Computed Tomography in Adults with Bronchiectasis and Nontuberculous Mycobacterial Pulmonary Disease: Typical Imaging Findings

Among patients with bronchiectasis, nontuberculous mycobacterial pulmonary disease (NTM-PD) ranged between 1 and 6% and it is suspected that its prevalence is underestimated. Our aim was to evaluate differences in computed tomography (CT) features in patients with bronchiectasis, with and without NTM-PD, in order to facilitate earlier diagnosis in the future. In addition, we evaluated longitudinal changes after successful NTM-PD treatment. One hundred and twenty-eight CTs performed in adults with bronchiectasis were scored for the involvement, type, and lobar distribution of bronchiectasis, bronchial dilatation, and bronchial wall thickening according to Reiff. In addition, associated findings, such as mucus plugging, tree-in-bud, consolidations, ground-glass opacities, interlobular thickening, intralobular lines, cavities, and atelectasis, were registered. Patients with NTM-PD (n = 36), as defined by ATS/IDSA diagnostic criteria, were compared to bronchiectasis patients without NTM-PD (n = 92). In twelve patients with an available consecutive CT scan after microbiological cure of NTM-PD imaging findings were also scored according to Kim and compared in the course. In patients with NTM-PD, there was a higher prevalence of bronchiectasis in the middle lobes (p < 0.001), extended bronchiolitis (p = 0.032) and more small and large nodules (p < 0.001). Furthermore, cavities turned out to be larger (p = 0.038), and walls thickened (p = 0.019) and extended (p = 0.016). Patients without NTM more often showed peripheral ground-glass opacities (0.003) and interstitial changes (p = 0.001). CT findings decreased after successful NTM-PD treatment in the follow-up CT; however, without statistical significance for most features (p = 0.056), but bronchiolitis was the only significantly reduced score item (p = 0.043). CT patterns in patients with bronchiectasis and NTM-PD differ from those of patients with bronchiectasis without NTM-PD, although the findings are non-specific radiological features. Follow-up CT findings after microbiological cure differed interindividual regarding the decline in imaging features. Our findings may help practitioners to identify NTM-PD in patients with bronchiectasis. Further research is needed regarding the use of CT as a potential imaging biomarker for the evaluation of treatment response.

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Serial computed tomography findings of Coronavirus disease 2019 (COVID-19) pneumonia treated with favipiravir and steroid therapy: report of 11 cases

Bulletin of the National Research Centre ◽

10.1186/s42269-021-00553-7 ◽

2021 ◽

Vol 45 (1) ◽

Author(s):

Naoki Irizato ◽

Hiroshi Matsuura ◽

Atsuya Okada ◽

Ken Ueda ◽

Hitoshi Yamamura

Keyword(s):

Computed Tomography ◽

Mechanical Ventilation ◽

Steroid Therapy ◽

Time Course ◽

Ground Glass ◽

Time Points ◽

Ct Findings ◽

Mixed Pattern ◽

Bronchial Dilatation

Abstract Background This study evaluated the time course of computed tomography (CT) findings of patients with COVID-19 pneumonia who required mechanical ventilation and were treated with favipiravir and steroid therapy. Results Eleven patients with severe COVID-19 pneumonia were included. CT findings assessed at the three time points showed that all patients had ground-glass opacities (GGO) and consolidation and mixed pattern at intubation. Consolidation and mixed pattern disappeared in most of the patients whereas GGO persisted in all patients at 1-month follow-up. In addition to GGO, a subpleural line and bronchus distortion and bronchial dilatation were frequent findings. The degree of resolution of GGO varied depending on each patient. The GGO score correlated significantly with the time from symptoms onset to initiation of steroid therapy (ρ = 0.707, p = 0.015). Conclusions At 1-month follow-up after discharge, non-GGO lesions were absorbed almost completely, and GGO were a predominant CT manifestation. Starting steroid therapy earlier after onset of symptoms in severe COVID-19 pneumonia may reduce the extent of GGO at 1-month follow-up.

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Impact of Initial Computed Tomography Findings on Management of Atypical Urinary Cytology of the Upper Urinary Tract

Urologia Internationalis ◽

10.1159/000512978 ◽

2021 ◽

pp. 1-5

Author(s):

Kotaro Takemura ◽

Taketo Kawai ◽

Yusuke Sato ◽

Jimpei Miyakawa ◽

Satoru Taguchi ◽

...

