Acute eosinophilic pneumonia: radiologic and clinical features.

PURPOSE: To determine the radiographic and computed tomographic (CT) characteristics of acute eosinophilic pneumonia. MATERIALS AND METHODS: Twelve consecutive patients with acute eosinophilic pneumonia were included in the study. The diagnosis was based on clinical symptoms and results of bronchoalveolar lavage. Plain chest radiographs were obtained in all patients; CT scans were obtained in three patients. Two thoracic radiologists reviewed the radiographs and CT scans. RESULTS: Ten patients had bilateral areas of air-space opacity on images obtained at presentation; in seven of these patients, interstitial areas of opacity were also present. Two patients had bilateral interstitial areas of opacity and no areas of air-space opacity. Interlobular septal thickening and ground-glass attenuation were present on CT scans in two patients; patchy bilateral consolidation was present on CT scans in one patient. Pleural effusion was present on radiographs in seven patients (58%) and was bilateral in five. Pleural effusion was present at some point during the course of disease in all patients. In all patients, air-space disease markedly improved within 3 days of initiation of treatment with corticosteroids. CONCLUSION: Acute eosinophilic pneumonia should be considered as a possible diagnosis when a previously healthy person presents with acute respiratory failure of unknown origin.

Acute eosinophilic pneumonia. A summary of 15 cases and review of the literature.

Idiopathic acute eosinophilic pneumonia (AEP) is an acute febrile illness that may be mistaken for an infectious pneumonia. Patients are often young and otherwise healthy. Clues to considering this disorder in a differential diagnosis include the acuity and severity of the clinical presentation and an initial chest X-ray with diffuse infiltrates, often interstitial, and the presence of Kerley B lines and/or evidence of pleural fluid. The diagnosis can be made through examination of bronchoalveolar lavage fluid in most cases, with careful exclusion of other similar eosinophilic lung disease. Although it can lead to life-threatening respiratory failure, AEP is easily treatable with corticosteroids. This disease has not been reported to recur in any patients to this point.

Tumors of the osseous spine: staging with MR imaging versus CT.

Twelve patients with tumors involving the osseous spine were evaluated with magnetic resonance (MR) imaging and computed tomography (CT), six with and six without intrathecal injection of contrast material. MR imaging was found to be superior to CT without contrast material and equal to CT with contrast material in delineating the anatomic relationships of the tumors, including bone involvement, spinal canal invasion, paraspinal soft-tissue extension, and vascular involvement. Since MR imaging can provide most of the anatomic information necessary for treatment planning, intrathecal injection of contrast material can be avoided in most instances when evaluating tumor involvement of the osseous spine. However, CT without contrast medium was superior to MR imaging in showing critical cortical bone destruction and calcified tumor matrix.

The knee: surface-coil MR imaging at 1.5 T1.

Seven normal knees (in five volunteers) and seven injured knees (in seven patients) were examined by high-resolution magnetic resonance (MR) imaging at 1.5 T with a surface coil. Seven medial meniscal tears, three anterior cruciate ligament tears, one posterior cruciate ligament avulsion, an old osteochondral fracture, femoral condylar chondromalacia, and one case of semimembranous tendon reinsertion were identified. MR images correlated well with recent double-contrast arthrograms or results of surgery. All tears were identified in both the sagittal and coronal planes. Because of its ability to demonstrate small meniscal lesions and ligamentous injuries readily, MR imaging with a surface coil may eventually replace the more invasive arthrography.

Intestinal transit time is delayed by artificial sphincters after massive enterectomy in dogs.

Artificial sphincters were created in three groups of dogs after the resection of 87.5 percent of the intestine in each animal. Intestinal transit time was measured after 6 weeks by observing the passage of a radiopaque medium through the animals' intestinal tracts. No statistically significant differences were found between the intestinal transit times of dogs with one artificial sphincter and control animals. In dogs with two artificial sphincters there was a delay in the radiologically monitored intestinal transit time that was statistically significant compared with that of the control group.

Meniscal tears: MR demonstration of experimentally produced injuries.

Magnetic resonance (MR) imaging was performed using a 1.5-T magnet on eight immature swine knees with surgically produced vertical and horizontal meniscal tears. Three radiologists, interpreting the images independently, detected all tears. Tears in the middle portion of the meniscus were best seen on sagittal views, while lesions of the anterior and posterior horns of the meniscus were best seen on coronal views. MR has several advantages over arthrography, the current diagnostic method for knee injuries: it is noninvasive, uses no ionizing radiation, and provides excellent soft-tissue contrast resolution.

Joint effusions: MR imaging.

Magnetic resonance (MR) images of the hips and knees of three healthy volunteers were reviewed and compared with images obtained from the hips of three patients with effusions. Comparison was also made with MR images obtained from two swine knees following the injections of saline in one and blood in the other. The anatomy of the knees and hips was well defined. The hip effusions were all easily recognized. MR images of the swine knees clearly demonstrated the experimentally produced joint effusions. The hip effusions and the experimentally introduced blood and saline all had long T1 and T2 values allowing easy differentiation from articular cartilage. We were unable to distinguish fresh blood from saline in the knee joints.

Posterior gastric artery and its significance as seen in angiograms.

The posterior gastric artery was detected angiographically in 46 or 100 patients (46 percent). The importance of radiologic detection of the presence or absence of this artery is emphasized, especially in surgical procedures related to the stomach and immediately adjacent structures.