OBJECTIVE: To determine the frequency of HRCT findings and their distribution in the lung parench... more OBJECTIVE: To determine the frequency of HRCT findings and their distribution in the lung parenchyma of patients with organizing pneumonia. METHODS: This was a retrospective review of the HRCT scans of 36 adult patients (26 females and 10 males) with biopsy-proven organizing pneumonia. The patients were between 19 and 82 years of age (mean age, 56.2 years). The HRCT images were evaluated by two independent observers, discordant interpretations being resolved by consensus. RESULTS: The most common HRCT finding was that of ground-glass opacities, which were seen in 88.9% of the cases. The second most common finding was consolidation (in 83.3% of cases), followed by peribronchovascular opacities (in 52.8%), reticulation (in 38.9%), bronchiectasis (in 33.3%), interstitial nodules (in 27.8%), interlobular septal thickening (in 27.8%), perilobular pattern (in 22.2%), the reversed halo sign (in 16.7%), airspace nodules (in 11.1%), and the halo sign (in 8.3%). The lesions were predominantly...
Siglas e abreviaturas utilizadas neste trabalho TCAR -Tomografia computadorizada de alta resoluçã... more Siglas e abreviaturas utilizadas neste trabalho TCAR -Tomografia computadorizada de alta resolução TC -Tomografia computadorizada PA -Pressão arterial bronquiectasia, é importante o conhecimento dos achados que podem levar à suspeita desta doença.
Multiple cystic lung disease represents a diverse group of uncommon disorders that can present a ... more Multiple cystic lung disease represents a diverse group of uncommon disorders that can present a diagnostic challenge due to the increasing number of diseases associated with this presentation. High-resolution computed tomography of the chest helps to define the morphological aspects and distribution of lung cysts, as well as associated findings. The combination of appearance upon imaging and clinical features, together with extrapulmonary manifestations, when present, permits confident and accurate diagnosis of the majority of these diseases without recourse to open-lung biopsy. The main diseases in this group that are discussed in this review are lymphangioleiomyomatosis, pulmonary Langerhans cell histiocytosis and folliculin gene-associated syndrome (Birt-Hogg-Dubé); other rare causes of cystic lung disease, including cystic metastasis of sarcoma, are also discussed. Disease progression is unpredictable, and understanding of the complications of cystic lung disease and their appearance during evolution of the disease are essential for management. Correlation of disease evolution and clinical context with chest imaging findings provides important clues for defining the underlying nature of cystic lung disease, and guides diagnostic evaluation and management.
Silva ACG et al. Radiol Bras 2003;36(5):277282 277 tanto no seu habitat natural quanto em animais... more Silva ACG et al. Radiol Bras 2003;36(5):277282 277 tanto no seu habitat natural quanto em animais e humanos (1) .
A 47-year-old man presented with progressive dyspnoea and dry cough. He had a history of dilated ... more A 47-year-old man presented with progressive dyspnoea and dry cough. He had a history of dilated cardiomyopathy and ventricular tachyarrhythmia. The patient had been treated with placement of an implantable cardioverterdefibrillator and amiodarone (200 mg/day for two years). On chest auscultation, fine crackles were audible at the right lung base. Blood count and routine serum biochemistry test results were normal except for a slightly elevated alanine transaminase level (60 U/l). Chest X-ray and computed tomography (CT) demonstrated an enlarged heart, right pleural effusion, and hyperdense consolidation in the right lung ( figure 1). The liver parenchyma was also dense. figure 1. Axial (A) and coronal (B) computed tomographic images demonstrating increased heart volume, right pleural effusion, and peripheral hyperdense consolidation in the right lower lobe of the lung. Note also the hyperdensity of the liver (the liver is denser than the heart) and the presence of a cardioverter-defibrillator a b
The purpose of this study was to evaluate pulmonary manifestations of ankylosing spondylitis on i... more The purpose of this study was to evaluate pulmonary manifestations of ankylosing spondylitis on inspiratory and expiratory high resolution CT. The study included 17 patients ranging from 40 to 62 years in age. Fifteen patients were male, and 8 were smokers. All patients underwent chest radiography and high-resolution CT. High-resolution CT was obtained using 1 or 2 mm collimation scans at 10-mm intervals at the end of maximal inspiration and at 3 cm intervals at the end of maximal expiration. Pulmonary abnormalities were evident on chest radiography in 2 patients and on CT in 15 patients. The abnormalities on CT included evidence of airway disease in 14 (82%), interstitial abnormalities in 11 (65%), and emphysema in 6 (35%) patients. Airway abnormalities included bronchial wall thickening in 7 (41%), mosaic perfusion in 3 (18%), centrilobular nodules in 3, bronchiolectasis in 2, and air trapping on expiratory CT in 7 (41%) patients. Interstitial abnormalities included parenchymal ba...
