Obliterative bronchiolitis due to Mycoplasma pneumoniae infection in a child

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Isles, A.F.; Masel, J.; O' Duffy, J.

1987-02-01

A six-year-old girl presented with Mycoplasma pneumoniae involving the right upper and lower lobes. She made a slow but complete recovery with resolution of the radiological changes. She represented 5 years later with a productive cough, recurrent wheezing and physical and radiological signs suggestive of obliterative bronchiolitis. This diagnosis was confirmed by ventilation - perfusion (dV/dt/dQ/dt) lung scan, and bronchography. The case highlights the value of dV/dt/dQ/dt scanning in the diagnosis of obliterative bronchiolitis and confirms the previous reports that mycoplasma infections are not always benign.

Congenital tracheobiliary fistula diagnosed with contrast-enhanced CT and 3-D reformation

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Chawla, Soni C. [Olive View-UCLA Medical Center, Department of Radiological Sciences, Sylmar, CA (United States); University of California, Los Angeles (UCLA), Department of Radiological Sciences, Sylmar, CA (United States); Jha, Priyanka; Breiman, Richard; Gooding, Charles [University of California, San Francisco (UCSF), Department of Radiological Sciences, San Francisco, CA (United States); Farmer, Diana [University of California, San Francisco (UCSF), Department of Pediatric Surgery, San Francisco, CA (United States)

2008-09-15

Congenital tracheobiliary fistula (CTBF) is a rare malformation. So far 24 cases have been reported in the English language literature. The imaging techniques used in diagnosis have been bronchography, fistulography, cholangiography, hepatobiliary nuclear imaging and MRI. We report a newborn patient who presented with right lung consolidation and biliptysis. The radiographic diagnosis of tracheobiliary fistula was made on multidetector CT scan of the chest and abdomen. Multiple 3-D volume-rendered reformations were performed. An abnormal air-filled tract was seen connecting the posteroinferior aspect of the carina and left biliary system, which was successfully treated surgically. (orig.)

Radiologic evaluation of bronchiectasis

International Nuclear Information System (INIS)

Ahn, Sang Won; Kang, Soo Yeon; Kim, Jong Deok; Chung, Duck Hwan

1987-01-01

Bronchiectasis is not an infrequent disease in Korea and is defined as irreversible abnormal dilatation of one or more bronchi. Bronchography is the definitive method of establishing the diagnosis, extent, and severity of bronchiectasis and its performance is essential to the surgeon before the operative procedure is begun. Retrospectively we reviewed 131 patients of bronchiectasis diagnosed by bronchography during the recent 5 years from January, 1982 to December, 1986 and obtained the following results: 1. Male to female ratio was 64:67, and peak incidence was between 21 and 40 year of age (68.7%:90/131) with 31.9 of mean age. 2. Chronic coughing, productive sputum, and blood-tinged sputum or hemoptysis were the three predominant symptoms, and duration of the symptoms was less than 5 years in 67.9%. 3. Among the presumptive etiologic factors, pulmonary tuberculosis was the most common one (33.6%: 44/131). interestingly, bronchial obstruction due to tracheal cancer, bronchial adenoma, and right upper mediastinal neurofibroma were also present in one case each. 4. In 91.6% of patients, plain chest film was abnormal, and one of the more unusual abnormal findings (which was beyond of our expectations) was typical right middle lobe collapse(7.6%: 10/31). 5. Left lower lobe (67.2%), lingular segment (52.0%), and right lower lobe (35.1%) were the three most frequent sites of involvement. 6. Among the basal segments, the superior segment was involved in half of the incidence because its anatomical relationship to the others made natural drainage easy. 7. Cylindrical type was the most common bronchographic finding (43.5%: 57/131)

Bronchography by tantalum aerosols, an experimental investigation of lung clearance and retention

International Nuclear Information System (INIS)

Causse, Andre.

1974-01-01

Lung clearance of tantalum used as contrast medium has been studied in three animal species: rat, monkey and cat. In rats and monkeys, 80 to 90 percent of the inhaled tantalum was removed with a half life of 10 to 30 hr, but the residual fraction was removed with a half life longer than 100 days; consequently persistent roentgenographic pictures could be observed. These results were in accordance with those obtained by other authors studying dogs and men (accidental inhalation of radioactive tantalum). In cats, about 98 percent was removed with a half life of 15 hr and the remaining fraction with a half life of 18 days. In the three species, the physiological lung clearance mechanisms did not seem disturbed. Microscopic examination showed the peribronchiolar localisation of remaining tantalum in rats and monkeys, with proliferation of granulomes and fibrotic reaction. These results must induce to the greatest care when using tantalum in man in order to outline peripheral airways [fr

Radiology in chest trauma

International Nuclear Information System (INIS)

Wenz, W.; Kloehn, I.; Wolfart, W.; Freiburg Univ.

1979-01-01

In chest trauma, a routine chest film, preferably in the lateral as well as the frontal projection, is the basic part of the work-up. Occasionally valuable additional methods are fluoroscopy, tomography, bronchography, contrast studies of the GI Tract and angiography and angiocardiography. In 679 chest trauma patients, traffic accidents and falls were the main reason for the trauma. There were 248 fractures; then - in order of frequency - hemopneumothorax (76), lung contusion (58), subcutaneous emphysema (33) cardiac (16) and vascular trauma (12) and damage to other organs. While 20-30% mistakes are made in diagnosing rib fractures in acute trauma, there is high accuracy in the diagnosis of the other injuries. Many cases are shown to demonstrate the value of diagnostic radiology. (orig.) [de

Diagnosis of chronic pulmonary emphysema with introduction of computed tomography

International Nuclear Information System (INIS)

