ISSN:0883-5993    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Pulmonary embolism (PE) and deep venous thrombosis (DVT) represent two manifestations of the same syndrome, venous thromboembolism. Contrast-enhanced computed tomography (CT) angiography is a practical, efficient alternative to conventional imaging for PE. Following the pulmonary examination, the inferior vena cava (IVC) and the iliac, femoral, and popliteal veins can be studied with CT without additional intravenous contrast administration. Indirect CT venography (CTV) after CT pulmonary angiography (CTPA) simplifies and shortens venous thromboembolism work-up. Initial studies indicate that CTV is comparable to ultrasound in the evaluation of femoral/popliteal DVT. CTV has the advantage of evaluating the iliac veins and inferior vena cava, vessels poorly seen on sonography and venography. Combining CTV with CTPA increases confidence in withholding treatment when results for both the pulmonary arteries and leg veins are negative and increases the diagnosis of venous thromboembolism by 25% over CTPA alone. This pictorial essay will review the normal venous anatomy, CTV technique, and the findings of acute and chronic DVT. Interpretive pitfalls and alternative diagnoses are also reviewed.

ISSN:0883-5993    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Pulmonary tuberculosis (TB) is the major opportunistic infection of acquired immunodeficiency syndrome (AIDS) on a worldwide basis. The purpose of this pictorial essay is to illustrate and review the spectrum of imaging findings associated with pulmonary TB in patients with AIDS and to describe important factors that may complicate the radiographic follow-up of patients being treated for TB.

ISSN:0883-5993    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

To assess the radiologic findings of systemic arterial supply to the normal basal segments of the left lower lobe, chest radiographs and CT scans of all 11 patients were reviewed retrospectively by two chest radiologists. On posteroanterior chest radiographs (n = 11), the anomalous systemic artery arising from the descending thoracic aorta was shown as a retrocardiac mass (n = 11). Absence of normal lower lobar pulmonary artery shadow (n = 11), partial obliteration of the descending aortic interface (n = 9), and increased interstitial markings in left lower lung zone (n = 8) were also noted. On contrast-enhanced scans (n = 11), abrupt tapering of the normal left lower lobar pulmonary artery distal to the origin of superior segmental artery (n = 11), aberrant systemic artery originating from the descending aorta (n = 11), mild volume loss in the left lower lobe (n = 11), diffuse dilatation of the intrapulmonary peripheral vasculature (n = 11) and areas of ground-glass opacity (n = 10) in the basal segments of the left lower lobe were seen. Because chest radiography and CT consistently demonstrate several combinations of characteristic findings, conventional aortography may not be necessary for proper diagnosis of this anomaly.

ISSN:0883-5993    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The aim of this study was to determine the likelihood of malignancy in small nodules in the nonprimary lobe in patients with resectable bronchogenic carcinoma. In 141 patients who underwent curative resection of bronchogenic carcinoma and had adequate follow-up CT examinations, the presence of small nodules in the nonprimary lobe preoperatively and change of preexisting nodules, if any, was assessed. The criteria used to determine benignity of a nodule was stability or decrease in size for 24 months on CT. Histopathology of the nodules was reviewed for an additional 10 patients who underwent surgical biopsy for an accompanying nodule before curative surgery. Sixty-two (44%) of 141 patients had a total of 138 small (≤ 10 mm) nodules in the nonprimary lobes (< 5 mm in 113, 5–10 mm in 25). Of these 138 nodules, 132 were benign with only six nodules malignant (with histopathologic confirmation for the enlarging nodules). The 132 benign nodules showed no change (n = 120), decrease in size (n = 11), or increase in size (n = 1) on follow-up studies, with the single enlarging nodule proved benign on biopsy. In 10 patients who had a preoperative biopsy of a single preexisting nodule in the nonprimary lobe (< 5 mm = 1; 5–10 mm = 5; > 10 mm = 4) two proved to be malignant (both > 10 mm) and eight were benign. Most small (< 10 mm) nodules associated with resectable bronchogenic carcinoma are benign, consistent with published results of other studies. However, a small number of nodules are malignant and CT does not reliably distinguish between benign and malignant nodules.

