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Purpose: Evaluate the feasibility of the virtual pleuroscopy (VP) in the detection of the pleural plaques., Method and Materials: Twenty consecutive patients, having asbestos exposure, explored by unenhanced multidetector CT-scan (Siemens, Sensation 16). The imaging parameters were as follows: beam width, 12 mm; beam pitch, 1; and reconstruction thickness, 1mm every 0.8mm at 120 kV and 180 mA. The image display used a surface-rendering algorithm and produced perspective red-scale images with a matrix of 512 x 512. Each VP image simulated a coned-down view, with a variable cone angle to explore the diaphragmatic pleura. The camera was placed 1 to 2 cm above the diaphragmatic dome. Four views are studied by diaphragm: crâniocaudal, lateral tangential, anterior and posterior. The observed virtual pleura aspect was classified in 5 groups (gr): gr 1: Rib band, gr 2: lobulated pleural thickening, gr 3: spicular, gr 4: plaques and gr 5: nodules. The results were compared to the other MDCT images using multiplanar reformatting., Results: The visualization of each diaphragm was optimal (35/40; 87.5%), limited (3/40; round atelectasis and asbestosis) or impossible (2/40; asbestosis). The classifications of the studied 38 diaphragmatic pleura were: gr 1 (n=15), gr 2 (n=5), gr 3 (n=11), gr 4 (n=7), gr 5 (n=0). The MDCT analysis showed normal pleura for both gr 1 and gr 2, a confirmed or beginning of fibrosis for gr 3 and confirmed the presence of pleural plaques on the diaphragmatic pleura in all cases of gr 4., Conclusion: The virtual pleuroscopy is a reality. It is a feasible technique. Other studies are necessary to confirm these preliminary results.

Radiological explorations of the thorax raise a certain number of risks for the mother and infant which should be well recognized by the pneumologist. Irradiation is the major risk and can be evaluated in comparison with other risks of radiation. We recall the dosimetric system based on the effective dose expressed in Sievert (Sv). The risks of irradiation are described. The dangers related to contrast agents are discussed. Each type of thoracic imaging is then considered from the standpoint of the technique, risks involved and means of radioprotection. Precise indications for each technique are given in detail for pregnant women. We review rapidly the physiological and pathological signs and symptoms observed during pregnancy and propose a practical attitude for ordering radiographic explorations.