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Pulmonary imaging

Søren Hess, Evan C Frary, Oke Gerke, Poul Henning Madsen
Pulmonary embolism (PE) is a common, ubiquitous, and potentially lethal disease. As symptoms and clinical findings are notoriously nonspecific, diagnostic imaging is essential to avoid undertreatment as well as overtreatment. Controversies remain regarding first-line imaging in suspected PE. The two main contemporary contenders are ventilation/perfusion scintigraphy with single-photon emission computed tomography (V/Q SPECT) with or without additional low-dose CT (SPECT/CT) and CT angiography (CTA). We present our results from a systematic review and meta-analysis of the diagnostic performances of these modalities: V/Q SPECT, V/Q SPECT/CT, and CTA are all viable options, but we consider V/Q SPECT/CT to be superior in most clinical settings with better overall diagnostic performance, that is, pooled sensitivities (97...
October 20, 2016: Seminars in Thrombosis and Hemostasis
Mougnyan Cox, Manisha Patel, Zhenteng Li, Sarah Kamel, Sandeep Deshmukh, Christopher Roth, Laurence Needleman
Venous thromboembolism (VTE) is a serious common disorder with substantial cost and morbidity to society and can be life threatening in some cases. The majority of VTE is diagnosed on lower extremity ultrasound or CT pulmonary angiography, but some cases of deep venous thrombosis (DVT) may be occasionally diagnosed on CT of the abdomen and pelvis by the alert radiologist. The purpose of our study was to determine the fraction of new/unsuspected DVTs diagnosed on CTAP and the subsequent management and clinical course of these patients...
October 19, 2016: Emergency Radiology
Jui-Hung Hung, Ching Hsueh, Chiung-Ying Liao, Shang-Yun Ho, Yuan-Chun Huang
Pulmonary sclerosing hemangioma is an uncommon benign tumor of the lung; however, on rare occasions it can arise from the pulmonary hilar region. Herein, we report a 53-year-old female patient who presented with a round opacity in the right upper lung field on a radiograph. Chest computed tomography scanning revealed a 3.1 cm mass in the right pulmonary hilum. Thoracoscopic tumor excision was subsequently performed. On pathohistologic study, the tumor was well defined and composed of round stromal cells and surface cells arranged in a papillary, sclerotic, solid, and hemorrhagic pattern...
2016: Case Reports in Medicine
Evangelos Giannitsis, Hugo A Katus
BACKGROUND: Pulmonary embolism (PE) is associated with high all-cause and PE-related mortality and requires individualized management. After confirmation of PE, a refined risk stratification is particularly warranted among normotensive patients. Previous prognostic models favored combinations of echocardiography or computed tomography suggestive of right ventricular (RV) dysfunction together with biomarkers of RV dysfunction (natriuretic peptides) or myocardial injury (cardiac troponins) to identify candidates for thrombolysis or embolectomy...
October 19, 2016: Clinical Chemistry
Sebastien F Barre, David Haberthür, Tiziana P Cremona, Marco Stampanoni, Johannes C Schittny
The pulmonary airways are subdivided into conducting and gas-exchanging airways. The small tree of gas-exchanging airways which is fed by the most distal conducting airway represents an acinus. Very little is known about the development of the number of acini. The goal of this study was to estimate their number throughout rat postnatal development. Right middle rat lung lobes were obtained at postnatal day 4-60, stained with heavy metals, paraffin embedded, and scanned by synchrotron radiation based X-ray tomographic microscopy or imaged using micro computed tomography after critical point drying...
October 19, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
Wei Yu, Bo Ye, Liyun Xu, Zhaoyu Wang, Hanbo Le, Shanjun Wang, Hanbo Cao, Zhenda Chai, Zhijun Chen, Qingquan Luo, Yongkui Zhang
BACKGROUND: The solitary pulmonary nodule (SPN) is a common and challenging clinical problem, especially solid SPN. The object of this study was to explore the predictive factors of SPN appearing as pure solid with malignance and to establish a clinical prediction model of solid SPNs. METHODS: We had a retrospective review of 317 solid SPNs (group A) having a final diagnosis in the department of thoracic surgery, Shanghai Chest Hospital from January 2015 to December 2015, and analyzed their clinical data and computed tomography (CT) images, including age, gender, smoking history, family history of cancer, previous cancer history, diameter of nodule, nodule location (upper lobe or non-upper lobe, left or right), clear border, smooth margin, lobulation, spiculation, vascular convergence, pleural retraction sign, air bronchogram sign, vocule sign, cavity and calcification...