Revista brasileira de cirurgia cardiovascular : órgão oficial da Sociedade Brasileira de Cirurgia Cardiovascular
To evaluate if the findings of multislice computed tomography (MSCT) are associated with clinical... more To evaluate if the findings of multislice computed tomography (MSCT) are associated with clinical and laboratory tests routinely used in the late follow-up of children undergoing surgical treatment of total anomalous pulmonary venous connection (TAPVC). From January 2002 to December 2007, 12 patients operated due to CATVP were evaluated with history, physical examination, chest X-ray, electrocardiogram, echocardiography and MSCT. Specific changes observed in each one of these tests were identified and compared with MSCT qualitative findings. Eleven patients were in functional class I (NYHA), three had nonspecific murmurs, and three were below the 15th percentile of weight and height. Two had pulmonary field abnormalities and three had a slight increase of the cardiac area in the X-ray examination. In the electrocardiogram, one patient had right ventricular overload and one had junctional rhythm. All echocardiograms were within the normal range, except for one patient with stenosis b...
Paracoccidioidomycosis (PCM) is the most common systemic mycosis in Latin America. Although most ... more Paracoccidioidomycosis (PCM) is the most common systemic mycosis in Latin America. Although most cases occur in developing countries, recent immigration patterns and an increase in travel have led to a growing number of PCM cases in the United States and Europe. PCM is caused by the dimorphic fungus Paracoccidioides brasiliensis, and the chronic form may progress to severe pulmonary involvement. Several radiologic patterns have been described for pulmonary PCM, including linear and reticular opacities, variable-sized nodules, patchy ill-defined opacities, airspace consolidation, and cavitary lesions. Fibrosis and paracicatricial emphysema are common associated findings. Chest computed tomography (CT) is the method of choice for evaluating pulmonary PCM, with the most common CT findings being ground-glass attenuation, consolidation, small or large nodules, masses, cavitations, interlobular septal thickening, emphysema, and fibrotic lesions. PCM is also an important cause of the "reversed halo" sign at high-resolution CT and should be considered in the differential diagnosis. Awareness of the multiple radiologic manifestations of PCM as well as its epidemiologic and clinical characteristics may permit early diagnosis and initiation of specific treatment, thereby reducing associated morbidity and mortality.
Objective: To investigate the clinical application of CT and CT-guided percutaneous transthoracic... more Objective: To investigate the clinical application of CT and CT-guided percutaneous transthoracic needle biopsy (CT-PTNB) in patients with indeterminate pulmonary nodules (IPNs). Methods: We retrospectively studied 113 patients with PNs undergoing CT and CT-PTNB. Variables such as gender, age at diagnosis, smoking status, CT findings, and CT-PTNB techniques were analyzed. Data analysis was performed with the Student's t-test for independent samples the chi-square test, and normal approximation test for comparison of two proportions. Results: Of the 113 patients studied, 68 (60.2%) were male and 78 (69%) were smokers. The diameter of malignant lesions ranged from 2.6 cm to 10.0 cm. Most of the IPNs (85%) were located in the peripheral region. The biopsied IPNs were found to be malignant in 88 patients (77.8%) and benign in 25 (22.2%). Adenocarcinoma was the most common malignant tumor, affecting older patients. The IPN diameter was significantly greater in patients with malignant PNs than in those with benign IPNs (p < 0.001). Having regular contour correlated significantly with an IPN being benign (p = 0.022), whereas spiculated IPNs and bosselated IPNs were more often malignant (in 50.7% and 28.7%, respectively). Homogeneous attenuation and necrosis were more common in patients with malignant lesions (51.9% and 26.9%, respectively) Conclusions: In our sample, CT and CT-PTNB were useful in distinguishing between malignant and benign IPNs. Advanced age and smoking were significantly associated with malignancy. Certain CT findings related to IPNs (larger diameter, spiculated borders, homogeneous attenuation, and necrosis) were associated with malignancy.