ISSN:0883-5993    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

To evaluate and compare thin section CT scans (TSS) and minimum intensity projection images (MinIPs) in healthy individuals, 10 nonsmokers with normal pulmonary function tests were studied using ten 1-mm collimated, helically acquired TSS images after full inspiration and expiration at two anatomic levels. Ten-millimeter-thick MinIPs were generated from the helical scans. Two thoracic radiologists compared TSS and MinIPs for artifacts and air trapping. Hounsfield unit (HU) measurements of TSS and MinIPs were obtained. The lung parenchyma on MinIPs demonstrates a smooth anterior-to-posterior attenuation gradient, accentuated by expiration. Motion and beam-hardening artifacts on TSS images resulted in regions of high and low attenuation on MinIPs, respectively. Expiratory TSS and MinIPs demonstrated air trapping (n = 31/40; range, 0–25%; mean, 7.2%). In comparison with TSS, MinIPs improved the conspicuity of air trapping (n = 20) and appeared to detect more air trapping (n = 7). No statistical differences were found when comparing the mean HU values of TSS and MinIPs. MinIPs demonstrated a smooth anterior-to-posterior attenuation gradient. Compared with TSS, MinIPs improve the conspicuity of air trapping in healthy individuals. Therefore, expiratory MinIPs may be useful in detecting air trapping as a result of disease.

ISSN:0883-5993    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The purpose of this study was to evaluate CT findings in nosocomialPseudomonas aeruginosaPneumonia (PAP) and to compare features of PAP in patients with isolatedP. aeruginosacultures and those with coexistent infections. A retrospective database search revealed 28 patients with nosocomial PAP (12 men, 16 women; mean age, 57 years) in which thoracic CT had been performed within a mean of 1.7 days from the time of respiratory culture. Two chest radiologists blinded to culture data performed a consensus reading noting distribution and pattern of consolidation, ground-glass opacity, nodules, peribronchial infiltration, necrosis, effusions, and pleural enhancement. Coexistent respiratory cultures were recorded. Consolidation was present in all patients, involving multiple lobes in 23 (82%) and demonstrating upper zonal involvement in 23 (82%). Nodular features were present in 14 (50%), including tree-in-bud patterns with centrilobular distributions in 9 (64%) and larger, randomly distributed nodules in 5 (36%). Five of five patients with consolidations limited to the lower lung zones had associated upper lung nodules. Ground-glass opacity was seen in nine (31%) and peribronchial infiltration in 16 (57%). Necrosis was present in eight (29%). Thirteen (46%) bilateral and five (18%) unilateral pleural effusions were present with enhancement occurring in two (1%). Coexistent positive respiratory cultures were identified in 13 patients. The distribution of consolidation, frequency and distribution of nodules, and frequency of necrosis did not differ significantly between patients with and without other positive cultures. With CT, PAP most commonly presents with multifocal airspace consolidation. Nodular features were identified in half, with one-third demonstrating tree-in-bud opacities. Unsuspected necrosis occurred in one-third of cases. CT findings in patients with and without other respiratory isolates did not differ in the distribution and frequency of consolidations, nodularity, or necrosis.

ISSN:0883-5993    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Radiology has been abounding with technological advances since the chest film first became the mainstay in diagnosing thoracic disease, and yet the conventional chest examination has endured as a front-line tool. The ability to perceive structural alterations is facilitated by a solid foundation in anatomy, which should be easy to achieve in a practice environment in which CT has become so commonplace. Not only is knowledge of anatomic nuances important for analysis of conventional radiographs, but it can only be an asset as multiplanar imaging is increasingly utilized and new modalities are developed over time. Some fundamental anatomic variations are revisited here through correlating the perspective provided by the lateral radiograph with the equally common one provided by routine axial CT images.

ISSN:0883-5993    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

A case of an immunocompetent patient with severeAspergillusinfection and radiographic findings typically described with angioinvasive aspergillosis is presented. WhenAspergillusis isolated from the sputum in a patient with normal immunity, invasive aspergillosis should be considered when there are extensive radiographic findings characteristic of invasive fungal disease.

ISSN:0883-5993    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The case presented describes an unusual appearance of thoracic tuberculosis with multiple pleural nodules associated with a parasternal mass as depicted on computed tomography. The patient is a 22-year-old woman who presented with pleuritic chest pain, a left parasternal mass, and weight loss. The pleura of the left hemithorax was studded with multiple low-attenuation, rim-enhancing nodules, and a left parasternal mass with similar imaging features was seen anterior to an enlarged left internal mammary lymph node. There were no pulmonary parenchymal changes nor any mediastinal or hilar lymphadenopathy. Cytologic examination of the specimen obtained with fine needle aspiration of the pleural and parasternal masses yielded granulomatous inflammation. The symptoms remitted with antituberculous chemotherapy and a follow-up CT obtained 6 months later showed complete resolution of the pleural nodules and parasternal mass and considerable regression of the left internal mammary lymph node. Involvement of the pleura with discrete nodules in the absence of parenchymal changes or mediastinal lymphadenopathy is rare in tuberculosis. To the best of the present authors' knowledge, the combination of a tuberculous parasternal mass and multiple pleural nodules as the sole manifestations of thoracic tuberculosis has not been reported previously.

ISSN:0883-5993    

出版商:OVID    

年代:2002

数据来源: OVID