October 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Mark J Schuuring, Peter I Bonta, Michele van Vugt, Frank Smithuis, Otto M van Delden, Jouke T Annema, Kees Stijnis
A 44-year-old woman with a history of pulmonary embolism and abdominal echinococcosis complained of sudden thoracic pain and shortness of breath. A D-dimer of 77.5 mg/l (reference ≤0.5 mg/l) was found. Chest CT scan revealed obstruction of the right lower and middle lobe pulmonary artery (PA). Anticoagulation therapy was initiated for the presumed diagnosis of recurrent pulmonary embolism. However, due to persistent symptoms of dyspnea, follow-up CT angiography of the chest was performed 3 months later. A persistent PA obstruction was found and the presumed diagnosis of embolism was questioned...
October 20, 2016: Respiration; International Review of Thoracic Diseases
Ivo Roca, Nuria Rivas, Jaume Francisco, Jordi Perez, Gabriel Acosta, Gerard Oristrell, Maria Terricabres, David Garcia-Dorado, Angel Moya
BACKGROUND: Ablation in aortic cusps could be necessary in up to 15% of the patients, especially in para-Hisian atrial tachycardia and ventricular arrhythmias arising from outflow tracts. Risk of coronary damage has led to recommendation of systematic coronary angiography (CA) during the procedure. Other image tests as intravascular (ICE) or transesophageal echocardiography (TEE) have been proposed. Both methods have limitations: additional vascular access for ICE and needing for additional CA in some patients in case of TEE...
October 19, 2016: Journal of Cardiovascular Electrophysiology
Grzegorz Bauman, Francesco Santini, Orso Pusterla, Oliver Bieri
PURPOSE: To present a technique for simultaneous mapping of T1 , T2 , and relative spin density (M0 ) in human lung using inversion recovery ultra-fast steady-state free precession (IR-ufSSFP) imaging. METHODS: Pulmonary relaxometry with IR-ufSSFP is based on an interleaved time series acquisition of 2D images acquired at 1.5T. The technique was tested in a phantom and in four healthy volunteers using breath-hold and electrocardiogram triggering. Typically, 30 transient state images were acquired in a single breath-hold within < 10 s...
October 19, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Masateru Nagae, Yasuo Mikami, Kentaro Mizuno, Tomohisa Harada, Takumi Ikeda, Hitoshi Tonomura, Ryota Takatori, Hiroyoshi Fujiwara, Toshikazu Kubo
INTRODUCTION: Polymethylmethacrylate (PMMA) cement is useful for spinal reconstruction, but can cause complications including new vertebral fractures, neurological disorders and pulmonary embolism. We report a case in PMMA cement used for spinal reconstruction after tumor curettage dislodged and penetrated the gastrointestinal tract. DIAGNOSES: The patient was diagnosed with a retroperitoneal extragonadal germ cell tumor at age 27 years. After chemotherapy and tumor resection, the tumor remained...
October 2016: Medicine (Baltimore)
Zied Moatemri, Ghassen Soussi, Salsabil Dabboussi, Samira Mhamdi, Chiraz Aichaouia, Mohsen Khadraoui, Rezaik Cheikh
We report a case of thoracic sarcoidosis in a 72-year-old female, snuff taker, who presented with multinodular pulmonary lesions on chest x-ray. Clinical and biological findings were poor. Thoracic imaging showed soft tissue density nodules with irregular borders. The diagnosis of 'cannon ball' metastases was suspected. A thorough investigation strategy could not prove malignancy. A complete radiologic clearing was obtained spontaneously within three months. A rereading of pathology slides performed afterwards showed multinucleated giant cells on hemorrhagic background with a lymphocytic alveolitis...
October 7, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
Takashi Koide, Takeshi Saraya, Yayoi Tsukahara, Francesco Bonella, Eda Börner, Manabu Ishida, Yukari Ogawa, Ichiro Hirukawa, Miku Oda, Masafumi Shimoda, Kosuke Ohkuma, Masachika Fujiwara, Saori Takata, Takuma Yokoyama, Daisuke Kurai, Haruyuki Ishii, Hajime Goto, Hajime Takizawa
BACKGROUND: The galaxy sign is an irregularly marginated pulmonary nodule formed by a confluence of multiple small nodules, and it is a diagnostic radiological finding for pulmonary sarcoidosis. However, the clinical significance of the galaxy sign for sarcoidosis has been poorly investigated. OBJECTIVE: This study aimed to investigate the clinical significance and detailed radiological features of the galaxy sign in patients with pulmonary sarcoidosis. METHODS: We retrospectively reviewed 87 patients with biopsy-proven sarcoidosis and 108 patients with pulmonary tuberculosis...
October 7, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
Kayako Isohashi, Eku Shimosegawa, Sadahiro Naka, Yasukazu Kanai, Genki Horitsugi, Ikuko Mochida, Keiko Matsunaga, Tadashi Watabe, Hiroki Kato, Mitsuaki Tatsumi, Jun Hatazawa
BACKGROUND: In boron neutron capture therapy (BNCT), positron emission tomography (PET) with 4-borono-2-(18)F-fluoro-phenylalanine (FBPA) is the only method to estimate an accumulation of (10)B to target tumor and surrounding normal tissue after administering (10)B carrier of L-paraboronophenylalanine and to search the indication of BNCT for individual patient. Absolute concentration of (10)B in tumor has been estimated by multiplying (10)B concentration in blood during BNCT by tumor to blood radioactivity (T/B) ratio derived from FBPA PET...