Hirai, Hiroaki

1990-01-01

Early or slight chronic pulmonary emphysema (CPE) may be difficult to diagnose. Therefore, this study examined local and overall lung CT densities, pulmonary function, and clinical features in 15 patients with selective alveolo-bronchography-proven CPE and 9 healthy volunteers to establish the method for diagnosing CPE early. Selective alveolo-bronchography revealed a ring shadow of 900 μm or more in all patients. CT densities in the whole lung, and all of the upper, horizontal middle, lower, anterior, frontal middle, and posterior regions were significantly lower in the CPE group than the control group. Mean CT density in the upper region was significantly lower than in the lower region in the CPE group, although there was no difference in CT densities between the upper and lower regions in the control group. In the control group, mean CT density in the anterior region was significantly lower than in the posterior region. Mean values of FVC, %FVC, FFV 1.0 , FFV 1.0 %, PEF, and V 50 /V 25 were significantly decreased in the CPE group. Mean lung CT densities were capable of detecting CPE in 12 patients. There was significant correlation between mean CT densities and both FEV 1.0 % and PEF. The discrepancy in CT density between the upper and lower regions showed a positive correlation to V 50 /V 25 . According to clinical features, patients having persistent cough and sputum had a larger diameter of ring shadow and a great difference in CT density between the upper and lower regions than those having dyspnea. The existence of both cough and sputum seemed to be associated with inhomogeneously destroyed alveoli. In conclusion, when FEV 1.0 % of 55%-80% and V 50 /V 25 of 3.2 or more are seen in patients with chronic obstructive pulmonary disease or cigarette smokers aged 40 years or over, and when CT reveals mean lung density of -912 H.U. or less or the difference of 23 H.U. or more in the upper and lower regions, emphysema can be diagnosed clinically. (N.K.)

The evaluation of radiological and clinical findings of bronchiectasis

International Nuclear Information System (INIS)

Yoo, Jung Keun; Kang, Sung Ihn; Kim, Kil Jung; Ko, Seung Sook; Kim, Young Sook; Kim, Young Chul

1985-01-01

Bronchiectasis means a permanent abnormal dilatation off one or more large bronchi owing to destruction of the elastic and muscular components of the bronchial wall. Radiological study is the most important and mandatory procedure. Especially bronchography is essential for the definitive diagnosis of bronchiectasis and for the precise delineation of the type and extent of the disease. The radiological and clinical findings of 48 cases of bronchiectasis diagnosed by bronchography and treated at Chosun University Hospital during the 5 years from January 1980 to December 1984 were analyzed retrospectively. The results were as follows; 1. Among the 48 cases, 34 cases (70.8%) were male and 14 cases (29.2%) were female. Peak incidence was in second decade. 2. Chronic cough productive sputum and hemoptysis are main symptoms and others are chest pain, dyspnea and recurrent bouts of pneumonia. The most common physical sign is persistent moist rales over the involved area in 23 cases (47.9%). Others are no sign in 17 cases (35.4%), wheezing in 11 cases (22.9%) and digit clubbing in 3 cases (6.3%). 3. The presumed causes were composed of not known in 30 cases (62.5%)> and complications of measles in 7 cases (14.6%), pertussis in 5 cases (10.4%) and pneumonia in 4 cases (8.3%). Two cases were Kartagener's syndrome and unilateral hyperlucent lung. 4. Plain chest common radiological findings was accentuation of lung marking in 36 cases (85.7%), the others are include in order of frequency; pneumonic infiltration, linear radiolucencies, cystic radiolucencies, decreased affected lung volume, air-fluid, level and pleural thickening. 5. Bilateral bronchiectasis was demonstrated in 11 cases (22.9%) and the disease was much more often involved left lung than right. The most commonly involved lobe is left lower lobe, and the most common site of involvement was the posterior basal segment of the lower lobe. The type of bronchiectasis is cylindrical in 22 cases (45.8%), varicose in 11

Some urgent problems of radiopulmonology

International Nuclear Information System (INIS)

Vinner, M.G.

1986-01-01

3-stage diagnosis and appropriate organizational structure has been proposed. The main emphasis is laid on a high quality of tomographic and bronchographic investigation at the first stage in polyclinic and hospital X-ray rooms. Roentgenologists' responsibilities in a pulmonological center (the 2nd stage of diagnosis) and radiosurgical hospital (the 3rd stage) were distinguished. Radiosurgical methods are used at the 3rd stage. Tomography, bronchography and transthoracic puncture are the main diagnosicmethods in radiopulmonology. It is desirable that roentgenologists in a pulmonological center and radiosurgical hospital should master apart from transthoracic puncture bronchofibroscopy performed under local anesthesia and X-ray TV control. The authors have put forward ideas of overcoming difficulties in the diagnosis of disseminated, common and rare pulmonary diseases, of the necessity of drawing together X-ray departments for this purpose

Treatment of tracheomalacia with Palmaz stent: a case report.

Science.gov (United States)

Inan, Mustafa; Ayvaz, Süleyman; Basaran, Umit Nusret

2005-01-01

Tracheomalacia is a potentially life-threatening clinical problem. The expandable Palmaz stent can be used for the treatment of tracheomalacia. We describe a female infant with tracheomalacia who showed respiratory distress the day after birth. Tracheomalacia was diagnosed by bronchoscopic examination, computed tomography and bronchography. At 75 days of age, an expandable metallic stent (Palmaz stent) was inserted into the trachea under fluoroscopic control. The patient's respiratory status improved rapidly. Bronchoscopic examination 6 months after the insertion did not show any granulation tissue. However, in bronchoscopic examination carried out two years later, we detected invasion of the Palmaz stent to the trachea and development of granulation tissue. We think that expandable metallic stent placement should be considered in patients who show intractable respiratory symptoms caused by tracheomalacia in the earlier stages of the treatment. But long-term complications of this procedure are crucial.

[Clinical features, diagnosis and surgical treatment of solitary air cysts of the lungs].

