Lund–Mackay Computed Tomography Score Is Associated With Obstructive Pulmonary Function Changes in Chronic Cough Patients

2019 ◽  
Vol 33 (3) ◽  
pp. 294-301 ◽  
Author(s):  
Shin Kariya ◽  
Mitsuhiro Okano ◽  
Takaya Higaki ◽  
Tomoyasu Tachibana ◽  
Toru Rikimaru ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Function ◽  
Pulmonary Function ◽  
Paranasal Sinus ◽  
Chronic Cough ◽  
Eosinophil Count ◽  
Upper Airway ◽  
Peripheral Blood Eosinophil ◽  
X Ray ◽  
Chest X Ray

Background A remarkable relationship between upper airway conditions and lung diseases has been reported. At the same time, sinonasal findings in chronic cough patients have not been fully examined. Objective The purpose of this study is to show paranasal sinus findings and lung function in chronic cough patients without asthma and chest X-ray abnormalities. Methods A total of 1412 patients with persistent cough were enrolled in this study. Of these patients, 376 patients were evaluated for further examination, as the patients with asthma and/or chest X-ray abnormality were excluded from the study. Normal control subjects without any chronic respiratory symptoms were also recruited. Pulmonary function was examined by spirometry. A bronchial obstruction reversibility test was applied. The Lund–Mackay computed tomography (CT) score, peripheral blood eosinophil count, and immunoglobulin E concentration in serum samples were examined. The Sino-Nasal Outcome Test was used to determine the severity of clinical symptoms. Results The patients with an abnormal soft tissue shadow in the paranasal sinus had significant obstructive lung function. The percent predicted forced expiratory volume in 1 second (FEV1.0) and the FEV1.0/forced vital capacity ratio negatively correlated with Lund–Mackay CT scores both before and after bronchodilator inhalation. There was a statistically significant correlation between pulmonary function and eosinophil count. Conclusion The patients with chronic cough frequently had paranasal sinus abnormalities. The Lund–Mackay CT score may be useful for assessing the condition of the lower airway in chronic cough patients. Upper airway examinations should play a part in the management of chronic cough.

scholarly journals Is it time to scrap Scadding and adopt computed tomography for initial evaluation of sarcoidosis?

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 600 ◽  
Author(s):  
Andrew Levy ◽  
Nabeel Hamzeh ◽  
Lisa A. Maier
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Lung Function ◽  
Disease Severity ◽  
Interobserver Variability ◽  
Initial Evaluation ◽  
High Resolution Computed Tomography ◽  
X Ray ◽  
Chest X Ray ◽  
Parenchymal Disease

In this review, we argue for the use of high-resolution computed tomography (HRCT) over chest X-ray in the initial evaluation of patients with sarcoidosis. Chest X-ray, which has long been used to classify disease severity and offer prognostication in sarcoidosis, has clear limitations compared with HRCT, including wider interobserver variability, a looser association with lung function, and poorer sensitivity to detect important lung manifestations of sarcoidosis. In addition, HRCT offers a diagnostic advantage, as it better depicts targets for biopsy, such as mediastinal/hilar lymphadenopathy and focal parenchymal disease. Newer data suggest that specific HRCT findings may be associated with important prognostic outcomes, such as increased mortality. As we elaborate in this update, we strongly recommend the use of HRCT in the initial evaluation of the patient with sarcoidosis.

scholarly journals Efficacy of chest X-ray in the diagnosis of COVID-19 pneumonia: comparison with computed tomography through a simplified scoring system designed for triage

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Akın Çinkooğlu ◽  
Selen Bayraktaroğlu ◽  
Naim Ceylan ◽  
Recep Savaş
Keyword(s):  
Computed Tomography ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Scoring System ◽  
Imaging Modality ◽  
Ground Glass Opacity ◽  
Initial Presentation ◽  
X Ray ◽  
Chest X Ray

Abstract Background There is no consensus on the imaging modality to be used in the diagnosis and management of Coronavirus disease 2019 (COVID-19) pneumonia. The purpose of this study was to make a comparison between computed tomography (CT) and chest X-ray (CXR) through a scoring system that can be beneficial to the clinicians in making the triage of patients diagnosed with COVID-19 pneumonia at their initial presentation to the hospital. Results Patients with a negative CXR (30.1%) had significantly lower computed tomography score (CTS) (p < 0.001). Among the lung zones where the only infiltration pattern was ground glass opacity (GGO) on CT images, the ratio of abnormality seen on CXRs was 21.6%. The cut-off value of X-ray score (XRS) to distinguish the patients who needed intensive care at follow-up (n = 12) was 6 (AUC = 0.933, 95% CI = 0.886–0.979, 100% sensitivity, 81% specificity). Conclusions Computed tomography is more effective in the diagnosis of COVID-19 pneumonia at the initial presentation due to the ease detection of GGOs. However, a baseline CXR taken after admission to the hospital can be valuable in predicting patients to be monitored in the intensive care units.