Magnetic resonance imaging (MRI) of the lung has progressed tremendously in recent years. Because... more Magnetic resonance imaging (MRI) of the lung has progressed tremendously in recent years. Because of improvements in speed and image quality, MRI is now ready for routine clinical use. The main advantage of MRI of the lung is its unique combination of structural and functional assessment in a single imaging session. We review the three major clinical indications for MRI of the lung: staging of lung tumors; evaluation of pulmonary vascular disease; and investigation of pulmonary abnormalities in patients who should not be exposed to radiation.
The purpose of this study was to identify the normal variance of emphysema index (EI) measured in... more The purpose of this study was to identify the normal variance of emphysema index (EI) measured in examinations acquired with 64 multidetector-row computed tomography (64-MDCT). A longitudinal, noninterventional study was performed retrieving all patients in our institution who are currently registered in our lung nodule protocol. All patients with clinical, functional, or significant radiological changes were excluded. We assumed that EI should remain unchanged within a short period of time. We reviewed 475 MDCTs in order to select 50 clinically stable patients who had two sequential chest MDCTs performed within a time interval of less than three months, and who presented at least one lung free of abnormalities but emphysema. CT densitovolumetry was used to calculate EI with thresholds set at -950 Hounsfield units (HUs) (EI-950) and -970 HUs (EI-970); on both studies from each patient. We observed the variation of total lung volume (TLV), mean lung density (MDL), and EI for measurements at the baseline and at follow-up scans. Differences observed between baseline and follow-up measurements were: TLV μ= 149 ml; IC = μ +1.96 (133); EI-950 μ = 0.02%; p 95 = 0.89%; EI-970 μ = 0.04%; p 95 = 0.23% and MLD μ = 15 HU; IC = μ +1.96 (18). The correlations obtained were the following: TLV r = 0.96, EI-950 r = 0.79, EI-970 r = 0.85. Accepting that emphysema would remain unchanged within three months on stable patients, differences of less than 0.89% for EI-950 and of less than 0.23% for EI-970 are within the variance of the method.
The aim of this study was to analyze chest CT scans of patients with thoracic textiloma. This was... more The aim of this study was to analyze chest CT scans of patients with thoracic textiloma. This was a retrospective study of 16 patients (11 men and 5 women) with surgically confirmed thoracic textiloma. The chest CT scans of those patients were evaluated by two independent observers, and discordant results were resolved by consensus. The majority (62.5%) of the textilomas were caused by previous heart surgery. The most common symptoms were chest pain (in 68.75%) and cough (in 56.25%). In all cases, the main tomographic finding was a mass with regular contours and borders that were well-defined or partially defined. Half of the textilomas occurred in the right hemithorax and half occurred in the left. The majority (56.25%) were located in the lower third of the lung. The diameter of the mass was ≤ 10 cm in 10 cases (62.5%) and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 10 cm in the remaining 6 cases (37.5%). Most (81.25%) of the textilomas were heterogeneous in density, with signs of calcification, gas, radiopaque marker, or sponge-like material. Peripheral expansion of the mass was observed in 12 (92.3%) of the 13 patients in whom a contrast agent was used. Intraoperatively, pleural involvement was observed in 14 cases (87.5%) and pericardial involvement was observed in 2 (12.5%). It is important to recognize the main tomographic aspects of thoracic textilomas in order to include this possibility in the differential diagnosis of chest pain and cough in patients with a history of heart or thoracic surgery, thus promoting the early identification and treatment of this postoperative complication.
