ABSTRACT
AIM: To analyse the morphological characteristics of the reversed halo sign (RHS) on unenhanced chest computed tomography (CT), which raise suspicion of pulmonary infarction (PI) associated with pulmonary embolism (PE), and to compare these characteristics with those observed in the RHS caused by other diseases. MATERIAL AND METHODS: CT images of 145 patients (250 RHSs) were reviewed retrospectively. Sixty-four patients had the RHS due to PI; in 81 immunocompetent patients, the RHS was caused by alternative pulmonary diseases. All PIs secondary to PE were confirmed at CT angiography. Other diagnoses were confirmed using published criteria. Two independent thoracic radiologists, who were blinded patient demographics, clinical data, and final diagnoses, analysed the morphological CT features of the RHSs. RESULTS: Seventy-four RHSs were found in the PI group and 176 RHSs in the group of other diseases. Single RHSs were associated more frequently with PI compared with the group without PIs; three or more lesions were seen only in patients with other diseases. Low-attenuation areas inside the RHS, with or without reticulation, were observed in 94.59% of PI-associated lesions, and in no patient in the group without PI (p<0.001). Subpleural involvement (p<0.001) and lower-lung predominance (p=0.001) were also associated more frequently with PI. Pleural effusion was observed in 64.06% of patients with PI and in only 6.17% of those with other diseases (p<0.001). CONCLUSIONS: A single RHS with low-attenuation areas inside the halo, with or without reticulation, is highly suggestive of PI. Lower-lung predominance and pleural effusion also suggest PI.
Subject(s)
Pulmonary Infarction/diagnostic imaging , Tomography, X-Ray Computed/methods , Adult , Contrast Media , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Pulmonary Embolism/diagnostic imaging , Radiographic Image Interpretation, Computer-Assisted , Radiography, Thoracic , Retrospective StudiesSubject(s)
Acute Lung Injury/chemically induced , Amiodarone/adverse effects , Anti-Arrhythmia Agents/adverse effects , Tachycardia, Ventricular/drug therapy , Alanine Transaminase/blood , Cardiomyopathy, Dilated/complications , Cardiomyopathy, Dilated/diagnostic imaging , Cough/chemically induced , Dyspnea/chemically induced , Humans , Male , Middle Aged , Pleural Effusion/chemically induced , Pleural Effusion/diagnostic imaging , Tachycardia, Ventricular/complications , Tomography, X-Ray ComputedABSTRACT
Metastatic pulmonary calcification is a consequence of calcium deposition in the normal pulmonary parenchyma, secondary to abnormal calcium metabolism. The most characteristic radiological manifestation is poorly defined nodular opacities that are mainly seen in the upper lung zone. The aim of this report is to describe the CT and MRI findings observed in two patients with metastatic pulmonary calcification. The disease may present in CT as consolidations with calcification, and with a high lesion/muscle signal intensity ratio on T(1) weighted imaging without contrast in MRI. The high signal on T(1) weighted imaging probably occurs because the low calcium concentration of the lesion changes the surface effects of diamagnetic calcium particles, causing T(1) shortening of water protons. MRI is a good option for characterising calcium accumulation caused by a metabolic disorder.
Subject(s)
Calcinosis/diagnosis , Kidney Failure, Chronic/complications , Lung Diseases/diagnosis , Adult , Calcinosis/etiology , Female , Glomerulonephritis/complications , Humans , Lung Diseases/etiology , Magnetic Resonance Imaging , Male , Nephrotic Syndrome/complications , Tomography, X-Ray ComputedABSTRACT
Imaging studies play a critical role in the diagnosis and staging of lung cancer. CT and 18-fluorodeoxyglucose positron emission tomography CT (PET/CT) are widely and routinely used for staging and assessment of treatment response. Many radiologists still use MRI only for the assessment of superior sulcus tumours, and in cases where invasion of the spinal cord canal is suspected. MRI can detect and stage lung cancer, and this method could be an excellent alternative to CT or PET/CT in the investigation of lung malignancies and other diseases. This pictorial essay discusses the use of MRI in the investigation of lung cancer.
Subject(s)
Lung Neoplasms/diagnosis , Magnetic Resonance Imaging/standards , Tomography, X-Ray Computed/standards , Fluorodeoxyglucose F18 , Humans , Lung Neoplasms/secondary , Magnetic Resonance Imaging/methods , Neoplasm Staging , Positron-Emission Tomography , Practice Guidelines as Topic , Radiopharmaceuticals , Reproducibility of Results , Tomography, X-Ray Computed/methodsABSTRACT
We report two children who presented with multiple renal cysts involving only one kidney and in whom there was no family history of renal disease and who did not have syndromes known to be associated with renal cystic disease. This unilateral involvement may represent a distinct entity, which has only been previously described in three cases; however, long-term follow-up will be needed to confirm this hypothesis. We illustrate the sonographic and computed tomographic findings, and the differential diagnosis is discussed.