December 2016: EJNMMI Research
Agne Ulyte, Nomeda Valeviciene, Darius Palionis, Simona Kundrotaite, Algirdas Tamosiunas
OBJECTIVE: In cardiac magnetic resonance imaging (CMR), incidental pathological findings are frequently found outside the investigated cardiovascular system. Some of these findings might have clinical implications. The aim of this study was to determine the prevalence of incidental extracardiac findings (ECF) in CMR and their clinical significance. METHODS: A total of 4165 CMR reports from 2009-2012 were retrospectively reviewed for ECF. Two hundred-twenty reports with ECF were found...
September 22, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Cai-Hua Wang, Chuan-Cai Xu, Jun-Hong Jiang, Yan-Bin Chen, Sheng-Hua Zhan
Primary pulmonary synovial sarcoma (PPSS) is a rare disease. Diagnosis is made postoperatively following resection of the tumor. We describe the case of a 39-year-old non-smoking woman whose chest imaging revealed a heterogeneous mass (5.4 cm × 4.6 cm), with soft tissue density in the right upper lobe and pleural effusion in the right hemithorax. The tumor was enhanced on a computed tomography scan, in which enlargement of the mediastinal lymph nodes compressing the adjacent superior vena cava was observed...
September 10, 2016: Thoracic Cancer
Lijian Huang, Lufeng Zhao, Hu Tang, Ying Chai
Left bronchial isomerism is a rare condition characterized by a bronchial structure on the right side that is a mirror image of the left side. In this report, we record our experience with a 62-year-old female lung cancer patient in whom left bronchial isomerism was discovered during surgery using a thoracoscope. A right upper pulmonary lobectomy was successfully completed, the key to which was successful separation of the right upper and middle lobes. As there is a risk of excising the wrong bronchi in such cases, thoracic surgeons need to identify bronchus variations...
October 17, 2016: Thoracic Cancer
Tadeusz Płusa
Sarcoidosis is a systemic disease of unknown initiating factor. In the pathogenesis of the disease it emphasizes the importance of genetic factors, specificity of inflammation and toll-like receptors. No less important cell in the development of lesions is fibrocyte, which creates the final image of the disease in the form of fibrosis of the lung parenchyma. Data from experimental and clinical studies indicate that the progenitor cell can turn into fibrocyte. This indicates the possibility of controlling the process, which is already implemented in practice in Lung Institute in Pittsburgh, USA...
September 29, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Pratik Naik, Laura Cashin, Sonny Huitron
Foreign body granulomatosis is a rare complication of intravenous injection of pulverized oral prescription tablets. We present the case of an active duty male who was ultimately diagnosed with foreign body granulomatosis caused by the crushing and intravenous injection of acetaminophen with oxycodone (Percocet). The 24-year-old patient initially presented with multiple syncopal episodes, hemoptysis and hypoxia. The patient presentation and imaging findings involved in foreign body granulomatosis can mimic many pulmonary disorders and can be widely variable...
October 2016: Military Medicine
Fatemeh Nooshabadi, Hee-Jeong Yang, Yunfeng Cheng, Madeleine S Durkee, Hexin Xie, Jianghong Rao, Jeffrey D Cirillo, Kristen C Maitland
Tuberculosis is a pulmonary disease with an especially high mortality rate in immuno-compromised populations, specifically children and HIV positive individuals. The causative agent, Mycobacterium tuberculosis (Mtb), is a very slow growing and difficult organism to work with, making both diagnosis and development of effective treatments cumbersome. We utilize a fiber-optic fluorescence microendoscope integrated with a whole-body imaging system for in vivo Mtb detection. The system exploits an endogenous enzyme of Mtb (β-lactamase, or BlaC) using a BlaC-specific NIR fluorogenic substrate...
October 18, 2016: Journal of Biophotonics
Claire W Michael, Rana S Hoda, Anjali Saqi, Jordan Kazakov, Tarik Elsheikh, Nami Azar, N Paul Ohori
The Papanicolaou Society of Cytopathology has developed a set of guidelines for pulmonary cytology including indications for bronchial brushings, washings and endobronchial ultrasound-guided fine needle aspiration, technical recommendations for cytologic sampling, recommended terminology and classification scheme, recommendations for ancillary testing and recommendations for postcytologic diagnosis management and follow-up. All recommendation documents are based on the expertise of the authors, extensive literature review and feedback from presentations at national and international conferences...
October 18, 2016: Diagnostic Cytopathology
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