Science.gov (United States)

Gudovskiĭ, L M; Platov, I I; Korenev, A E

2001-01-01

86 cases of solitary air cysts of the lung (6.83% of all maldevelopments) were analyzed. This maldevelopment of bronchial tree is found most often in men (10:7) and more often in the right lung than in the left (18:13). There were no clinical symptoms in 33 (38.37%) patients. Uncomplicated course of the disease was in 51 (59.3%) patients, the disease was complicated by infection in 28 (32.56%) patients. Solitary bronchial cysts were complicated by spontaneous pneumothorax in 8.14% cases, by hemoptysis--in 6.98%. Roentgenography of the chest thorax on two projections and tomography (including CT) are enough for diagnosis of solitary air bronchial cysts. Bronchoscopy, bronchography and APG are not much informative in diagnosis of cysts and should be used on special indications. Cystectomy or cystectomy with partial resection of lung tissue were performed in 67.14% patients with good results.

Clinicoroentgenological control in chronic pneumonia

International Nuclear Information System (INIS)

Mamilyaev, R.M.

1984-01-01

A comprehensive clinicoroentgenological study was used to examine 494 patients with chronic pneumonia. Morphological and functional changes observed in the pulmonary pare and functional changes observed in the pulmonary parenchyma and bronchial tree were studied. Types of pneumosclerosis, tigns of exacerbation of chronic pneumonia and abscess formation, morphological and functional disorders of bronchial penetrability in the pneumonic zone were described. Three forms of chronic pneumonia: bronchial, bronchiectatic and abscessing are signled out. The bronchial form is subdivided into chronic pneumonia with chronic bronchitis without deformity and wi.th deforming chronic bronchitis. In the bronchiectatic form pneumonia can be with cylindrical, saccular and cyst-like bronchiectasia. The general diagnosis of chronic pneumonia is established clinically depending on type and variants in 89-94% of cases, by X-ray and sonographic findings in all patients; types and variants of disease are most frequently defined after bronchography

X-ray semiotics of radiations affections of the lungs

International Nuclear Information System (INIS)

Rabinovich, R.M.; Shapiro, I.V.

1976-01-01

On the hasis of analysis of roentgenograms, tomograms, and bronchograms in 189 patients a repeated study was made of the X-ray semiotics of radiation affections of the lungs. The leading roentgenological symptom of radiation affections of the lungs irrespective of their primary localization, was linear deformity and intensification of the broncho-vascular patten in the peripheral zone. This was expressed on roentgenograms in the form of radially- and cross- coursing shadows from the root: tomog.raphically it was manifested in narrowed shadows of the vessels, a change of their course, their approximation and a tendency to approach the centre; analogous disturbances of topography of the bronchi with phenomena of deforming bronchitis were seen in bronchography. A significant si.gn of radiation injuries of the lung tissue is a tendency to progressive development of connective tissue, which was expressed roentgenologically in extensive pneumosclerosis, sometimes with an outcome into fibrothorax with marked topographic disturbances. Radiation injuries are accompanied by an adhesive reaction of the pleura

National synchrotron light source medical personnel protection interlock

International Nuclear Information System (INIS)

Buda, S.; Gmur, N.F.; Larson, R.; Thomlinson, W.

1998-01-01

This report is founded on reports written in April 1987 by Robert Hettel for angiography operations at the Stanford Synchrotron Research Laboratory (SSRL) and a subsequent report covering angiography operations at the National Synchrotron Light Source (NSLS); BNL Informal Report 47681, June 1992. The latter report has now been rewritten in order to accurately reflect the design and installation of a new medical safety system at the NSLS X17B2 beamline Synchrotron Medical Research Facility (SMERF). Known originally as the Angiography Personnel Protection Interlock (APPI), this system has been modified to incorporate other medical imaging research programs on the same beamline and thus the name has been changed to the more generic Medical Personnel Protection Interlock (MPPI). This report will deal almost exclusively with the human imaging (angiography, bronchography, mammography) aspects of the safety system, but will briefly explain the modular aspects of the system allowing other medical experiments to be incorporated

NATIONAL SYNCHROTRON LIGHT SOURCE MEDICAL PERSONNEL PROTECTION INTERLOCK

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BUDA,S.; GMUR,N.F.; LARSON,R.; THOMLINSON,W.

1998-11-03

This report is founded on reports written in April 1987 by Robert Hettel for angiography operations at the Stanford Synchrotron Research Laboratory (SSRL) and a subsequent report covering angiography operations at the National Synchrotron Light Source (NSLS); BNL Informal Report 47681, June 1992. The latter report has now been rewritten in order to accurately reflect the design and installation of a new medical safety system at the NSLS X17B2 beamline Synchrotron Medical Research Facility (SMERF). Known originally as the Angiography Personnel Protection Interlock (APPI), this system has been modified to incorporate other medical imaging research programs on the same beamline and thus the name has been changed to the more generic Medical Personnel Protection Interlock (MPPI). This report will deal almost exclusively with the human imaging (angiography, bronchography, mammography) aspects of the safety system, but will briefly explain the modular aspects of the system allowing other medical experiments to be incorporated.

Torsion (volvulus) of the lung

International Nuclear Information System (INIS)

Felson, B.

1986-01-01

Torsion or volvulus of the lung is a relatively rare but serious condition that can often be recognized or at least suspected radiographically. It occurs under three different sets of circumstances: spontaneously, usually in association with some other pulmonary abnormality; with traumatic pneumothorax; and as a complication of thoracic surgery. The author studied nine cases of torsion of the lung, including examples from each of these categories. The radiographic signs of torsion are as follows: a collapsed or consolidated lobe that occupies an unusual position, hilar displacement in a direction inappropriate for an apparently collapsed lobe, alteration of the normal position and sweep of the pulmonary vasculature, raid opacification of an ipsilateral lobe after trauma or lobectomy, marked change in position of an opacified lobe on sequential films, bronchial cutoff with no evidence of a mass, abnormal position of an affected lobe (shown on CT, angiography, or bronchography), and lobar air trapping. Mortality is high if the torsion goes unrecognized and operation is delayed

A Study of Variations of the Branching Patterns of right Upper Lobar Bronchus by Corrosive Cast Method

