ISSN:0883-5993    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

To assess the type, severity, and regional lung distribution of cystic fibrosis (CF) lesions as shown using high-resolution CT (HRCT), comparing these findings with chest radiographs and pulmonary function tests (PFTs), we obtained HRCTs in 36 patients with CF (mean age 13), who were clinically stable. We assessed four lung regions (upper and lower, right and left) and assigned each a semiquantitative score for (a) bronchial abnormalities, (b) parenchymal abnormalities, and (c) overinflation, based on the severity and profusion of the corresponding lesions. A similar regional assessment of chest radiographs was also done using the Chrispin-Norman method. PFT results were correlated with the radiological data. On HRCT, bronchial lesions were present in 89% of the patients and in 78% of the regions; bronchiectasis was the predominant abnormality in our population, visible in 100% of the abnormal regions. Less frequent were bronchial wall thickening (48%) and mucous plugs (29%). Parenchymal abnormalities were recognizable in 58% of the patients and 31% of the regions; alveolar consolidation was more frequent (80%) than were destructive changes (36%). Overinflation was found in 81% of the patients and 85% of the regions. We found the severity and profusion of bronchial lesions and parenchymal destructive changes to be unevenly distributed among the different regions, the upper lungs being more heavily involved than the lower, particularly on the right. Alveolar consolidation and overinflation were more uniform in distribution. HRCT patient scores correlated significantly with radiographic scores (r= 0.861) and with PFTs, especially with forced expiratory volume for 1 s (FEV1;r= 0.658). HRCT can be useful in the clinical management of patients with CF, depicting the type and distribution of bronchial and parenchymal lesions, particularly when chest radiographic results are unclear. In the planning and postural drainage, special attention should be given to the apical and posterior parts of the lungs, especially on the right; these are the areas most frequently and most severely involved by the disease.

ISSN:0883-5993    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Dynamic computed tomography (CT) is frequently performed to assess the mediastinum in trauma patients with a suspected thoracic aortic rupture. Its usefulness lies in demonstrating a mediastinal hematoma. However, many patients still undergo conventional aortography despite a normal chest CT, because of a perceived insensitivity of this technique for diagnosing aortic rupture. One application of helical CT is CT angiography, in which multiple thin sections are acquired through a blood vessel during the injection of iodinated contrast. Good demonstration of vascular pathology can be achieved, especially with 3-D reconstructions. This article reviews a series of four surgically proven thoracic aortic ruptures studied using helical CT, and one case proven to be false-positive by both helical CT angiography and conventional angiography. Correlation between conventional and helical CT angiography was excellent, with similar findings and the same interpretation pitfalls. Helical CT is fast and noninvasive. Combined examination of other anatomical areas can be performed in the same procedure in major trauma patients. Helical CT may potentially decrease the need for aortography in these acutely injured patients.

ISSN:0883-5993    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Acute aortic dissection with intramural hematoma has been believed to have a good prognosis, but we have encountered the transition of this entity to a classic dissection or aneurysm. We report the serial computed tomography (CT) features in 27 cases of acute aortic dissection with intramural hematoma. Eleven patients (40.7%) developed a classic dissection or aneurysm during follow-up. Four patients (14.8%) showed transition to a classic dissection without resolution of the intramural hematoma; each had a dilated ascending aorta measuring >5 cm in diameter on the initial CT. One case (3.7%) developed an enlarging aneurysm without resolution of the intramural hematoma. In 19 cases (70.4%), the hematoma resolved; among these 19, the aortic diameter was significantly larger (p< 0.01) than those in a normal control group. Two of these 19 later developed an aneurysm, and four developed a classic dissection. This entity often (40.7%; 11 of 27) required surgical intervention or periodic follow-up CT examinations, particularly with a dilated ascending aorta of >5 cm in diameter.

ISSN:0883-5993    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Mean pulmonary artery pressure (PAP) has been demonstrated to correlate with measures of pulmonary artery size. We tested the hypothesis that residence at elevated altitudes, a determinant of mean PAP, can be associated with increases in pulmonary artery size on chest radiographs from healthy adults. The study population consisted of three groups of asymptomatic, nonsmoking adults without hazardous respiratory exposures living at altitudes approximating 0 m (group 1, n = 197), 1,400 m (group 2, n = 145), and 2,600 m above sea level (group 3, n = 196). The width of the right descending pulmonary artery (RDPA) was measured at its widest diameter before bifurcation. In a multivariate regression model, significant associations were detected between RDPA width and residence at elevated altitudes (F= 13.84, p = 0.0002), age (F= 32.49, p < 0.0001), and gender (F= 56.10, p < 0.0001), with 36% of the variability of the measure determined by these three variables (r2= 0.36). Mean RDPA width increased as altitude at residence increased. Larger mean values were noted among older individuals and males. We conclude that residence at altitudes of 1,400 and 2,600 m above sea level is associated with increases in pulmonary artery size on chest radiograph.

ISSN:0883-5993    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0883-5993    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Thymic carcinoma is a rare malignant neoplasm of the thymic epithelium, distinguished from invasive thymoma by the presence of malignant cytology and a greater incidence of local invasion and embolic metastases. Some common features of thymic carcinomas include (a) large and highly aggressive anterior mediastinal mass; (b) areas of necrosis, hemorrhage, calcification, or cyst formation; (c) gross invasion of contiguous mediastinal structures and wide spread to involve distant intrathoracic sites; (d) high incidence of extrathoracic metastases; (e) broad age range, with an average of 46 years; (f) very low incidence of paraneoplastic syndromes; and (g) very poor prognosis. Three case reports are presented, followed by an overview of the disease with emphasis on the radiographic features.

ISSN:0883-5993    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Lung hernia is defined as a protrusion of lung parenchyma beyond the confines of the musculoskeletal thorax. Lung hernias can be classified according to location (i.e., cervical, thoracic, or diaphragmatic) and etiology. Approximately 80% of reported cases of lung hernia are acquired, usually related to trauma or surgery. Symptoms are few, infrequent, and vague. A painless, local, and inconstant bulging is evident on physical examination. The diagnosis of a lung herniation is accomplished using chest radiographs in the most cases. Surgery is usually reserved for large hernias or incarcerated hernias.

ISSN:0883-5993    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Mediastinal lymphangioma is rare in adults, and there are few reports of their computed tomographic (CT) findings. We present the CT results in three cases of mediastinal lymphangioma. One showed a well-defined, multilocular, water-density mass enveloping mediastinal structures, without their displacement or compression; one presented as a well-defined, homogeneous, water-density mass in the right paratracheal region; and one was associated with hemorrhage into cysts and a significant increase in size over 5 years. CT is useful for diagnosis and evaluation of the extent or contents of mediastinal lymphangiomas.

ISSN:0883-5993    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Peripheral right upper lobe collapse describes the unusual plain film finding in which the collapsed lobe simulates a peripheral, pleural-based mass. Most investigators have postulated that the peripheral opacity is explained by the interface between the superior segment of the lower lobe and the posterior aspect of the collapsed upper lobe, which does not swing as far medial as in the normal pattern of collapse. In our patient, using computed tomography (CT) correlation, we demonstrated that the finding is explained by the interface between the middle lobe and the anterior aspect of the collapsed upper lobe.

ISSN:0883-5993    

出版商:OVID    

年代:1996

数据来源: OVID