Objetivo: Apresentar os aspectos na tomografia computadorizada da pneumonia pelo Rhodococcus equi... more Objetivo: Apresentar os aspectos na tomografia computadorizada da pneumonia pelo Rhodococcus equi em sete pacientes com síndrome da imunodeficiência adquirida. Métodos: Estudo retrospectivo das tomografias de sete pacientes com síndrome da imunodeficiência adquirida e infecção pelo Rhodococcus equi. Resultados: Os achados mais freqüentes foram: consolidação (n = 7) com escavação (n = 6), opacidades em vidro fosco (n = 6), nódulos do espaço aéreo (n = 4) e nódulos centrolobulares com árvore em brotamento (n = 3). Conclusão: Os achados mais comuns na infecção pulmonar pelo Rhodococcus equi em pacientes com síndrome da imunodeficiência adquirida foram as consolidações escavadas.
Unilateral pulmonary vein atresia is a rare congenital heart disease. Its symptoms begin to manif... more Unilateral pulmonary vein atresia is a rare congenital heart disease. Its symptoms begin to manifest in childhood and may be similar to those of other left-side heart obstructions. The diagnosis of this disorder is difficult and usually requires several imaging methods. This report presents the case of a 7-year-old girl whose diagnosis was aided through the use of multislice computed tomography.
A case report of left pericardial absence in a 12-year-old boy is described. The suspected diagno... more A case report of left pericardial absence in a 12-year-old boy is described. The suspected diagnosis was not shown either by cross-sectional echocardiography or angiography, but was correctly established by computed tomography (CT), showing the effectiveness of this diagnostic test for diagnosis of pericardial defects.
The advent of new prophylactic and treatment options has resulted in a considerable increase in t... more The advent of new prophylactic and treatment options has resulted in a considerable increase in the length of survival of HIV-infected patients. However, pulmonary parenchymal complications remain the main cause of morbidity and mortality in these patients [1]. Early ...
OBJECTIVE: To determine the frequency of HRCT findings and their distribution in the lung parench... more OBJECTIVE: To determine the frequency of HRCT findings and their distribution in the lung parenchyma of patients with organizing pneumonia. METHODS: This was a retrospective review of the HRCT scans of 36 adult patients (26 females and 10 males) with biopsy-proven organizing pneumonia. The patients were between 19 and 82 years of age (mean age, 56.2 years). The HRCT images were evaluated by two independent observers, discordant interpretations being resolved by consensus. RESULTS: The most common HRCT finding was that of ground-glass opacities, which were seen in 88.9% of the cases. The second most common finding was consolidation (in 83.3% of cases), followed by peribronchovascular opacities (in 52.8%), reticulation (in 38.9%), bronchiectasis (in 33.3%), interstitial nodules (in 27.8%), interlobular septal thickening (in 27.8%), perilobular pattern (in 22.2%), the reversed halo sign (in 16.7%), airspace nodules (in 11.1%), and the halo sign (in 8.3%). The lesions were predominantly...
Siglas e abreviaturas utilizadas neste trabalho TCAR -Tomografia computadorizada de alta resoluçã... more Siglas e abreviaturas utilizadas neste trabalho TCAR -Tomografia computadorizada de alta resolução TC -Tomografia computadorizada PA -Pressão arterial bronquiectasia, é importante o conhecimento dos achados que podem levar à suspeita desta doença.
Multiple cystic lung disease represents a diverse group of uncommon disorders that can present a ... more Multiple cystic lung disease represents a diverse group of uncommon disorders that can present a diagnostic challenge due to the increasing number of diseases associated with this presentation. High-resolution computed tomography of the chest helps to define the morphological aspects and distribution of lung cysts, as well as associated findings. The combination of appearance upon imaging and clinical features, together with extrapulmonary manifestations, when present, permits confident and accurate diagnosis of the majority of these diseases without recourse to open-lung biopsy. The main diseases in this group that are discussed in this review are lymphangioleiomyomatosis, pulmonary Langerhans cell histiocytosis and folliculin gene-associated syndrome (Birt-Hogg-Dubé); other rare causes of cystic lung disease, including cystic metastasis of sarcoma, are also discussed. Disease progression is unpredictable, and understanding of the complications of cystic lung disease and their appearance during evolution of the disease are essential for management. Correlation of disease evolution and clinical context with chest imaging findings provides important clues for defining the underlying nature of cystic lung disease, and guides diagnostic evaluation and management.
