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Chest CT Scan

Rodolfo Mendes Queiroz, Danilo Brotto Ferreira de Santana, Rogério Nastri Filho, Gláucia Aparecida Magnani Landell, Paulo Roberto Félix, Marcus Vinícius Nascimento Valentin
We describe the case of a female patient, 21 years old, complaining of dyspnea attacks and wheezing 2 years ago. Chest radiography showed volume loss in the left lower lobe and ipsilateral retrocardiac triangular basal opacity. CT scan showed an extensive solid mass with apex protruding into the left main and lower lobar bronchi, causing distal atelectasis. Histopathological and immunohistochemical study of transbronchial biopsy of the lesion revealed a typical carcinoid tumor, confirmed after tumor resection with total left pneumectomy...
January 2018: Revista da Associação Médica Brasileira
Alicia Blackman, Wayne Mohammed
This case presents a woman in her early 20s who died after the sudden onset of chest pain. Five years earlier, she was investigated for a cardiac murmur during pregnancy and an echocardiogram revealed a 6.0×3.0 cm blood-filled sac compressing the left atrium and anterolateral aspect of the left ventricle with communication to the aortic root. She later had a CT scan of the chest with contrast, which showed aneurysmal dilatation of the left main coronary artery. She was placed on aspirin but defaulted from clinic 11 months post partum...
March 20, 2018: BMJ Case Reports
Hans Roland Dürr, Jessica Rauh, Andrea Baur-Melnyk, Thomas Knösel, Lars Lindner, Falk Roeder, Volkmar Jansson, Alexander Klein
BACKGROUND: Liposarcomas are the second most common type of soft tissue sarcomas, 30-50% of these are of myxoid subtype. The aim of this retrospective study was to analyze the local control rate, the metastatic pattern and survival of patients in a consecutive single-institution series. METHODS: From 1983 to 2015, 43 patients with myxoid liposarcoma of the extremities and trunk wall underwent resections. The margin was defined as R0 (wide) or R1 (marginal). Patients were followed for evidence of local recurrence or distant metastasis...
March 20, 2018: BMC Cancer
Federico Davini, Sara Ricciardi, Carmelina Cristina Zirafa, Ilenia Cavaliere, Gaetano Romano, Franca Melfi
Background: The incidental detection of solitary pulmonary nodule (SPN) is currently increasing due to the widespread use of computed tomography (CT) during the follow up in oncological patients or in screening trials. A quick and definitive histological diagnosis of these nodes is mandatory as, in case of primitive lung cancer, an early detection could improve both surgical results and prognosis. The minimally invasive pulmonary resection (MIPR) is the gold standard procedure for diagnosis and treatment of small lung nodules, but it can be difficult to localize deep nonpalpable nodes that lie in the lung parenchyma...
2018: Journal of Visualized Surgery
Bradford Bennett, Drew Johnson, Andrew Panakos, Aleksandr Rozenberg
A 51-year-old woman with history of migraine headaches and intermittent nausea, vomiting, palpitations, and diaphoresis presented to the emergency department with hypertensive emergency 1 month after starting a beta blocker for migraine prophylaxis. Contrast-enhanced computed tomography of the chest incidentally revealed a large abdominal mass in the area of the left adrenal gland. Iodine-123 metaiodobenzylguanidine scan imaging showed localized uptake into the left adrenal gland. Along with imaging results, laboratory testing confirmed the diagnosis of pheochromocytoma...
February 2018: Radiology Case Reports
Ramez N Eskander, James Kauderer, Krishnansu S Tewari, Robert S Mannel, Robert E Bristow, David M O'Malley, Stephen C Rubin, Gretchen E Glaser, Chad A Hamilton, Keiichi Fujiwara, Warner K Huh, Frederick Ueland, Jean-Marie Stephan, Robert A Burger
PURPOSE: We sought to determine the level of concordance among surgeons' assessment of residual disease (RD) and pre-treatment computed tomography (CT) findings among women who underwent optimal surgical cytoreduction for advanced stage ovarian cancer. METHODS: This is a post-trial ad hoc analysis of a phase 3 randomized clinical trial evaluating the impact of bevacizumab in primary and maintenance therapy for patients with advanced stage ovarian cancer following surgical cytoreduction...
March 14, 2018: Gynecologic Oncology
Lianne J P Sonnemans, Bela Kubat, Mathias Prokop, Willemijn M Klein
OBJECTIVE: To investigate whether virtual autopsy with postmortem CT (PMCT) improves clinical diagnosis of the immediate cause of death. DESIGN: Retrospective observational cohort study. INCLUSION CRITERIA: inhospital and out-of-hospital deaths over the age of 1 year in whom virtual autopsy with PMCT and conventional autopsy were performed. EXCLUSION CRITERIA: forensic cases, postmortal organ donors and cases with incomplete scanning procedures...
