CLASSIFICATION OF PULMONARY-LESIONS INTO CENTRAL AND PERIPHERAL WITH A TEMPLATE APPLIED ON CHEST-X-RAY

To facilitate the understanding of the anatomical localization of pulm onary lesions and to optimize diagnostic evaluation, a template was de signed which, on conventional chest X-rays, could be employed to discr iminate between central and peripheral pulmonary lesions. The term 'ce ntral' implies that the lesion should be visible in the tracheobronchi al tree through a fibre-optic bronchoscope, and the term 'peripheral' suggests that the lesion is not visible through a bronchoscope. In 20 patients examined by fibre-optic bronchoscopy, the bronchoscope was we dged into four pre-selected segmental branchi in each lung. Using fluo roscopy, the tip of the bronchoscope was marked out on the skin with l eadshot. On subsequent chest X-rays, with posterior-anterior and right lateral views, the distances and angles of the markings of the bronch i were mapped out in relation to the main carina. These data were used to design the template.