Silva ACG et al. Radiol Bras 2003;36(5):277282 277 tanto no seu habitat natural quanto em animais... more Silva ACG et al. Radiol Bras 2003;36(5):277282 277 tanto no seu habitat natural quanto em animais e humanos (1) .
A 47-year-old man presented with progressive dyspnoea and dry cough. He had a history of dilated ... more A 47-year-old man presented with progressive dyspnoea and dry cough. He had a history of dilated cardiomyopathy and ventricular tachyarrhythmia. The patient had been treated with placement of an implantable cardioverterdefibrillator and amiodarone (200 mg/day for two years). On chest auscultation, fine crackles were audible at the right lung base. Blood count and routine serum biochemistry test results were normal except for a slightly elevated alanine transaminase level (60 U/l). Chest X-ray and computed tomography (CT) demonstrated an enlarged heart, right pleural effusion, and hyperdense consolidation in the right lung ( figure 1). The liver parenchyma was also dense. figure 1. Axial (A) and coronal (B) computed tomographic images demonstrating increased heart volume, right pleural effusion, and peripheral hyperdense consolidation in the right lower lobe of the lung. Note also the hyperdensity of the liver (the liver is denser than the heart) and the presence of a cardioverter-defibrillator a b
The purpose of this study was to evaluate pulmonary manifestations of ankylosing spondylitis on i... more The purpose of this study was to evaluate pulmonary manifestations of ankylosing spondylitis on inspiratory and expiratory high resolution CT. The study included 17 patients ranging from 40 to 62 years in age. Fifteen patients were male, and 8 were smokers. All patients underwent chest radiography and high-resolution CT. High-resolution CT was obtained using 1 or 2 mm collimation scans at 10-mm intervals at the end of maximal inspiration and at 3 cm intervals at the end of maximal expiration. Pulmonary abnormalities were evident on chest radiography in 2 patients and on CT in 15 patients. The abnormalities on CT included evidence of airway disease in 14 (82%), interstitial abnormalities in 11 (65%), and emphysema in 6 (35%) patients. Airway abnormalities included bronchial wall thickening in 7 (41%), mosaic perfusion in 3 (18%), centrilobular nodules in 3, bronchiolectasis in 2, and air trapping on expiratory CT in 7 (41%) patients. Interstitial abnormalities included parenchymal ba...
Revista brasileira de cirurgia cardiovascular : órgão oficial da Sociedade Brasileira de Cirurgia Cardiovascular
To evaluate if the findings of multislice computed tomography (MSCT) are associated with clinical... more To evaluate if the findings of multislice computed tomography (MSCT) are associated with clinical and laboratory tests routinely used in the late follow-up of children undergoing surgical treatment of total anomalous pulmonary venous connection (TAPVC). From January 2002 to December 2007, 12 patients operated due to CATVP were evaluated with history, physical examination, chest X-ray, electrocardiogram, echocardiography and MSCT. Specific changes observed in each one of these tests were identified and compared with MSCT qualitative findings. Eleven patients were in functional class I (NYHA), three had nonspecific murmurs, and three were below the 15th percentile of weight and height. Two had pulmonary field abnormalities and three had a slight increase of the cardiac area in the X-ray examination. In the electrocardiogram, one patient had right ventricular overload and one had junctional rhythm. All echocardiograms were within the normal range, except for one patient with stenosis b...