March 16, 2018: BMJ Open
Aiko Ogawa, Yukari Takahashi, Hiromi Matsubara
BACKGROUND: Pulmonary veno-occlusive disease (PVOD) and pulmonary capillary hemangiomatosis (PCH) are rare causes of pulmonary hypertension. Although diagnosis is based on pathological findings, an early diagnosis is crucial because of poor prognosis compared to other types of pulmonary hypertension. Furthermore, vasodilators may cause fatal pulmonary edema in patients with PVOD/PCH. This study aimed to identify specific characteristics for patients with PVOD/PCH to clinically diagnose PVOD/PCH...
March 13, 2018: Journal of Cardiology
Rafael E de la Hoz, Jonathan Weber, Dongming Xu, John T Doucette, Xiaoyu Liu, Deborah A Carson, Juan C Celedón
We examined the chest CT scans of 1,453 WTC responders using the International Classification of High-resolution CT for Occupational and Environmental Respiratory Diseases. Univariate and bivariate analyses of potential work-related pleural abnormalities were performed with pre-WTC and WTC-related occupational exposure data, spirometry, demographics and quantitative CT measurements. Logistic regression was used to evaluate occupational predictors of those abnormalities. Chest CT scans were performed first at a median of 6...
March 15, 2018: Archives of Environmental & Occupational Health
Peter Paik, Sanjay K Arukala, Anupam A Sule
Central venous catheters are placed in approximately five million patients annually in the US. The preferred site of insertion is one with fewer risks and easier access. Although the right internal jugular vein is preferred, on occasion, the left internal jugular may have to be accessed. A patient was admitted for septic shock, cerebrovascular accident, and non-ST-segment elevation myocardial infarction. A central venous line was needed for antibiotic and vasopressor administration. Due to trauma from a fall to the right side and previously failed catheterization attempts at the left subclavian and femoral veins, the left internal jugular vein was accessed...
January 9, 2018: Curēus
Yan Xiu, Jie Zhang, Hongcheng Shi
A 73-year-old man presented with fatigue and anorexia and underwent FDG PET/CT scan to evaluate a right lung nodule revealed by a chest CT. The FDG PET/CT not only showed that the lung nodule was hypermetabolic but also revealed that there was significantly increased activity in the region of the duodenum. The findings were suspected as primary duodenal malignancy with metastases. However, an upper gastrointestinal tract endoscopic examination with further culture led to a diagnosis of duodenal cryptococcosis...
March 13, 2018: Clinical Nuclear Medicine
Lorenzo Carlo Pescatori, Matteo Brambati, Carmelo Messina, Giovanni Mauri, Giovanni Di Leo, Enzo Silvestri, Francesco Sardanelli, Luca Maria Sconfienza
AIM: To evaluate the clinical impact of CT scan in modifying the clinical management in patients referred to the emergency department. METHODS: We prospectively evaluated 300 patients (177 males, 63 ± 18 years old) admitted in the emergency department (ED) of a single institution, who underwent a CT examination for thoracic and/or abdominal complains. Demographic and clinical data were collected. Hypothesized outcome prior to CT scan and final management (i...
March 13, 2018: Emergency Radiology
Prudence Dy, Cristina Lajom, Josephino Sanchez
Neurogenic tumours of the mediastinum in adults occur most often at the posterior mediastinum, majority of which are benign of nerve sheath in origin. A 72-year-old woman, known asthmatic, presented with chronic symptoms of hoarseness, dysphagia, chest heaviness, easy fatigability, cough, epigastric pain, feeling of abdominal fullness and choking with food intake and at a supine position. Treated for other disorders, routine chest X-ray incidentally found a homogenous convex radiodensity at the right paratracheal area; mass which was also observed with CT and 18F-fludeoxyglucose-positron emission tomography/CT scan studies...
March 13, 2018: BMJ Case Reports
James B Leonard, Kashif M Munir, Hong K Kim
Metoclopramide (MCP) is a commonly used anti-emetic in the emergency department (ED). Its use is generally well tolerated; although infrequent adverse reactions such as extrapyramidal reactions or tardive dyskinesia are reported. However, many ED providers are not familiar with the potentially life-threatening hypertensive emergency that can be precipitated by MCP administration in patients with pheochromocytoma. A previously healthy 36-year-old woman presented to the ED with headache and nausea. She developed acute hypertensive emergency (acute agitation, worsening headache, chest pain and wide complex tachycardia) when her blood pressure (BP) increased to 223/102mmHg (initial BP, 134/86mmHg) after receiving intravenous MCP...