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SV Solanki

2015-06-01

Full Text Available Introduction: Respiratory system is the basic prerequisite for living organisms. So precise knowledge of normal anatomy and various dimensions of human respiratory tract is inevitable. The right upper lobe bronchus is prevailingly trifurcates into apical, anterior and posterior segmental bronchi. Material and Methods: The present study was done on 28 tracheo-bronchial casts prepared by corrosive cast method in the anatomy department of B. J. medical college of Ahmedabad, Gujarat, India from 2011 to 2013. Result and Observation: In 16 specimens (57% normal trifurcate branching pattern was seen in right upper lobar bronchus. Most common variation observed was bifurcate pattern in right upper lobar bronchus in 36% of specimens. In 7% specimens quadrivial pattern was seen in right upper lobar bronchus in which it divided into four bronchi. Conclusion: The knowledge of anatomy and variation in branching pattern of the tracheo-bronchial tree enables the physicians to recognize clinical picture and pathology of human lungs, as well as the application of therapeutic and diagnostic methods like tracheal intubation, bronchoscopy, bronchography and postural drainage etc.

Analysis of the results of CAT of thorax with bronchiectasis protocol, period 2000-2001 Hospital Calderon Guardia

International Nuclear Information System (INIS)

Pacheco Segura, Maureen

2003-01-01

This investigation analyses the computerized axial tomography (CAT) of thorax with protocol of bronchiectasis. It was carried out in the Servicio de Radiologia e Imagenes Medicas of the Hospital Calderon Guardia, Costa Rica. The bronchiectasis is the abnormal permanent expansion of the bronchial tuber and is important to diagnose it because the patient can suffer of pulmonary infections, these can be accompanied by bronchial blood flow and hemoptysis. When they are disseminated can be associated with significant obstruction of the aerial tract. When they are gotten into focus can be confused with neoplasia and other diseases. From the bronchiectasis diagnosis it is used methods of image such as x-ray of thorax, bronchography and computerized axial tomography (CAT) of thorax, usually the diagnosis is confirmed by means of a computerized axial tomography (CAT); which is the image of election to establish the presence and extension of the bronchiectasis. In addition, this study analyzes the radiological clinical relation in the patients which were performed the computerized axial tomography (CAT) of thorax with protocol of bronchiectasis and it identifies the most suitable radiological technique to obtain a satisfactory result in the computerized axial tomography with protocol of bronchiectasis [es

Pictorial essay: Allergic bronchopulmonary aspergillosis

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Ritesh Agarwal

2011-01-01

Full Text Available Allergic bronchopulmonary aspergillosis (ABPA is the best-known allergic manifestation of Aspergillus-related hypersensitivity pulmonary disorders. Most patients present with poorly controlled asthma, and the diagnosis can be made on the basis of a combination of clinical, immunological, and radiological findings. The chest radiographic findings are generally nonspecific, although the manifestations of mucoid impaction of the bronchi suggest a diagnosis of ABPA. High-resolution CT scan (HRCT of the chest has replaced bronchography as the initial investigation of choice in ABPA. HRCT of the chest can be normal in almost one-third of the patients, and at this stage it is referred to as serologic ABPA (ABPA-S. The importance of central bronchiectasis (CB as a specific finding in ABPA is debatable, as almost 40% of the lobes are involved by peripheral bronchiectasis. High-attenuation mucus (HAM, encountered in 20% of patients with ABPA, is pathognomonic of ABPA. ABPA should be classified based on the presence or absence of HAM as ABPA-S (mild, ABPA-CB (moderate, and ABPA-CB-HAM (severe, as this classification not only reflects immunological severity but also predicts the risk of recurrent relapses.

Pictorial essay: Allergic bronchopulmonary aspergillosis

International Nuclear Information System (INIS)

Agarwal, Ritesh; Khan, Ajmal; Garg, Mandeep; Aggarwal, Ashutosh N; Gupta, Dheeraj

2011-01-01

Allergic bronchopulmonary aspergillosis (ABPA) is the best-known allergic manifestation of Aspergillus-related hypersensitivity pulmonary disorders. Most patients present with poorly controlled asthma, and the diagnosis can be made on the basis of a combination of clinical, immunological, and radiological findings. The chest radiographic findings are generally nonspecific, although the manifestations of mucoid impaction of the bronchi suggest a diagnosis of ABPA. High-resolution CT scan (HRCT) of the chest has replaced bronchography as the initial investigation of choice in ABPA. HRCT of the chest can be normal in almost one-third of the patients, and at this stage it is referred to as serologic ABPA (ABPA-S). The importance of central bronchiectasis (CB) as a specific finding in ABPA is debatable, as almost 40% of the lobes are involved by peripheral bronchiectasis. High-attenuation mucus (HAM), encountered in 20% of patients with ABPA, is pathognomonic of ABPA. ABPA should be classified based on the presence or absence of HAM as ABPA-S (mild), ABPA-CB (moderate), and ABPA-CB-HAM (severe), as this classification not only reflects immunological severity but also predicts the risk of recurrent relapses

Current studies and future perspectives of synchrotron radiation imaging trials in human patients

Energy Technology Data Exchange (ETDEWEB)

Longo, Renata, E-mail: renata.longo@ts.infn.it [Department of Physics, University of Trieste, via Valerio 2 3410 Trieste (Italy); INFN- sezione di Trieste, via Valerio 2 3410 Trieste (Italy)

2016-02-11

The coherent and monochromatic x-ray beams available at the synchrotron radiation (SR) laboratories are ideal tools for the development and the initial application of new imaging techniques. In the present paper the history of the clinical studies in k-edge subtraction imaging with SR is summarized, including coronary angiography and bronchography. The results of the recent trial in phase-contrast mammography at Elettra (Trieste, Italy) are discussed, in order to assess the clinical impact of the new imaging modality and the potential interest in its translation to clinical practice. The direct measurement of linear attenuation coefficient obtained during the SR mammography trial is also discussed. The new program of phase-contrast breast CT under development at Elettra is presented. Recently, 3D breast imaging (tomosynthesis and cone beam breast CT) has been introduced in clinical practice with significant improvement in diagnostic accuracy. The aim of this research is to study the contribution of the phase-contrast to the image quality of breast CT. Increasing the image quality of the x-ray medical images at the level of the results obtained at the SR laboratories is highly desirable, hence the promising techniques for the translation of the phase-contrast imaging to the hospitals are briefly discussed.