Keyword(s):

Computed Tomography ◽

Urinary Tract ◽

Upper Urinary Tract ◽

Wall Thickening ◽

Urinary Cytology ◽

Class Iii ◽

Ct Findings ◽

Retrograde Ureteropyelography ◽

Tumor Like Lesions

Introduction: Management of patients with atypical urinary cytology (class III) of the upper urinary tract is often complicated because some patients develop upper urinary tract urothelial carcinoma (UTUC). Here, we aimed to help define the optimal management of these patients. Methods: We investigated 31 patients who underwent retrograde ureteropyelography (RP) and were diagnosed with atypical findings of upper urinary tract cytology. Results: UTUC was revealed in 17 of 31 patients during the follow-up period of 1 year or longer. Tumor-like lesions and wall thickening in the upper urinary tract on initial computed tomography (CT) were significant predictors of UTUC (p = 0.0002 and p = 0.012, respectively). All 11 patients with tumor-like lesions and 3 of 8 patients with wall thickening on initial CT underwent nephroureterectomy, and UTUC was confirmed histologically. Moreover, 3 of 12 patients with hydronephrosis only or with normal findings later went on to develop UTUC. Repeated RP performed within 6 months from the initial RP was able to distinguish patients with UTUC from those without, even in individuals with normal CT findings. Discussion/Conclusion: Repeated RP based on initial CT findings is recommended in patients with atypical urinary cytology of the upper urinary tract. Nephroureterectomy without repeated RP may be warranted in patients with tumor-like lesions on initial CT findings.

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Serial high-resolution computed tomography imaging in patients with wegener granulomatosis: differentiation between active inflammatory and chronic fibrotic lesions

Acta Radiologica ◽

10.1080/02841850510021733 ◽

2005 ◽

Vol 46 (5) ◽

pp. 484-491 ◽

Cited By ~ 15

Author(s):

C. Lohrmann ◽

M. Uhl ◽

O. Schaefer ◽

N. Ghanem ◽

E. Kotter ◽

...

Keyword(s):

Computed Tomography ◽

Ground Glass ◽

Mediastinal Lymphadenopathy ◽

Wall Thickening ◽

High Resolution Computed Tomography ◽

Wegener Granulomatosis ◽

Bronchial Wall ◽

Inflammatory Lesions ◽

Ground Glass Attenuation

Purpose: To evaluate pulmonary pathologies in Wegener granulomatosis with sequential computed tomography (CT) in order to differentiate active inflammatory lesions from chronic fibrotic lesions. Material and Methods: Serial CT findings in 38 patients with Wegener granulomatosis were retrospectively analyzed (mean follow-up period, 21 months). The presence, extension, and distribution of the following findings were evaluated with CT: parenchymal nodules, masses, ground-glass attenuation, airspace consolidation, bronchial wall-thickening, bronchiectasis, linear areas of attenuation, pleural irregularities, pleural effusions, hilar and mediastinal lymphadenopathy. Results: Observed in 92% of patients, nodules were the most common CT pathology. Areas of ground-glass attenuation, consolidation, masses of linear attenuation, and tracheal/bronchial wall-thickening were detected in 24%, 26%, 32%, 39%, and 68% of patients. At follow-up, the clearance of lesions was most consistent for areas of ground-glass attenuation (89%), masses (87%), and cavitated nodules (85%). In the follow-up scan, 58% of all nodules, 47% of pulmonary consolidations, and 66% of bronchial wall-thickening were completely resolved. Areas of bronchiectasis and septal/non-septal lines remained stable in 70% and 71% of patients. Conclusion: The majority of the lesions decreased or resolved completely with or without areas of linear attenuation. Ground-glass attenuation, cavitated nodules and masses appear to represent active inflammatory lesions. In most probability, areas of bronchiectasis and septal/non-septal lines more often represent chronic fibrotic changes rather than active inflammatory changes. In combination with clinical evaluation and bronchoscopy, CT assists in the assessment of disease activity.

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Imaging diagnosis of classical and new pneumoconiosis: predominant reticular HRCT pattern

Insights into Imaging ◽

10.1186/s13244-021-00966-y ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Akira Masanori

Keyword(s):

Computed Tomography ◽

Interstitial Lung Disease ◽

Imaging Features ◽

Imaging Findings ◽

Imaging Diagnosis ◽

High Resolution Computed Tomography ◽

Pleural Fibrosis ◽

Pathologic Findings ◽

Characteristic Imaging ◽

The Individual

AbstractOur understanding of the manifestations of pneumoconioses is evolving in recent years. Associations between novel exposures and diffuse interstitial lung disease have been newly recognized. In advanced asbestosis, two types of fibrosis are seen, probably related to dose of exposure, existence of pleural fibrosis, and the host factor status of the individual. In pneumoconiosis of predominant reticular type, nodular opacities are often seen in the early phase. The nodular pattern is centrilobular, although some in metal lung show perilymphatic distribution, mimicking sarcoidosis. High-resolution computed tomography enables a more comprehensive correlation between the pathologic findings and clinically relevant imaging findings. The clinician must understand the spectrum of characteristic imaging features related to both known dust exposures and to historically recent new dust exposures.

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Cardiac metastasis of osteosarcoma

Open Medicine ◽

10.2478/s11536-010-1018-5 ◽

2010 ◽

Vol 5 (5) ◽

pp. 551-555

Author(s):

Hilal Sahin ◽

Naim Ceylan ◽

Selen Bayraktaroglu ◽

Recep Savas

Keyword(s):

Computed Tomography ◽

Case Report ◽

Case Reports ◽

Primary Tumour ◽

Cardiac Metastasis ◽

Imaging Findings ◽

Cardiac Metastases ◽

Enhanced Computed Tomography ◽

Demographic Features

AbstractCardiac osteosarcoma metastasis is extremely rare and is documented in several case reports in the literature. The behaviour of osteosarcoma metastases is similar to the primary tumour. Thoracic non-enhanced computed tomography (CT) examination is beneficial in the detection of calcific cardiac metastases. In this case report, we describe a 29-year-old woman with cardiac osteosarcoma metastasis after 7 years of follow-up, compare the demographic features with previous cases and discuss the imaging findings.