Paracoccidioidomycosis (PCM) is the most common systemic mycosis in Latin America. Although most ... more Paracoccidioidomycosis (PCM) is the most common systemic mycosis in Latin America. Although most cases occur in developing countries, recent immigration patterns and an increase in travel have led to a growing number of PCM cases in the United States and Europe. PCM is caused by the dimorphic fungus Paracoccidioides brasiliensis, and the chronic form may progress to severe pulmonary involvement. Several radiologic patterns have been described for pulmonary PCM, including linear and reticular opacities, variable-sized nodules, patchy ill-defined opacities, airspace consolidation, and cavitary lesions. Fibrosis and paracicatricial emphysema are common associated findings. Chest computed tomography (CT) is the method of choice for evaluating pulmonary PCM, with the most common CT findings being ground-glass attenuation, consolidation, small or large nodules, masses, cavitations, interlobular septal thickening, emphysema, and fibrotic lesions. PCM is also an important cause of the &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;reversed halo&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; sign at high-resolution CT and should be considered in the differential diagnosis. Awareness of the multiple radiologic manifestations of PCM as well as its epidemiologic and clinical characteristics may permit early diagnosis and initiation of specific treatment, thereby reducing associated morbidity and mortality.
Objective: To investigate the clinical application of CT and CT-guided percutaneous transthoracic... more Objective: To investigate the clinical application of CT and CT-guided percutaneous transthoracic needle biopsy (CT-PTNB) in patients with indeterminate pulmonary nodules (IPNs). Methods: We retrospectively studied 113 patients with PNs undergoing CT and CT-PTNB. Variables such as gender, age at diagnosis, smoking status, CT findings, and CT-PTNB techniques were analyzed. Data analysis was performed with the Student's t-test for independent samples the chi-square test, and normal approximation test for comparison of two proportions. Results: Of the 113 patients studied, 68 (60.2%) were male and 78 (69%) were smokers. The diameter of malignant lesions ranged from 2.6 cm to 10.0 cm. Most of the IPNs (85%) were located in the peripheral region. The biopsied IPNs were found to be malignant in 88 patients (77.8%) and benign in 25 (22.2%). Adenocarcinoma was the most common malignant tumor, affecting older patients. The IPN diameter was significantly greater in patients with malignant PNs than in those with benign IPNs (p < 0.001). Having regular contour correlated significantly with an IPN being benign (p = 0.022), whereas spiculated IPNs and bosselated IPNs were more often malignant (in 50.7% and 28.7%, respectively). Homogeneous attenuation and necrosis were more common in patients with malignant lesions (51.9% and 26.9%, respectively) Conclusions: In our sample, CT and CT-PTNB were useful in distinguishing between malignant and benign IPNs. Advanced age and smoking were significantly associated with malignancy. Certain CT findings related to IPNs (larger diameter, spiculated borders, homogeneous attenuation, and necrosis) were associated with malignancy.
Magnetic resonance imaging (MRI) of the lung has progressed tremendously in recent years. Because... more Magnetic resonance imaging (MRI) of the lung has progressed tremendously in recent years. Because of improvements in speed and image quality, MRI is now ready for routine clinical use. The main advantage of MRI of the lung is its unique combination of structural and functional assessment in a single imaging session. We review the three major clinical indications for MRI of the lung: staging of lung tumors; evaluation of pulmonary vascular disease; and investigation of pulmonary abnormalities in patients who should not be exposed to radiation.
The purpose of this study was to identify the normal variance of emphysema index (EI) measured in... more The purpose of this study was to identify the normal variance of emphysema index (EI) measured in examinations acquired with 64 multidetector-row computed tomography (64-MDCT). A longitudinal, noninterventional study was performed retrieving all patients in our institution who are currently registered in our lung nodule protocol. All patients with clinical, functional, or significant radiological changes were excluded. We assumed that EI should remain unchanged within a short period of time. We reviewed 475 MDCTs in order to select 50 clinically stable patients who had two sequential chest MDCTs performed within a time interval of less than three months, and who presented at least one lung free of abnormalities but emphysema. CT densitovolumetry was used to calculate EI with thresholds set at -950 Hounsfield units (HUs) (EI-950) and -970 HUs (EI-970); on both studies from each patient. We observed the variation of total lung volume (TLV), mean lung density (MDL), and EI for measurements at the baseline and at follow-up scans. Differences observed between baseline and follow-up measurements were: TLV μ= 149 ml; IC = μ +1.96 (133); EI-950 μ = 0.02%; p 95 = 0.89%; EI-970 μ = 0.04%; p 95 = 0.23% and MLD μ = 15 HU; IC = μ +1.96 (18). The correlations obtained were the following: TLV r = 0.96, EI-950 r = 0.79, EI-970 r = 0.85. Accepting that emphysema would remain unchanged within three months on stable patients, differences of less than 0.89% for EI-950 and of less than 0.23% for EI-970 are within the variance of the method.
