Assuntos
Síndrome de Birt-Hogg-Dubé/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Idoso , Síndrome de Birt-Hogg-Dubé/complicações , Feminino , Humanos , Pneumopatias/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
AIM: To assess the computed tomography (CT) findings of solitary cavitary lesions which could potentially aid in differentiating malignant from non-malignant lung disease. MATERIALS AND METHODS: A retrospective study of patients diagnosed with a solitary lung cavity at two university hospitals, who underwent multidetector CT examinations of the chest between 2012 and 2014, was performed. Lesions were evaluated for maximum diameter, maximum wall thickness, and associated findings. Statistical analyses were then conducted and a receiver operating characteristic (ROC) curve was calculated to select the most accurate cut-off value for malignant and non-malignant lesions. RESULTS: CT and clinical records from 96 patients were reviewed. The most frequent aetiologies of non-malignant and malignant lung cavities were mycobacterial infection sequelae (50%, 33/66) and primary lung carcinoma (94%, 28/30), respectively. Significant differences (p<0.05) were found between malignant and non-malignant cases when comparing the averages of maximum wall thickness (15.2 and 7.8 mm, respectively) and maximum diameter of lesions (51 and 35 mm, respectively). The presence of either perilesional consolidation or centrilobular nodules favoured the diagnosis of non-malignant conditions (p<0.05). Maximum wall thicknesses thresholds of ≤7 or ≥24 mm were the most accurate in suggesting non-malignant and malignant aetiologies, respectively. CONCLUSION: Malignant and non-malignant solitary lung cavities differ significantly at CT. Non-malignant lesions tend to exhibit thinner walls, but more perilesional consolidation and centrilobular nodules than malignant lesions. The results reveal that maximum wall thicknesses of ≤7 and ≥24 mm are indicative of non-malignant and malignant disease, respectively.
Assuntos
Nódulo Pulmonar Solitário/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Pulmão , Masculino , Pessoa de Meia-Idade , Curva ROC , Reprodutibilidade dos Testes , Estudos RetrospectivosRESUMO
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.
Assuntos
Neoplasias Pulmonares/diagnóstico , Imageamento por Ressonância Magnética/normas , Tomografia Computadorizada por Raios X/normas , Fluordesoxiglucose F18 , Humanos , Neoplasias Pulmonares/secundário , Imageamento por Ressonância Magnética/métodos , Estadiamento de Neoplasias , Tomografia por Emissão de Pósitrons , Guias de Prática Clínica como Assunto , Compostos Radiofarmacêuticos , Reprodutibilidade dos Testes , Tomografia Computadorizada por Raios X/métodosRESUMO
Pulmonary embolism (PE) is the third most common acute cardiovascular disease after myocardial infarction and stroke, and results in thousands of deaths each year. Improvements in MRI accuracy are ongoing with the use of parallel imaging for angiography techniques and pulmonary perfusion. This, associated with other potential advantages of MRI (e.g. a radiation free method and better safety profile of MR contrast media), reinforces its use. The aim of this paper is to perform a pictorial review of the principal findings of MRI in acute PE. Acute PE can manifest itself as complete arterial occlusion and the affected artery may be enlarged. We report the main vascular and parenchymal signs, and an overview of current literature regarding accuracy, limitations and technical aspects is provided.
Assuntos
Competência Clínica/normas , Imageamento por Ressonância Magnética/métodos , Embolia Pulmonar/diagnóstico , Doença Aguda , Adolescente , Adulto , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Drug-induced lung diseases are a frequent cause of morbidity. Diffuse pulmonary haemorrhage is an uncommon complication of drug therapy, and is a potentially life-threatening situation. We report the high-resolution CT and clinical findings of a 32-year-old man with diffuse pulmonary haemorrhage induced by ketorolac tromethamine.
Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Hemorragia/diagnóstico por imagem , Cetorolaco de Trometamina/efeitos adversos , Pneumopatias/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Hemorragia/induzido quimicamente , Humanos , Pneumopatias/induzido quimicamente , Masculino , Intensificação de Imagem RadiográficaRESUMO
Of 156 cases of histoplasmosis observed in the State of Rio Grande do Sul (Brazil), during a 21-year period (1978-1999) 137 were included in this study. Sixty-seven per cent of the patients had hematogeneous disseminated histoplasmosis, 24% had a self-limited syndrome (acute pulmonary histoplasmosis, histoplasmoma or primary pulmonary lymph node complex), and 9 per cent had chronic pulmonary histoplasmosis. Clinical, mycological, and epidemiological data were reviewed and commented.
Assuntos
Histoplasmose/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Histoplasmose/diagnóstico por imagem , Histoplasmose/microbiologia , Humanos , Lactente , Pneumopatias Fúngicas/diagnóstico por imagem , Pneumopatias Fúngicas/epidemiologia , Pneumopatias Fúngicas/microbiologia , Masculino , Pessoa de Meia-Idade , RadiografiaRESUMO
We performed a prospective observational study to define the clinical course and the prognostic factors of 31 patients with postinfectious bronchiolitis obliterans. All patients presented with an episode of acute bronchiolitis in the first 2 years of life, and respiratory symptoms and signs persisted since then. Other diseases which may cause chronic airflow obstruction were excluded. The patients were followed after their inclusion in the study and the clinical findings were recorded in a standardized questionnaire and form. Repeated chest radiographs and lung perfusion scans were obtained in all 31 patients and semiannual spirometry was performed in 8 older patients. Eight patients had lung biopsies. The clinical course varied in the 31 patients during a mean of 3.5 years of follow-up. The outcome of the patients included clinical remission (22.6%), persistence of respiratory symptoms and signs (67.7%), and death (9.7%). An older age at onset of illness and presence of atopy as suggested by an elevated serum IgE appeared to predispose to a poor prognosis.
Assuntos
Bronquiolite Obliterante/patologia , Bronquiolite Viral/complicações , Doença Aguda , Idade de Início , Atrofia , Feminino , Seguimentos , Humanos , Imunoglobulina E/análise , Lactente , Masculino , Prognóstico , Estudos ProspectivosRESUMO
The authors performed a prospective cohort study to define the high-resolution computed tomography features of 31 pediatric patients with postinfectious bronchiolitis obliterans. All patients underwent chest radiographs and lung perfusion scans, and 27 of the 31 patients underwent high-resolution computed tomography of the lung. The most common abnormal features shown on computed tomography included bronchial wall thickening, bronchiectasis, and areas of increased and decreased attenuation. High-resolution computed tomography showed a higher sensitivity than both chest radiography and lung perfusion scanning in detecting pulmonary abnormalities in these patients.