AB0796 THE EVALUATION OF LUNG DIAGNOSTIC PROCEDURE AT THE ONSET OF INFLAMMATORY RHEUMATIC DISEASES WITH INTERSTITIAL LUNG DISEASE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1422.3-1423
Author(s):  
T. Hoffmann ◽  
P. Oelzner ◽  
F. Marcus ◽  
M. Förster ◽  
J. Böttcher ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Interstitial Lung Disease ◽  
Lung Function ◽  
Lung Disease ◽  
Sensitivity And Specificity ◽  
Lung Function Test ◽  
Inflammatory Rheumatic Diseases ◽  
X Ray ◽  
Function Test ◽  
Chest X Ray

Background:Interstitial lung disease (ILD) in inflammatory rheumatic diseases (IRD) is associated with increased mortality. Moreover, the lung is one of the most effected organs on IRD. Consequently, screening methods were required to the detect ILD in IRD.Objectives:The objective of the following study is to evaluate the diagnostic value of lung function test, chest x-ray and HR-CT of the lung in the detection of ILD at the onset of IRD.Methods:The study is designed as a case-control study and includes 126 patients with a newly diagnosed IRD. It was matched by gender, age and the performance of lung function test and chest x-ray. The sensitivity and specificity were verified by crosstabs and receiver operating characteristic (ROC) curve analysis. The study cohort was divided in two groups (ILD group: n = 63 and control group: n = 63). If possible, all patients received a lung function test and optional a chest x-ray. Patients with pathological findings in the screening tests (chest x-ray or reduced diffusing capacity for carbon monoxide (DLCO) < 80 %) maintained a high-resolution computer tomography (HR-CT) of the lung. Additionally, an immunological bronchioalveolar lavage was performed in the ILD group as gold standard for the detection of ILD.Results:The DLCO (< 80 %) revealed a sensitivity of 83.6 % and specificity of 45.8 % for the detection of ILD. Other examined parameter of lung function test showed no sufficient sensitivity as screening test (FVC = Forced Vital Capacity, FEV1 = Forced Expiratory Volume in 1 second, TLC = Total Lung Capacity, TLCO = Transfer factor of the Lung for carbon monoxide). Also, a combination of different parameter did not increase the sensitivity. The sensitivity and specificity of chest x-ray for the verification of ILD was 64.2 % versus 73.6 %. The combination of DLCO (< 80 %) and chest x-ray showed a sensitivity with 95.2 % and specificity with 38.7 %. The highest sensitivity (95.2 %) and specificity (77.4 %) was observed for the combination of DLCO (< 80 %) and HR-CT of the lung.Conclusion:The study highlighted that a reduced DLCO in lung function test is associated with a lung involvement in IRD. DLCO represented a potential screening parameter for lung manifestation in IRD. Especially patients with suspected vasculitis should receive an additional chest x-ray. Based on the high sensitivity of DLCO in combination with chest x-ray or HR-CT for the detection of ILD in IRD, all patients with a reduced DLCO (< 80%) should obtained an imaging of the lung.Disclosure of Interests:None declared

scholarly journals Diagnosing gastric volvulus in chest X-ray: report of three cases

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Narendra Pandit ◽  
Abhijeet Kumar ◽  
Tek Narayan Yadav ◽  
Qamar Alam Irfan ◽  
Sujan Gautam ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Abdomen ◽  
Gastric Volvulus ◽  
X Ray ◽  
Pain Abdomen ◽  
Life Threatening ◽  
Chest X Ray ◽  
High Index Of Suspicion ◽  
Specific Symptoms ◽  
Prompt Diagnosis

Abstract Gastric volvulus is a rare abnormal rotation of the stomach along its axis. It is a surgical emergency, hence requires prompt diagnosis and treatment to prevent life-threatening gangrenous changes. Hence, a high index of suspicion is required in any patients presenting with an acute abdomen in emergency. The entity can present acutely with pain abdomen and vomiting, or as chronic with non-specific symptoms. Chest X-ray findings to diagnose it may be overlooked in patients with acute abdomen. Here, we report three patients with gastric volvulus, where the diagnosis was based on the chest X-ray findings, confirmed with computed tomography, and managed successfully with surgery.