The aim of this study was to analyze chest CT scans of patients with thoracic textiloma. This was... more The aim of this study was to analyze chest CT scans of patients with thoracic textiloma. This was a retrospective study of 16 patients (11 men and 5 women) with surgically confirmed thoracic textiloma. The chest CT scans of those patients were evaluated by two independent observers, and discordant results were resolved by consensus. The majority (62.5%) of the textilomas were caused by previous heart surgery. The most common symptoms were chest pain (in 68.75%) and cough (in 56.25%). In all cases, the main tomographic finding was a mass with regular contours and borders that were well-defined or partially defined. Half of the textilomas occurred in the right hemithorax and half occurred in the left. The majority (56.25%) were located in the lower third of the lung. The diameter of the mass was ≤ 10 cm in 10 cases (62.5%) and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 10 cm in the remaining 6 cases (37.5%). Most (81.25%) of the textilomas were heterogeneous in density, with signs of calcification, gas, radiopaque marker, or sponge-like material. Peripheral expansion of the mass was observed in 12 (92.3%) of the 13 patients in whom a contrast agent was used. Intraoperatively, pleural involvement was observed in 14 cases (87.5%) and pericardial involvement was observed in 2 (12.5%). It is important to recognize the main tomographic aspects of thoracic textilomas in order to include this possibility in the differential diagnosis of chest pain and cough in patients with a history of heart or thoracic surgery, thus promoting the early identification and treatment of this postoperative complication.
Objetivo: Apresentar os aspectos na tomografia computadorizada da pneumonia pelo Rhodococcus equi... more Objetivo: Apresentar os aspectos na tomografia computadorizada da pneumonia pelo Rhodococcus equi em sete pacientes com síndrome da imunodeficiência adquirida. Métodos: Estudo retrospectivo das tomografias de sete pacientes com síndrome da imunodeficiência adquirida e infecção pelo Rhodococcus equi. Resultados: Os achados mais freqüentes foram: consolidação (n = 7) com escavação (n = 6), opacidades em vidro fosco (n = 6), nódulos do espaço aéreo (n = 4) e nódulos centrolobulares com árvore em brotamento (n = 3). Conclusão: Os achados mais comuns na infecção pulmonar pelo Rhodococcus equi em pacientes com síndrome da imunodeficiência adquirida foram as consolidações escavadas.
Unilateral pulmonary vein atresia is a rare congenital heart disease. Its symptoms begin to manif... more Unilateral pulmonary vein atresia is a rare congenital heart disease. Its symptoms begin to manifest in childhood and may be similar to those of other left-side heart obstructions. The diagnosis of this disorder is difficult and usually requires several imaging methods. This report presents the case of a 7-year-old girl whose diagnosis was aided through the use of multislice computed tomography.
A case report of left pericardial absence in a 12-year-old boy is described. The suspected diagno... more A case report of left pericardial absence in a 12-year-old boy is described. The suspected diagnosis was not shown either by cross-sectional echocardiography or angiography, but was correctly established by computed tomography (CT), showing the effectiveness of this diagnostic test for diagnosis of pericardial defects.
The advent of new prophylactic and treatment options has resulted in a considerable increase in t... more The advent of new prophylactic and treatment options has resulted in a considerable increase in the length of survival of HIV-infected patients. However, pulmonary parenchymal complications remain the main cause of morbidity and mortality in these patients [1]. Early ...
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