Healed Varicella Pneumonia: A Case of Diffuse Pulmonary Microcalcifications.

Varicella pneumonia is a potentially fatal complication of the Varicella-zoster virus (VZV), which causes the well-known chickenpox disease of childhood. Identifying this type of pneumonia by characteristic features is important for radiologists and radiology residents. Typical manifestations of active Varicella pneumonia include diffuse pulmonary nodules, which may mimic other diseases. Healed Varicella pneumonia can present as diffuse, calcified pulmonary micronodules. We describe a case of healed Varicella pneumonia in a patient with a history of remote VZV infection.

Giant Right Coronary Ostial Aneurysm in a Patient With Marfan Syndrome.

Aortic root dilation and aortic insufficiency are prominent causes of morbidity in Marfan syndrome. These pathologies necessitate surgical repair, including aortic root and aortic valve replacement procedures, to improve prognosis. Coronary artery aneurysms, particularly giant coronary ostial aneurysms, are rare complications of these surgeries in the Marfan population. Due to the significant life-threatening sequelae of coronary artery aneurysms, it is imperative to bring attention regarding this complication to the radiologist assessing thoracic imaging in this patient population.

Diffusion Weighted Imaging in Unilateral Adrenal Infarction: A Case of Colicky Right Upper Quadrant Pain in a Pregnant Female.

Diffusion weighted imaging (DWI) is a magnetic resonance imaging (MRI) non-contrast sequence that can indicate tissue ischemia or infarction. Adrenal infarct may present similarly to biliary or gallbladder pathologies, and the differential diagnosis during emergency work-up can be narrowed utilizing DWI sequences. In this paper, we describe the usefulness of DWI for urgent diagnosis in a case of non-hemorrhagic adrenal infarct of a pregnant female presenting with right upper quadrant pain. Although uncommon, adrenal infarct may occur in patients with hypercoagulability and localizing pain that is unexplained by other imaging modalities. We outline the imaging features of DWI in evaluating adrenal infarct as a safe and time effective application for patients with contraindications to imaging with ionizing radiation.

Endobronchial Tuberculosis and Bronchostenosis: A Rare Case of Bronchial Occlusion in a Patient With History of Tuberculosis.

Pulmonary tuberculosis is common worldwide, and many of these patients develop endobronchial tuberculosis (EBTB). Bronchostenosis is a known complication of EBTB though most patients with endobronchial stenosis do not develop severe bronchostenosis or occlusion. We present a rare case of a patient with a right upper lobe bronchus occlusion and a history of tuberculosis.

Against the Odds: A Novel Technique to Perform Cholangiography from a Percutaneous Approach through the Cystic Duct.

Percutaneous cholangiography is typically performed via a transhepatic approach and is reserved for patients with contraindications to traditional cholangiogram imaging modalities. For those with suspected cholelithiasis or choledocholithiasis who cannot undergo magnetic resonance imaging for diagnosis, percutaneous cholecystostomy with cholangiogram is a viable option. Endoscopic retrograde cholangiopancreatography may also be precluded due to anatomic or obstructive limitations, in which case, percutaneous transhepatic cholangiography (PTC) may be indicated for diagnosis. PTC may be difficult in a patient with minimal biliary tree dilatation, or tortuous cystic duct anatomy. In cases such as these, a steerable microcatheter (SMC) may be utilized to enable or expedite PTC. The technique to traverse and catheterize the cystic duct and opacify the gallbladder, bile ducts, and duodenum utilizing an SMC is described. This report outlines a non-vascular application of the SMC resulting in a successful cholangiogram, with reduced operative time and thus reduced radiation exposure to the patient.