Current studies and future perspectives of synchrotron radiation imaging trials in human patients

International Nuclear Information System (INIS)

Longo, Renata

2016-01-01

The coherent and monochromatic x-ray beams available at the synchrotron radiation (SR) laboratories are ideal tools for the development and the initial application of new imaging techniques. In the present paper the history of the clinical studies in k-edge subtraction imaging with SR is summarized, including coronary angiography and bronchography. The results of the recent trial in phase-contrast mammography at Elettra (Trieste, Italy) are discussed, in order to assess the clinical impact of the new imaging modality and the potential interest in its translation to clinical practice. The direct measurement of linear attenuation coefficient obtained during the SR mammography trial is also discussed. The new program of phase-contrast breast CT under development at Elettra is presented. Recently, 3D breast imaging (tomosynthesis and cone beam breast CT) has been introduced in clinical practice with significant improvement in diagnostic accuracy. The aim of this research is to study the contribution of the phase-contrast to the image quality of breast CT. Increasing the image quality of the x-ray medical images at the level of the results obtained at the SR laboratories is highly desirable, hence the promising techniques for the translation of the phase-contrast imaging to the hospitals are briefly discussed.

Reversible bronchial dilatation in children: comparison of serial high-resolution computer tomography scans of the lungs

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Gaillard, E.A. E-mail: erol.gaillard@lwh-tr.nwest.nhs.uk; Carty, H.; Heaf, D.; Smyth, R.L

2003-09-01

Introduction: bronchiectasis is generally considered irreversible in the adult population, largely based on studies employing bronchography in cases with a significant clinical history. It is assumed, that the same is true for children. Few studies have examined the natural history of bronchiectasis in children and diagnostic criteria on high-resolution computer tomography of the lungs are derived from studies on adults. Frequently, bronchiectasis is reported in children in cases where localised bronchial dilatation is present, incorrectly labelling these children with an irreversible life-long condition. Objective: to evaluate changes in appearance of bronchial dilatation, unrelated to cystic fibrosis in children, as assessed by sequential high-resolution computer tomography (HRCT) of the lungs. Methods: the scans of 22 children with a radiological diagnosis of bronchiectasis, seen at Alder Hey Children's Hospital between 1994 and 2000, who had at least two CT scans of the lungs were reviewed by a single radiologist, who was blinded to the original report. Results: following a median scan interval of 21 months (range 2-43), bronchial dilatation resolved completely in six children and there was improvement in appearances in a further eight, with medical treatment alone. Discussion: a radiological diagnosis of bronchiectasis should be considered with caution in children as diagnostic criteria derived from studies in adults have not been validated in children and the condition is generally considered irreversible.

Helical CT in evaluation of the bronchial tree

International Nuclear Information System (INIS)

Perhomaa, M.; Laehde, S.; Rossi, O.; Suramo, I.

1997-01-01

Purpose: To establish a protocol for and to assess the value of helical CT in the imaging of the bronchial tree. Material and Methods: Noncontrast helical CT was performed in 30 patients undergoing fiberoptic bronchoscopy for different reasons. Different protocols were compared; they included overlapping 10 mm, 5 mm, or 3 mm slices and non-tilted, cephalad or caudal tilted images. Ordinary cross-sectional and multiplanar 2D reformats were applied for visualization of the bronchial branches. The effect of increasing the helical pitch was tested in one patient. Results: A total of 92.1-100% of the segmental bronchi present in the helical acquisitions were identified by the different protocols. The collimation had no significant impact on the identification of the bronchial branches, but utilization of 3-mm overlapping slices made it easier to distinguish the nearby branches and provided better longitudinal visualization of the bronchi in 2D reformats. The tilted scans illustrated the disadvantage of not covering all segmental bronchi in one breath-hold. An increase of the pitch from 1 to 1.5 did not cause noticeable blurring of the images. CT and bronchoscopic findings correlated well in the area accessible to bronchoscopy, but CT detected 5 additional pathological lesions (including 2 cancers) in the peripheral lung. Conclusion: Helical CT supplemented with bronchography-like 2D reformats provides an effective method complementary to bronchoscopy in the examination of the bronchial tree. (orig.)

New frontiers in CT imaging of airway disease

International Nuclear Information System (INIS)

Grenier, Philippe A.; Beigelman-Aubry, Catherine; Fetita, Catalin; Preteux, Francoise; Brauner, Michel W.; Lenoir, Stephane

2002-01-01

Combining helical volumetric CT acquisition and thin-slice thickness during breath hold provides an accurate assessment of both focal and diffuse airway diseases. With multiple detector rows, compared with single-slice helical CT, multislice CT can cover a greater volume, during a simple breath hold, and with better longitudinal and in-plane spatial resolution and improved temporal resolution. The result in data set allows the generation of superior multiplanar and 3D images of the airways, including those obtained from techniques developed specifically for airway imaging, such as virtual bronchography and virtual bronchoscopy. Complementary CT evaluation at suspended or continuous full expiration is mandatory to detect air trapping that is a key finding for depicting an obstruction on the small airways. Indications for CT evaluation of the airways include: (a) detection of endobronchial lesions in patients with an unexplained hemoptysis; (b) evaluation of extent of tracheobronchial stenosis for planning treatment and follow-up; (c) detection of congenital airway anomalies revealed by hemoptysis or recurrent infection; (d) detection of postinfectious or postoperative airway fistula or dehiscence; and (e) diagnosis and assessment of extent of bronchiectasis and small airway disease. Improvement in image analysis technique and the use of spirometrically control of lung volume acquisition have made possible accurate and reproducible quantitative assessment of airway wall and lumen areas and lung density. This contributes to better insights in physiopathology of obstructive lung disease, particularly in chronic obstructive pulmonary disease and asthma. (orig.)

