Analysis of Granulomatous Lymphocytic Interstitial Lung Disease Using Two Scoring Systems for Computed Tomography Scans-A Retrospective Cohort Study.

Background: Granulomatous lymphocytic interstitial lung disease (GLILD) is present in about 20% of patients with common variable immunodeficiency disorders (CVID). GLILD is characterized by nodules, reticulation, and ground-glass opacities on CT scans. To date, large cohort studies that include sensitive CT outcome measures are lacking, and severity of structural lung disease remains unknown.

Reliability of diagnosing incidental pulmonary embolism in cancer patients.

Background: With the routine use of advanced multi-slice CT scanners, pulmonary embolism (PE) is increasingly detected as an incidental finding among cancer patients. Although this generally leads to therapeutic interventions, the accuracy of diagnosing PE on routinely performed contrast enhanced CT scans is unknown.

Methods: Consecutive cancer patients diagnosed with incidental PE were eligible for inclusion.

Bone suppression increases the visibility of invasive pulmonary aspergillosis in chest radiographs.

Objective: Chest radiographs (CXR) are an important diagnostic tool for the detection of invasive pulmonary aspergillosis (IPA) in critically ill patients, but their diagnostic value is limited by a poor sensitivity. By using advanced image processing, the aim of this study was to increase the value of chest radiographs in the diagnostic work up of neutropenic patients who are suspected of IPA.

Methods: The frontal CXRs of 105 suspected cases of IPA were collected from four institutions.

Cardiothoracic CT: one-stop-shop procedure? Impact on the management of acute pulmonary embolism.

In the treatment of pulmonary embolism (PE) two groups of patients are traditionally identified, namely the hemodynamically stable and instable groups. However, in the large group of normotensive patients with PE, there seems to be a subgroup of patients with an increased risk of an adverse outcome, which might benefit from more aggressive therapy than the current standard therapy with anticoagulants. Risk stratification is a commonly used method to define subgroups of patients with either a high or low risk of an adverse outcome.

Pulmonary pathology of pandemic influenza A/H1N1 virus (2009)-infected ferrets upon longitudinal evaluation by computed tomography.

We investigated the development of pulmonary lesions in ferrets by means of computed tomography (CT) following infection with the 2009 pandemic A/H1N1 influenza virus and compared the scans with gross pathology, histopathology and immunohistochemistry. Ground-glass opacities observed by CT scanning in all infected lungs corresponded to areas of alveolar oedema at necropsy. These areas were most pronounced on day 3 and gradually decreased from days 4 to 7 post-infection.

Imaging of acute pulmonary embolism using multi-detector CT angiography: an update on imaging technique and interpretation.

Computed tomography angiography (CTA) of the pulmonary arteries has become the main diagnostic test for the evaluation of pulmonary embolism (PE). Not only due to the good availability, low cost and minimal invasiveness of this technique, but mainly because of the introduction of multi-detector CT techniques resulting in significant improvement in resolution, speed and image quality. This continuous gain in image acquisition speed went along with the introduction of new techniques of image acquisition, such as the dual-source CT scanning and novel concepts of image interpretation beyond morphological findings including the definition of the resulting perfusion defects and assessment of the cardiopulmonary circulation as a functional unit.

Cystic fibrosis: are volumetric ultra-low-dose expiratory CT scans sufficient for monitoring related lung disease?

Purpose: To assess whether chest computed tomography (CT) scores from ultra-low-dose end-expiratory scans alone could suffice for assessment of all cystic fibrosis (CF)-related structural lung abnormalities.

Materials And Methods: In this institutional review board-approved study, 20 patients with CF aged 6-20 years (eight males, 12 females) underwent low-dose end-inspiratory CT and ultra-low-dose end-expiratory CT. Informed consent was obtained.

Ectopic origin of bronchial arteries: assessment with multidetector helical CT angiography.

The purpose of this study was to determine non-invasively the frequency of ectopic bronchial arteries (BA) (i.e., bronchial arteries originating at a level of the descending aorta other than T5-T6 or from any aortic collateral vessel) on multidetector-row CT angiograms (CTA) obtained in patients with hemoptysis.

Right ventricular dysfunction and pulmonary obstruction index at helical CT: prediction of clinical outcome during 3-month follow-up in patients with acute pulmonary embolism.

Purpose: To retrospectively quantify right ventricular dysfunction (RVD) and the pulmonary artery obstruction index at helical computed tomography (CT) on the basis of various criteria proposed in the literature and to assess the predictive value of these CT parameters for mortality within 3 months after the initial diagnosis of pulmonary embolism (PE).

Materials And Methods: Institutional review board approval was obtained, and informed consent was not required for retrospective study. In 120 consecutive patients (55 men, 65 women; mean age +/- standard deviation, 59 years +/- 18) with proved PE, two readers assessed the extent of RVD by quantifying the ratio of the right ventricle to left ventricle short-axis diameters (RV/LV) and the pulmonary artery to ascending aorta diameters, the shape of the interventricular septum, and the extent of obstruction to the pulmonary artery circulation on helical CT images, which were blinded for clinical outcome in consensus reading.

Comparison of observer variability and accuracy of different criteria for lung scan interpretation.

Unlabelled: Different criteria have been advocated for the interpretation of ventilation/perfusion (V/Q) lung scans in patients with suspected pulmonary embolism (PE). Besides these predefined criteria, many physicians use an integration of the different sets of criteria and their own experience-the so-called Gestalt interpretation. The purpose of this study was to evaluate interobserver variability and accuracy of 3 sets of criteria: the Hull and PIOPED (Prospective Investigation of Pulmonary Embolism Diagnosis) criteria and the Gestalt interpretation.

How to use a gestalt interpretation for ventilation-perfusion lung scintigraphy.

Unlabelled: The use of a so-called gestalt interpretation, an integration of different sets of criteria and the physician's own experience, has been advocated in the interpretation of lung scintigraphs of patients with clinically suspected pulmonary embolism. However, data on the reliability of this approach are limited. The aim of this study was to investigate the observer variability and accuracy of the gestalt interpretation of perfusion scintigraphy (combined with chest radiography) as well as the impact of adding ventilation scintigraphy and clinical pretest information.

Optimal scan delay in spiral CT for the diagnosis of acute pulmonary embolism.

Purpose: The purpose of this work was to assess whether easily obtained clinical parameters can predict optimal scan delay for contrast-enhanced spiral CT of pulmonary arteries and to compare image quality between individualized contrast timing versus a fixed scan delay.

Method: We used an individualized delay in 85 patients by measuring the contrast transit time through the pulmonary circulation (Group A) and assessed the correlation between transit time and clinical parameters. In 56 patients (Group B), we used a 20 s fixed scan delay.