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Computed tomography findings in patients with H1N1 influenza A infection

Radiologia Brasileira ◽

10.1590/s0100-39842013000500006 ◽

2013 ◽

Vol 46 (5) ◽

pp. 299-306 ◽

Cited By ~ 6

Author(s):

Viviane Brandão Amorim ◽

Rosana Souza Rodrigues ◽

Miriam Menna Barreto ◽

Gláucia Zanetti ◽

Edson Marchiori

Keyword(s):

Computed Tomography ◽

Influenza A ◽

H1n1 Virus ◽

Severe Disease ◽

H1n1 Influenza ◽

Wall Thickening ◽

High Resolution Computed Tomography ◽

Air Trapping ◽

Bronchial Wall

The present study aimed to review high resolution computed tomography findings in patients with H1N1 influenza A infection. The most common tomographic findings include ground-glass opacities, areas of consolidation or a combination of both patterns. Some patients may also present bronchial wall thickening, airspace nodules, crazy-paving pattern, perilobular opacity, air trapping and findings related to organizing pneumonia. These abnormalities are frequently bilateral, with subpleural distribution. Despite their nonspecificity, it is important to recognize the main tomographic findings in patients affected by H1N1 virus in order to include this possibility in the differential diagnosis, characterize complications and contribute in the follow-up, particularly in cases of severe disease.

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Role of multidetector computed tomography in evaluation of abdominal trauma in Sothern Rajasthan, India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20192526 ◽

2019 ◽

Vol 7 (6) ◽

pp. 2350

Author(s):

Puran . ◽

Narendra Kumar Kardam

Keyword(s):

Computed Tomography ◽

Multidetector Computed Tomography ◽

Abdominal Trauma ◽

Imaging Modality ◽

Abdominal Injury ◽

Male Predominance ◽

Ct Findings ◽

Highly Sensitive

Background: Abdominal injury constitutes a significant portion of all blunt and penetrating body injuries. Computed tomography is an important and fast technique which gives rapid information on the type of abdominal injury and helps in management of the patient accordingly. The aim of the present study was to evaluate the usefulness of Multidetector Computed Tomography (MDCT) in detection of intra-abdominal injury in patients with blunt abdominal trauma and to provide information that could accurately determine choice of management (non- operative versus operative). And to correlate the computed tomography (CT) findings with either clinical observation, follow up CT scan (if required) or surgical findings (wherever applicable).Methods: A total of 50 patients with abdominal trauma who underwent computed tomography (CT) examination were included. CT findings were compared with surgical findings in operated cases, and in the rest CT findings were compared by clinical outcome.Results: Among the 50 cases studied, all 50 had positive CT findings of abdominal trauma, out of which 24 patients underwent surgery and the remaining were managed conservatively. The age group of the patients was ranging from 8 to 66 years with male predominance. In this study the commonest organs affected were liver and spleen accounting for 48% and 44% respectively.Conclusions: Computed tomography is an important and highly sensitive imaging modality for diagnosis of organ injuries in patients with abdominal trauma and accordingly deciding the management of patient.

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Mucinous Neoplasm of the Appendix as a Mimic of Cystic Adnexal Pathology

Journal of Clinical Imaging Science ◽

10.4103/jcis.jcis_27_18 ◽

2018 ◽

Vol 8 ◽

pp. 32 ◽

Cited By ~ 1

Author(s):

Chris Hutchinson ◽

Jonathan Lyske ◽

Vimal Patel ◽

Gavin Low

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Mucinous Tumor ◽

Imaging Findings ◽

Resonance Imaging ◽

Mucinous Neoplasm ◽

Ultrasound Computed Tomography ◽

Adnexal Pathology

Pelvic pain presents a common diagnostic conundrum with a myriad of causes ranging from benign and trivial to malignant and emergent. We present a case where a mucinous neoplasm of the appendix acted as a mimic for tubular adnexal pathology on imaging. With the associated imaging findings on ultrasound, computed tomography, and magnetic resonance imaging, we wish to raise awareness of mucinous tumors of the appendix when tubular right adnexal pathology is present both in the presence of pelvic or abdominal pain or when noted incidentally. Tubular pathology such as uncomplicated paraovarian cysts or hydrosalpinx is frequently treated conservatively with long-interval follow-up imaging or left to clinical follow-up. Thus, if incorrectly diagnosed as tubular pathology, an appendix mucocele or mucinous neoplasm of the appendix is likely to be undertreated. We wish to clarify some of the confusion around nomenclature and classification of the multiple entities that are comprised by the terms mucocele and mucinous tumor of the appendix.

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