Przewlekły kaszel jako główna manifestacja chłoniaka Hodgkina – opis przypadku

2019 ◽  
Vol 23 (3) ◽  
Author(s):  
Katarzyna Wójcicka ◽  
Andrzej Pogorzelski
Keyword(s):  
Chronic Cough ◽  
Correct Diagnosis ◽  
Diagnostic Methods ◽  
Radiographic Examination ◽  
Older Children ◽  
X Ray ◽  
Volume Curve ◽  
Flow Volume Curve ◽  
Mediastinal Widening ◽  
Chest X Ray

A cough lasting longer than 4-8 weeks, defined as chronic cough, always requires thorough diagnostic evaluation. In addition to detailed history-taking and physical examination, simple and available diagnostic methods, such as chest x-ray and spirometry, should be performed. They may be helpful tool to establish the underlying cause of cough. Many younger children may have difficulties in performing the forced expiratory maneuvers and fulfilling repeatability criteria for spirometry. The disturbances resulting from insufficient cooperation should be considered in interpratation of the obtained results. The shape of the flow-volume curve, which suggests upper or central airways obstruction, can not be ignored and always requires further investigation for diagnosis of respiratory pathology. The chest x-ray is the most frequently performed radiographic examination in children. Accurate interpretation is essential in reaching a correct diagnosis. Mediastinal widening on the chest x-ray in children can occur due to a large variety of causes. The normal thymus can take on a variety of sizes and shapes and still be considered normal in the first few years of life. In older children mediastinal widening should be differentiated from mediastinal masses. Lymph node enlargement represents a frequent cause, usually as a result of infection or malignancy. The article reports a case of a 12-year-old boy with chronic cough, mediastinal widening on the chest X-ray and abnormal spirometry results, who was finally diagnosed with stage III Hodgkin’s lymphoma.

Differential diagnosis of hemoptysis

2021 ◽  
pp. 47-55
Author(s):  
Petr Arkadievich Ilyin
Keyword(s):  
Infectious Disease ◽  
Computed Tomography ◽  
Lung Cancer ◽  
Differential Diagnosis ◽  
Correct Interpretation ◽  
Diagnostic Investigation ◽  
Detailed History ◽  
X Ray ◽  
Chest X Ray ◽  
Upper Gastrointestinal

Blood expectoration or hemoptysis is the coughing up of sputum with blood from the larynx, bronchi or lungs. Hemoptysis is most often caused by diseases of the respiratory tract and lungs — bronchitis or pneumonia, as well as lung cancer, aspergilloma, tuberculosis, bronchiectasis, pulmonary embolism, etc. In the diagnostic investigation of the cause of hemoptysis, it is important to take a detailed history (in the case of an epidemiological history, a laboratory analysis of the secreted sputum for the detection of the causative agent of an infectious disease is necessary), to make the correct interpretation of the patient’s complaints and an assessment of the nature of the sputum (differential diagnosis with bleeding from the upper gastrointestinal tract). A chest X-ray is performed and, then, if indicated, computed tomography, bronchoscopy, and other studies are made. The article presents an algorithm for differential diagnostic investigation of hemoptysis in a patient

Pericardial masses and congenital abnormalities

ESC CardioMed ◽  
2018 ◽  
pp. 1582-1584
Author(s):  
Angelos G. Rigopoulos ◽  
Hubert Seggewiss
Keyword(s):  
Computed Tomography ◽  
Surgical Management ◽  
Congenital Abnormalities ◽  
Benign Lesions ◽  
Chest Computed Tomography ◽  
X Ray ◽  
Wall Calcification ◽  
Chest X Ray ◽  
Pericardial Cysts ◽  
The Right

Pericardial masses include cysts, pericardial tumours, and pericardial haematomas. Pericardial cysts are benign lesions commonly located in the right cardiophrenic angle that remain typically asymptomatic and are incidentally found in chest X-ray or chest computed tomography but might cause pressure symptoms or become infected, thus requiring surgical management. Hydatid cysts due to echinococcosis are the most common acquired pericardial cysts, characterized by wall calcification, and indicate surgery.

Focal abnormalities

ESC CardioMed ◽  
2018 ◽  
pp. 411-412
Author(s):  
Nicola Sverzellati ◽  
Gianluca Milanese ◽  
Mario Silva
Keyword(s):  
Computed Tomography ◽  
Clinical Assessment ◽  
Lung Nodules ◽  
Technological Equipment ◽  
X Ray ◽  
Progressive Development ◽  
Software Applications ◽  
Lung Abnormalities ◽  
Challenging Tasks ◽  
Chest X Ray

Both the detection and interpretation of focal abnormalities on chest X-ray (CXR) are challenging tasks. CXR accuracy depends on the view (e.g. the supine view has limited sensitivity) and technological equipment. The detection of small focal abnormalities (e.g. lung nodules) varies between anatomical regions according to the presence of dense anatomic structures, such as the bones and the hila. The interpretation of focal abnormalities on CXR is paramount within the whole clinical assessment, because CXR findings can guide the patient’s management, or warrant further investigations, such as computed tomography. Focal lung abnormalities on CXR are still a cornerstone of diagnostic algorithms; however, the radiological approach has progressively changed in the last decade because of the progressive development of both hardware and software applications that enable sensitive detection and accurate characterization.

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