Bronchography in dogs. Comparative study with two barium sulphate solutions; Broncografía en perros. Estudio comparativo con dos concentraciones de sulfato de bario

Energy Technology Data Exchange (ETDEWEB)

Thibaut, J.; Gallardo, P.; Vargas, L.; Deppe, R.; Born, R. [Universidad Austral de Chile, Valdivia (Chile)

1998-07-01

Two solutions of barium sulphate, 60 and 30% w/v, were compared with the ''overflow'' Bronchographic method. Two groups of eight healthy adult does of both sexes, weighing 7 to 18 kg were used for the study. The dogs were anaesthetised with thiopentone sodium 2% (20 mg/kg iv). After intubation, each dog received contrast medium by a catheter connected to a syringe, in a 9 mi dose. Two series of two x-rays plates were taken in left lateral recumbent, 3 and 6 min after administering the contrast medium and in ventrodorsal projection, 30 sec. later. The x-ray plates obtained were analysed and compared intra and inter group considering the advance speed of the contrast medium, the radiographic density and outlines. Adverse reactions were controlled.

Lung bud anomalies: Radiologic findings in 30 patients

International Nuclear Information System (INIS)

Son, Kyung Myung; Yang, Hae Ryoun; Jeon, Jeong Su; Kim, Ok Hwa; Kim, Choon Yul; Bahk, Yong Whee

1990-01-01

Bronchogenic cyst, pulmonary sequestration, congenital cystic adenomatoid malformation and congenital lobar emphysema are four major congenital cystic pulmonary diseases that represent a spectrum of closely related anomalies arising at early stage of embryonic lung bud maturation. Most of them present with recurrent pulmonary infections or chest pain since childhood and usually the diagnosis is made at this age. Sometimes the lesions are silent and found at adult age. We retrospectively analyzed the pain chest radiograms of 30 patients with a lung bud anomaly. The diagnosis was established by surgery and biopsy, but bronchography, computed tomography and ultrasonography aided in the diagnosis, seventeen bronchogenic cysts, 8 pulmonary sequestrations, 2 congenital cystic adenomatoid malformations, 2 congenital lobar emphysema and 1 congenital bronchial stenosis are included in this study. Nine out of 13 intrapulmonary bronchogenic cysts involved the lower lobes: thin-walled cysts with or without air-fluid level were the characteristic chest roentgenographic finding. However, mediastinal bronchogenic cysts showed well-marginated mass. The pulmonary sequestration showed similar cysts mass with or without air-fluid levels in five out of eight patients, but the cyst wall was not so sharply defined as in the bronchogenic cyst. In two patients of congenital cystic adenomatoid malformation, a large thin-walled cyst with air fluid level was noted and differentiation from intrapulmonary bronchogenic cyst was difficult both by chest roentgenogram and computed tomography. Two patients of congenital lobar emphysema and one patient of bronchial stenosis showed unilateral hyperlucent lung without discrete cystic mass formation

Synchrotron radiation applications in medical research at Brookhaven National Laboratory

International Nuclear Information System (INIS)

Thomlinson, W.

1997-08-01

In the relatively short time that synchrotrons have been available to the scientific community, their characteristic beams of UV and X-ray radiation have been applied to virtually all areas of medical science which use ionizing radiation. The ability to tune intense monochromatic beams over wide energy ranges clearly differentiates these sources from standard clinical and research tools. The tunable spectrum, high intrinsic collimation of the beams, polarization and intensity of the beams make possible in-vitro and in-vivo research and therapeutic programs not otherwise possible. From the beginning of research operation at the National Synchrotron Light Source (NSLS), many programs have been carrying out basic biomedical research. At first, the research was limited to in-vitro programs such as the x-ray microscope, circular dichroism, XAFS, protein crystallography, micro-tomography and fluorescence analysis. Later, as the coronary angiography program made plans to move its experimental phase from SSRL to the NSLS, it became clear that other in-vivo projects could also be carried out at the synchrotron. The development of SMERF (Synchrotron Medical Research Facility) on beamline X17 became the home not only for angiography but also for the MECT (Multiple Energy Computed Tomography) project for cerebral and vascular imaging. The high energy spectrum on X17 is necessary for the MRT (Microplanar Radiation Therapy) experiments. Experience with these programs and the existence of the Medical Programs Group at the NSLS led to the development of a program in synchrotron based mammography. A recent adaptation of the angiography hardware has made it possible to image human lungs (bronchography). Fig. 1 schematically depicts the broad range of active programs at the NSLS

National Synchrotron Light Source medical personnel protection interlock

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Buda, S.; Gmuer, N.F.; Larson, R.; Thomlinson, W.

1998-11-01

This report is founded on reports written in April 1987 by Robert Hettel for angiography operations at the Stanford Synchrotron Research Laboratory (SSRL) and a subsequent report covering angiography operations at the National Synchrotron Light Source (NSLS); BNL Informal Report 47681, June 1992. The latter report has now been rewritten in order to accurately reflect the design and installation of a new medical safety system at the NSLS X17B2 beamline Synchrotron Medical Research Facility (SMERF). Known originally as the Angiography Personnel Protection Interlock (APPI), this system has been modified to incorporate other medical imaging research programs on the same beamline and thus the name has been changed to the more generic Medical Personnel Protection Interlock (MPPI). This report will deal almost exclusively with the human imaging (angiography, bronchography, mammography) aspects of the safety system, but will briefly explain the modular aspects of the system allowing other medical experiments to be incorporated. This MPPI report is organized such that the level of detail changes from a general overview to detailed engineering drawings of the hardware system. The general overview is presented in Section 1.0, MPPI Operational Mode and Procedures. The various MPPI components are described in detail in Section 2.0. Section 3.0 presents some simplified logic diagrams and accompanying text. This section was written to allow readers to become familiar with the logic system without having to work through the entire set of detailed engineering drawings listed in the Appendix. Detailed logic specifications are given in Section 4.0. The Appendix also contains copies of the current MPPI interlock test procedures for Setup and Patient Modes.

