Azygos Continuation of the Inferior Vena Cava: Potential for Misdiagnosis as Lung Neoplasm.

Background: The azygos venous system is an accessory venous pathway supplying an important collateral circulation between the superior and inferior vena cava (IVC).

Case Summary: We report a case of complicated community-acquired pneumonia with interruption of the IVC with azygos continuation that was misdiagnosed as lung neoplasm.

Discussion: The aim of this case report is to emphasize the importance of recognizing an enlarged azygos vein at the confluence with the superior vena cava and in the retrocrural space to avoid misdiagnosis as a right-sided para-tracheal mass.

Pulmonary hamartomas: CT pixel analysis for fat attenuation using radiologic-pathologic correlation.

Introduction: To assess the accuracy of CT pixel analysis for fat attenuation in pulmonary hamartomas.

Methods: Retrospective review identified 32 patients in three separate groups; pathologically proven hamartoma (n = 11), hamartoma diagnosed on imaging (n = 9) and a control group (n = 14) of pathology-proven non-hamartomatous smoothly marginated solitary pulmonary nodules. All lesions were assessed using: visual assessment for fat, pixel analysis of the inner 2/3rds and mean attenuation of the entire lesion, using an internal reference for fat.

Reexpansion pulmonary edema: computed tomography findings in 22 patients.

Purpose: To determine the computed tomography (CT) imaging features of reexpansion pulmonary edema.

Materials And Methods: A retrospective review was performed of 22 consecutive patients with clinical and radiologic features consistent with reexpansion pulmonary edema (14 male, 8 female; mean age, 56±22.8 y; range, 19 to 82 y) and with available CT scan images within 3 days of drainage of pleural effusion or pneumothorax.

Image quality in low-dose multidetector computed tomography: a pilot study to assess feasibility and dose optimization in whole-body bone imaging.

Objective: To study the impact of dose parameters on image quality at whole-body low-dose multidetector computed tomography (CT) in an attempt to derive parameters that allow diagnostic quality images of the skeletal system without incurring significant radiation dose in patients referred for investigation of plasma cell dyscrasias.

Methods: By using a single cadaver, 14 different whole-body low-dose CT protocols were individually assessed by 2 radiologists, blinded to acquisition parameters (kVp and mAs, reconstruction algorithm, dose reduction software). Combinations of kVps that range from 80-140 kVp, and tube current time product from 14-125 mAs were individually scored by using a Likert scale from 1-5 in 4 separate anatomical areas (skull base, thoracic spine, pelvis, and distal femora).

Perifissural nodules seen at CT screening for lung cancer.

Purpose: To describe and characterize the potential for malignancy of noncalcified lung nodules adjacent to fissures that are often found in current or former heavy smokers who undergo computed tomography (CT) for lung cancer screening.

Materials And Methods: Institutional review board approval and informed consent were obtained. Baseline and follow-up thin-section multidetector CT scans obtained in 146 consecutive subjects at high risk for lung cancer (age range, 50-75 years; > 30 pack-year smoking history) were retrospectively reviewed.

Single coronary artery from the right aortic sinus of Valsalva with anomalous prepulmonic course of the left coronary artery.

Cardiac computed tomography allows for improved, noninvasive and accurate visualization of coronary artery anomalies. The case of a single coronary artery with origin from a single ostium in the right sinus of Valsalva with an anomalous course of the left coronary artery anterior to the pulmonary trunk is presented. The unusual distal reconstitution of a normal anatomical course at the junction of the mid and distal left anterior descending artery with occlusion of the proximal circumflex artery has not, to the authors' knowledge, been previously described.

Whole-Body MRI versus PET in assessment of multiple myeloma disease activity.

Objective: The purpose of this study was to compare FDG PET; whole-body MRI; and the reference standard, bone marrow aspiration and biopsy, to determine the best imaging technique for assessment of disease activity in multiple myeloma.

Subjects And Methods: Twenty-four patients (13 women, 11 men; mean age, 67.1 years; range, 44-83 years) with bone marrow biopsy-proven multiple myeloma were included in the study.

Steady-state free-precession (SSFP) cine MRI in distinguishing normal and bicuspid aortic valves.

Purpose: To assess the diagnostic sensitivity and specificity of double-oblique true fast imaging with steady-state precession (SSFP) cine MRI in distinguishing normal and bicuspid aortic valves.

Materials And Methods: Echocardiograms on patients referred for MRI of the heart and thoracic aorta over a four-year period were reviewed retrospectively. A total of 17 patients with bicuspid aortic valve were identified and compared to 21 randomly chosen control patients.

Coronal oblique turbo STIR imaging of the sacrum and sacroiliac joints at routine MR imaging of the lumbar spine.

The objective of the study was to evaluate the clinical impact of coronal oblique imaging of the lumbrosacral junction and the sacrum at initial presentation for MR imaging of the lumbar spine in patients presenting with low back pain or sciatic pain. Two hundred and sixty consecutive patients attending for MRI of the lumbar spine underwent simultaneous coronal oblique turbo short tau inversion recovery (STIR; TR 2500, TE 40, TI 150, echo train length 7, number of scan acquisitions 2) imaging of the sacrum and the sacroiliac joints with a field of view of 30-cm and 3-mm slices (acquisition time 3 min and 20 s). Images were reviewed by two experienced radiologists to determine the cause of back pain, with and without images of the sacrum and sacroiliac joints.