Some noticeable problems in the radiological diagnosis of thoracic sarcoidosis / 中华放射学杂志

Objective To discuss the noticeable problems in the radiological diagnosis of thoracic sarcoidosis through retrospective analysis of misdiagnosis. Methods Imaging examinations of 32 misdiagnosed cases with thoracic sarcoidosis including chest radiography, CT, and their clinical data were reviewed. The final diagnosis was made by pathology (9 cases) and clinical therapy (23 cases). Results Enlarged thoracic lymph nodes were detected in all cases. 23 of them presented mediastinal lymph node enlargement associated with bilateral hilar lymph node enlargement, 5 of them had mediastinal lymph node enlargement and unilateral hilar lymph node enlargement, and 4 of them had mediastinal lymph node enlargement without hilar lymph node enlargement. In these cases, 24 had pulmonary abnormalities. 19 of them showed multiple pulmonary nodes, 4 of them had patchy pulmonary shadows, and another 1 had pulmonary fibrosis. Pleural lesions included 2 hydrothorax and 1 multiple pleural nodes, and all of pleural lesions were associated with multiple pulmonary nodes. Conclusion When the radiological findings of thoracic sarcoidosis are atypical, the diagnosis is difficult and must combine with the clinical findings, or the outcome of the treatment.

Acute pulmonary embolism: some noticeable unenhanced CT imaging signs / 中华放射学杂志

Objective To describe some unenhanced spiral CT imaging signs that can clue to acute pulmonary embolism.Methods By retrospectively analyzing spiral CT imaging of acute pulmonary embolism proved by clinical treatment in 49 cases, some noticeable abnormal imaging signs were found.Results Among the 49 cases, 10 cases had abnormal attenuation changes in the pulmonary arteries, 6 of them had local high-attenuation centrally and 4 of them had local low-attenuation centrally.Conclusion The final diagnosis of acute pulmonary embolism depends on enhanced CT scan.But for cases that they could not use contrast media or cases that they only underwent unenhanced CT because of nonspecific heart-pulmonary symptom, abnormal attenuation changes of pulmonary arteries can clue to acute pulmonary embolism.