Imaging approach to the diagnosis of pulmonary sequestration

International Nuclear Information System (INIS)

Hang, J.D.; Guo, Q.Y.; Chen, C.X.; Chen, L.Y.

1996-01-01

Purpose: To describe the characteristic features of pulmonary sequestration (PS), to evaluate the usefulness of various imaging modalities, and to find a rational approach to accurate diagnosis. Material and Methods: Twenty-four patients with PS proved by operation and pathology were reviewed retrospectively. Plain chest films were done in all patients, bronchography in 3, sonography in 14, CT in 6 (including CT angiography in 1 case), MR in 8 (including MR angiography in 1 case) and aortography in 12 (including DSA in 1 case). Results: Plain chest films demonstrated a solid mass in 14 patients and a cystic mass in 10. Bronchograms showed displacement of adjacent bronchi with no filling of contrast medium within the lesion in 2 cases, while another case had a blind intermediate portion of the right bronchus (hypoplasia of middle and lower lobes associated with extralobar sequestration). Sonography demonstrated a solid lung mass in 12 cases and a solid mass with cystic areas in 2, and detected vessel-like structures within the mass or in its surroundings in 12. Doppler analysis showed arterial spectral wave confirming a feeding artery. CT revealed a solid mass in all patients, a mass with low density area in 4, and emphysema surrounding the mass in 3. MR imaging depicted anomalous arteries in all patients and venous drainage in 4 cases. Aortography demonstrated anomalous systemic arterial supply to the PS in all patients. In this series, 21 cases (87.5%) were correctly diagnosed preoperatively by the imaging modalities. Conclusion: Plain chest films can provide a diagnostic due to PS. Sonography, CT and MR are helpful for showing arterial blood supply and for making a definite diagnosis. We recommend a rational imaging approach for the diagnosis of PS. (orig.)

Comparison of iodine K-edge subtraction and fluorescence subtraction imaging in an animal system

International Nuclear Information System (INIS)

Zhang, H.; Zhu, Y.; Bewer, B.; Zhang, L.; Korbas, M.; Pickering, I.J.; George, G.N.; Gupta, M.; Chapman, D.

2008-01-01

K-Edge Subtraction (KES) utilizes the discontinuity in the X-ray absorption across the absorption edge of the selected contrast element and creates an image of the projected density of the contrast element from two images acquired just above and below the K-edge of the contrast element. KES has proved to be powerful in coronary angiography, micro-angiography, bronchography, and lymphatic imaging. X-ray fluorescence imaging is a successful technique for the detection of dilute quantities of elements in specimens. However, its application at high X-ray energies (e.g. at the iodine K-edge) is complicated by significant Compton background, which may enter the energy window set for the contrast material's fluorescent X-rays. Inspired by KES, Fluorescence Subtraction Imaging (FSI) is a technique for high-energy (>20 keV) fluorescence imaging using two different incident beam energies just above and below the absorption edge of a contrast element (e.g. iodine). The below-edge image can be assumed as a 'background' image, which includes Compton scatter and fluorescence from other elements. The above-edge image will contain nearly identical spectral content as the below-edge image but will contain the additional fluorescence of the contrast element. This imaging method is especially promising with thick objects with dilute contrast materials, significant Compton background, and/or competing fluorescence lines from other materials. A quality factor is developed to facilitate the comparison. The theoretical value of the quality factor sets the upper limit that an imaging method can achieve when the noise is Poisson limited. The measured value of this factor makes two or more imaging methods comparable. Using the Hard X-ray Micro-Analysis (HXMA) beamline at the Canadian Light Source (CLS), the techniques of FSI and KES were critically compared, with reference to radiation dose, image acquisition time, resolution, signal-to-noise ratios, and quality factor

Tratamento cirúrgico das bronquiectasias. Revisão de 34 casos

Directory of Open Access Journals (Sweden)

Aurora Lino

1997-07-01

treatment relies on surgical ressection. In the period between 1988 and 1995, 34 patients with bronchiectasis, 17 women and 17 men, with mean age of 43,8±17,9 years, underwent surgery. Indications for surgery were as follows: failure of medical treatment in 17 patients (50%, who presented with recurrent bronchopulmonary infections; occurrence of complications, such as hemoptysis and/or blood stained sputum, in 15 patients (44%; pulmonary mass lesion of uncertain etiology in 2 patients (5,8%. We were able to determine the etiology in 23 patients: bronchopneumonia in childhood and/or adolescence in 12 patients, sequelae to pulmonary tuberculosis in 10 patients and aspiration of a foreign body in one case. Sputum production, cough, hemoptysis and/or blood stained sputum were the most frequent symptoms. Anatomycal involvement of the lesions was documented by CT scan, in 26 patients, I 0 of whom also underwent bronchography. In 8 patients bronchography alone was performed. In all patients except one, lesions were unilateral and preferentially located in the LIL, RSL and RML. Before surgery, pulmonary function changes, were predominantly of the obstructive type (14 patients or 41 %.The following surgical procedures were done: 4 pneumectomys, 23 lobectomys (5 associated with segmental ressections, 4 segmentec-tomys and 3 bilobectomys. Post surgical mortality was null and morbidity was 20% (7 patients. In post-surgical follow-up, during 6-24 month period, 20 patients (58,8% remained asymptomatic, 11 (32,3% showed substantial clinical improvement without deterioration of their respiratory function and in 3 (8,8% surgical ressection was not beneficial. Palavras-chave: bronquiectasias, tratamento cirúrgico, avaliação funcional respiratória, : Key-words, bronchiectasis, surgical treatment, pulmonary function testing

