Surgery , Volume 102 , Issue 6 , 1886 - 1891
The Depression Index: an objective measure of the severity of pectus excavatum based on vertebral diameter, a morphometric correlate to patient size Fagelman, Kerry M. et al. Journal of Pediatric Surgery , Volume 50 , Issue 7 , 1130 - 1133


Pre-navigation bronchoscopic biopsy

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Pre Lung volume reduction surgery/endobronchial valve placement

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Report:
Presence of emphysema: [Yes/No.].
Type of disease: [centrilobular] [, paraseptal] [, panlobular] [, bullous]
Location/distribution of severity: [Heterogenous (Focal)/Homogenous (diffuse)/state lobar predominance/Size of bulla]
Pleural disease: [Yes/No. Type]
Fissures: [Complete/Incomplete, which and amount] Bronchiectasis: [Yes/No].
Signs of pulmonary hypertension: [Yes/No]. []
Fibrosis: [Yes/No].
Lung nodules: [Yes/No].
Bones/thoracic cage: [Yes/No].
Extra-pulmonary findings: [].

Heading Options Reason
Presence of emphysema: Yes/No.
Type of disease: centrilobular, paraseptal, panlobular, bullous
Location/distribution of severity: Heterogenous (Focal)/diffuse/state lobar predominance Upper lobe predominance or focal disease responds better to this treatment
Pleural disease: Yes/No. Type This may inhibit lung expansion
Fissures Complete/Incomplete, which and amount This is relevant to the placement of bronchial valves, collateral air drift may prevent intended collapse
Bronchiectasis: Yes/No. This is a separate disease process that would only benefit from resection in its own right and with different benefit. Presence in lung spared from emphysema
Signs of pulmonary hypertension: Yes/No. LVRS may increase pulmonary arterial hypertension
Fibrosis: Yes/No. Type. Location Interstitial disease may inhibit re-expansion.
Lung nodules: Insert options here In some cases resection and LVRS may be appropriate and beneficial
Bones/thoracic cage: Any restrictive thoracic cage abnormality should be noted
Extra-pulmonary findings:

References:
1. Washko GR, Hoffman E, Reilly JJ. Radiographic evaluation of the potential lung volume reduction surgery candidate. Proc Am Thorac Soc. 2008;5(4):421-6.
2. Coxson HO, Whittall KP, Nakano Y, et al. Selection of patients for lung volume reduction surgery using a power law analysis of the computed tomographic scan. Thorax. 2003;58(6):510-4.
3. Criner GJ, Scharf SM, Falk JA, et al. Effect of lung volume reduction surgery on resting pulmonary hemodynamics in severe emphysema. Am J Respir Crit Care Med. 2007;176(3):253-60.
4. Am J Respir Crit Care Med. 1999 Feb;159(2):552-6. Development of pulmonary hypertension after lung volume reduction surgery. Weg IL1, Rossoff L, McKeon K, Michael Graver L, Scharf SM.

Pre re-do sternotomy

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