March 5, 2018: American Journal of Emergency Medicine
John W Hayes, Daniel Gomez-Cardona, Ran Zhang, Ke Li, Juan Pablo Cruz-Bastida, Guang-Hong Chen
PURPOSE: Low signal correction (LSC) in the raw counts domain has been shown to effectively reduce noise streaks in CT because the data inconsistency associated with photon-starved regions may be mitigated prior to the log transformation step. However, a systematic study of the performance of these raw data correction methods is still missing in literature. The purpose of this work was to provide such a systematic study for two well-known low signal correction schemes using either the adaptive trimmed mean (ATM) filter or the anisotropic diffusion (AD) filter in the raw counts domain...
March 12, 2018: Medical Physics
D Yao, L Zhang, P L Wu, X L Gu, Y F Chen, L X Wang, X Y Huang
BACKGROUND: The primary pulmonary lymphoma (PPL), with a low incidence, was highly misdiagnosed in clinic. The present study analyzes the clinical features, laboratory and imaging data, pathologic characteristics, and summarizes misdiagnosis reasons of PPL cases, aims to provide a better understanding and increase the accuracy of early diagnosis and minimize the misdiagnosis of PPL. METHODS: The clinical data of 19 cases were collected from the first affiliated hospital of Wenzhou medical university (PRC) from April 2010 to May 2016...
March 12, 2018: BMC Cancer
Kate M Richmond, Katharine G Warburton, Simon J Finney, Sachin Shah, Benjamin A J Reddi
INTRODUCTION: Comprehensive clinical examination can be compromised in patients on veno-venous extracorporeal membrane oxygenation (VV-ECMO). Adjunctive diagnostic imaging strategies range from bedside imaging only to routine computed tomography (CT). The risk-benefit of either approach remains to be evaluated. Patients retrieved to the Royal Brompton Hospital (RBH) on VV-ECMO routinely undergo admission CT imaging of head, chest, abdomen and pelvis. This study aimed to identify how frequently changes in therapy or adverse events could be attributed to routine CT scanning...
March 1, 2018: Perfusion
Ray Y Chen, Laura E Via, Lori E Dodd, Gerhard Walzl, Stephanus T Malherbe, André G Loxton, Rodney Dawson, Robert J Wilkinson, Friedrich Thienemann, Michele Tameris, Mark Hatherill, Andreas H Diacon, Xin Liu, Jin Xing, Xiaowei Jin, Zhenya Ma, Shouguo Pan, Guolong Zhang, Qian Gao, Qi Jiang, Hong Zhu, Lili Liang, Hongfei Duan, Taeksun Song, David Alland, Michael Tartakovsky, Alex Rosenthal, Christopher Whalen, Michael Duvenhage, Ying Cai, Lisa C Goldfeder, Kriti Arora, Bronwyn Smith, Jill Winter, Clifton E Barry Iii
Background : By the early 1980s, tuberculosis treatment was shortened from 24 to 6 months, maintaining relapse rates of 1-2%. Subsequent trials attempting shorter durations have failed, with 4-month arms consistently having relapse rates of 15-20%. One trial shortened treatment only among those without baseline cavity on chest x-ray and whose month 2 sputum culture converted to negative. The 4-month arm relapse rate decreased to 7% but was still significantly worse than the 6-month arm (1.6%, P<0.01).  We hypothesize that PET/CT characteristics at baseline, PET/CT changes at one month, and markers of residual bacterial load will identify patients with tuberculosis who can be cured with 4 months (16 weeks) of standard treatment...
November 6, 2017: Gates Open Res
Morgan Schellenberg, Kenji Inaba, James M Bardes, Nicholas Orozco, Jessica Chen, Caroline Park, Tarina Kang, Demetrios Demetriades
BACKGROUND: Portable chest x-ray (CXR) and extended FAST (EFAST) screen patients for thoracic injury in the trauma bay. It is unclear if one test alone is sufficient, if both are required, or if the two investigations are complementary. Study objectives were to define the combined diagnostic yield of EFAST and CXR among stable blunt thoracic trauma patients and to determine if a normal EFAST and CXR might obviate the need for CT scan of the chest. METHODS: All blunt trauma patients ≥15 years presenting to LAC+USC Medical Center in 2016 were screened...
March 8, 2018: Journal of Trauma and Acute Care Surgery
Susan Yoong, Ravi Kothari, Adam Brooks
INTRODUCTION: Whole body computed tomography has become standard practice in many centres in the management of severely injured trauma patients, however, the evidence for it's diagnostic accuracy is limited. AIM: To assess the sensitivity of whole body CT in major trauma. METHOD: Retrospective review of all patients with injury severity score (ISS) > 15 presenting with blunt trauma to a UK Major Trauma Centre between May 2012 and April 2014...
March 8, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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