Radiologic evaluation of right middle lobe collapse

International Nuclear Information System (INIS)

Kwun, Dae Young; Kim, Jong Deok; Kim, Jong Chul

1989-01-01

There are many pathogenetic factors for collapse of right middle lobe; profuse peribronchial clustering of lymph nodes about the right middle lobe bronchus, poor drainage of the bronchus because of its acute angle of take-off from the intermediate bronchus, and the isolation of this small lobe from the right upper and lower lobes, and thus from the aerating effects of collateral ventilation. Retrospectively we reviewed 36 cases of right of right middle lobe collapse of which causes were confirmed by histopathologic or bronchographic findings during the recent 6 years from March 1983 to February 1988 at Inje College Pusan Paik Hospital, and obtained the following results: 1. Male to female ratio was 1:1:4,and peak incidence (64%) was in the fifth and sixth decades with the mean age of 51.1 years. 2. Bronchiectasis was the most common cause (30.6%), and the others were chronic bronchitis (25.0%), pulmonary tuberculosis (19.4%), lung cancer (16.7%), and non-specific inflammatory disease (8.3%). This suggests benign disease is 5 times more common cause of right middle lobe collapse than lung cancer. 3. Among the plain chest radiolograph findings, obliteration of right cardiac border and triangular radiopaque density were the most frequent findings(77.8% in each) and the next was downward and anterior displacement of minor and major fissures (55.6%) 4. Bronchography was done in 11 cases; bronchiectasis was found in 8 cases and chronic bronchitis in 3 cases. Right middle lobe bronchus was obstructed in 2 cases of chronic bronchitis. 5. Chest CT scan was performed in 4 cases of lung cancer, 2 of non-specific inflammatory disease, and 1 of pulmonary tuberculosis: all of lung cancer revealed hilar mass, budged or lobulated fissures, in homogenous density, and mediastinal lymph node enlargement, and all benign disease showed homogenous density and flat to concave fissures. Right middle lobar bronchus narrowing was seen in 5 cases and its obstruction in 2 cases

Analysis of the results of CAT of thorax with bronchiectasis protocol, period 2000-2001 Hospital Calderon Guardia; Analisis de los resultados de TAC de torax con protocolo de bonquiectasias, periodo 2000-2001 Hospital Calderon Guardia

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Pacheco Segura, Maureen [Costa Rica

2003-07-01

This investigation analyses the computerized axial tomography (CAT) of thorax with protocol of bronchiectasis. It was carried out in the Servicio de Radiologia e Imagenes Medicas of the Hospital Calderon Guardia, Costa Rica. The bronchiectasis is the abnormal permanent expansion of the bronchial tuber and is important to diagnose it because the patient can suffer of pulmonary infections, these can be accompanied by bronchial blood flow and hemoptysis. When they are disseminated can be associated with significant obstruction of the aerial tract. When they are gotten into focus can be confused with neoplasia and other diseases. From the bronchiectasis diagnosis it is used methods of image such as x-ray of thorax, bronchography and computerized axial tomography (CAT) of thorax, usually the diagnosis is confirmed by means of a computerized axial tomography (CAT); which is the image of election to establish the presence and extension of the bronchiectasis. In addition, this study analyzes the radiological clinical relation in the patients which were performed the computerized axial tomography (CAT) of thorax with protocol of bronchiectasis and it identifies the most suitable radiological technique to obtain a satisfactory result in the computerized axial tomography with protocol of bronchiectasis. [Spanish] En esta investigacion se analiza la tomografia axial computarizada (TAC) de torax con protocolo de bronquiectasis realizada en el Servicio de Radiologia e Imagenes Medicas del Hospital Calderon Guardia, Costa Rica. Las bronquiectasias se definen como la dilatacion permanente anormal de los bronquios y es importante diagnosticarlas porque el paciente puede sufrir de infecciones pulmonares. Ademas, estas pueden acompanarse de flujo sanguineo bronquial y hemoptisis. Cuando estan diseminadas se pueden asociar con obstruccion significativa de la via aerea. Si estan focalizadas se pueden confundir con neoplasias u otras enfermedades. Para el diagnostico de bronquiectasias

Macrolide antibiotics for bronchiectasis.

Science.gov (United States)

Kelly, Carol; Chalmers, James D; Crossingham, Iain; Relph, Nicola; Felix, Lambert M; Evans, David J; Milan, Stephen J; Spencer, Sally

2018-03-15

Bronchiectasis is a chronic respiratory disease characterised by abnormal and irreversible dilatation and distortion of the smaller airways. Bacterial colonisation of the damaged airways leads to chronic cough and sputum production, often with breathlessness and further structural damage to the airways. Long-term macrolide antibiotic therapy may suppress bacterial infection and reduce inflammation, leading to fewer exacerbations, fewer symptoms, improved lung function, and improved quality of life. Further evidence is required on the efficacy of macrolides in terms of specific bacterial eradication and the extent of antibiotic resistance. To determine the impact of macrolide antibiotics in the treatment of adults and children with bronchiectasis. We identified trials from the Cochrane Airways Trials Register, which contains studies identified through multiple electronic searches and handsearches of other sources. We also searched trial registries and reference lists of primary studies. We conducted all searches on 18 January 2018. We included randomised controlled trials (RCTs) of at least four weeks' duration that compared macrolide antibiotics with placebo or no intervention for the long-term management of stable bronchiectasis in adults or children with a diagnosis of bronchiectasis by bronchography, plain film chest radiograph, or high-resolution computed tomography. We excluded studies in which participants had received continuous or high-dose antibiotics immediately before enrolment or before a diagnosis of cystic fibrosis, sarcoidosis, or allergic bronchopulmonary aspergillosis. Our primary outcomes were exacerbation, hospitalisation, and serious adverse events. Two review authors independently screened the titles and abstracts of 103 records. We independently screened the full text of 40 study reports and included 15 trials from 30 reports. Two review authors independently extracted outcome data and assessed risk of bias for each study. We analysed