Characteristic CT Findings Research Articles

Pulmonary alveolar proteinosis.

Case 1: A 52-year-old Caucasian retired police officer presented 3 years prior to diagnosis with the chief complaint of inability to exercise due to breathlessness. The patient was a long-distance walker who had given up this recreational activity due to dyspnea on exertion. He experienced an intermittent nonproductive cough without wheezing, chest pain, arthritis, or fevers. His past medical history was notable for childhood asthma, sinus polypectomy, seasonal allergies, and tobacco use of 37 pack years. His physical exam was only notable for mild obesity, oxygen desaturation on room air from 94% to 82% after walking 1500 ft, and scattered crackles throughout his lung fields bilaterally. Pulmonary function tests revealed no obstruction, mild restriction, and a moderate gas transfer defect. An elevated lactate dehydrogenase (LDH) of 360 was noted on his chemistry panel. Chest radiographs at initial presentation in 12/00 and at diagnosis 11/02 revealed bilateral interstitial/alveolar infiltrates (Figure 1). CT scanning revealed progression of bilateral ground glass alveolar infiltrates from presentation 1/01 to 11/02 (Figures 2A‐2F). Based on the characteristic CT findings, the patient underwent a bronchoalveolar lavage that was diagnostic for pulmonary alveolar proteinosis (PAP) (Figure 3). Due to marked dyspnea and abnormal lung function, the patient was treated with whole lung lavage that led to a marked improvement in his exercise tolerance and pulmonary function tests, although only mild improvement on CT (Figures 2H‐2I). Case 2: A 49-year-old Caucasian state employee presented with persistent cold-like symp

CT findings in patients with familial Mediterranean fever during an acute abdominal attack

The aim of this study is to present the abdominal CT findings of patients with familial Mediterranean fever (FMF) examined during an acute abdominal attack. CT scans of 17 patients (10 women and 7 men; age range 11-45 years) were retrospectively reviewed. Attention was directed to mesenteric or peritoneal abnormalities and to the presence of appendiceal pathology. Patients were divided into two groups; group A (n=14) consisted of patients with an acute abdominal attack caused by FMF, and group B (n=3) consisted of patients whose attack proved to be owing to a separate pathology requiring surgery. Characteristic CT findings of acute abdomen in FMF included mesenteric pathology (n=12), mainly of engorged vessels with thickened mesenteric folds, mesenteric lymphadenopathy (n=6) and ascites (n=6). Signs of focal peritonitis were found in four patients. Radiologists should be familiar with such CT findings of peritoneal irritation in patients with FMF during an acute attack, and may suggest this clinical diagnosis in the proper clinical setting in a patient who has not been previously diagnosed. Alternatively, the radiologist should be aware of the possibility of a concurrent acute appendicitis or other acute abdominal pathology in patients with known FMF and should search for it.

Surgical Management of Abdominal Tuberculosis

Recent reports suggest an increased incidence of abdominal tuberculosis in the United States, particularly in high-risk groups. The aim of this study was to review the spectrum of abdominal tuberculosis and its surgical management at a tertiary referral center in the United States. The medical records of patients treated for abdominal tuberculosis at our institution between January 1992 and June 2001 were retrospectively reviewed. Eighteen patients were diagnosed with abdominal tuberculosis by microbiologic and/or histologic examination. The 10 men and eight women had a mean duration of symptoms of 4 months (range 1 to 24 months). Five were born in the United States, and 13 were foreign born (7 Asians and 6 Africans). The United States–born patients with abdominal tuberculosis, as compared to the foreign-born patients, were older (mean age 74 years vs. 35 years), more likely to have chronic medical illnesses (80% vs. 7%), and had concomitant pulmonary tuberculosis (60% vs. 0%). Computed tomography was the most frequent imaging modality (88%); findings suggestive of abdominal tuberculosis were mesenteric/omental stranding (50%), ascites (37%), and retroperitoneal lymphadenopathy (31%). Seventeen of the 18 patients required operative intervention, and one patient underwent CT-guided drainage of a psoas abscess. Laparoscopy was useful for diagnosis in eight patients; laparotomy was performed for complications of abdominal tuberculosis in six patients and to obtain a tissue diagnosis in three patients. Abdominal tuberculosis continues to represent a diagnostic challenge to clinicians. Among native-born white Americans, abdominal tuberculosis is primarily a disseminated disease of elderly, debilitated patients with chronic illnesses. Among foreign-born individuals, abdominal tuberculosis occurs in young, immunocompetent patients from endemic areas. Characteristic CT findings should be evaluated for abdominal tuberculosis in the appropriate clinical setting. Laparoscopy is an effective modality for diagnosis of peritoneal tuberculosis. ( J Gastrointest Surg 2002;6:862–867.)

Acute epiploic appendagitis: CT findings in 33 cases.

Acute epiploic appendagitis (AEA) is a benign self-limiting process presenting with acute abdominal pain often misdiagnosed clinically as either diverticulitis or appendicitis, but which has a pathognomonic CT appearance. The CT findings in 33 adult patients diagnosed by CT over a 33-month period as having AEA were retrospectively reviewed. The study group included 24 men and 9 women, with a mean age of 44.6 years. The mean age of the male patients was lower than that of the female patients, 40.9 vs 54.7 years. All patients presented with acute abdominal pain, mainly in the left ( n=21) and right ( n=9) lower quadrants, with localized tenderness in all patients and peritoneal irritation in 15 of them. Low-grade fever was found in 8 patients and mild leukocytosis in 16. Characteristic CT findings of an oval fatty mass with central streaky densities and surrounded by mesenteric stranding adjacent to the serosal surface of the colon were seen in all cases. Additional findings included mural thickening of the juxtaposed colon in 16 patients and peritoneal fluid in 7. One patient underwent surgery on the basis of an erroneous diagnosis of acute appendicitis. As CT is often used nowadays to evaluate various acute abdominal complaints, it may be the first imaging modality by which AEA is diagnosed. AEA should be included in the differential diagnosis in young male patients with localized left lower abdominal pain and tenderness.

Conservative management of epiploic appendagitis based on CT scan findings

Dear Editor, Epiploic appendagitis is a relatively rare, often underdiagnosed condition affecting young adults. A 31-year-old male presented with a 12-hour history of acute left iliac fossa pain of increasing severity, which had become constant and aggravated by movement. There was no history of gastrointestinal disturbance. On examination, there was marked tenderness and guarding in the left iliac fossa. The white cell count was raised (11.23x10/l) with a neutrophilia (7.9x10/l). Initially, a clinical diagnosis of diverticulitis was made in spite of the patient’s age. An abdominal CT showed an abnormality of the descending and sigmoid junction with a peripheral hyperattenuated ring, a central area of hypoattenuation of the anterior peritoneal lining and thickening and stranding of fat surrounding the lesion (see Figures 1 and 2). These findings confirmed the diagnosis of epiploic appendagitis. The patient was managed conservatively and by day 5 his symptoms had resolved and he was discharged home. Primary epiploic appendagitis (PEA) results from torsion and inflammation of an epiploic appendix, or less commonly following spontaneous venous thrombosis. While formerly thought to be relatively rare, recent literature suggests it is being underdiagnosed. Patients present with localised abdominal tenderness which may mimic the acute surgical emergencies of diverticulitis or appendicitis. Gastrointestinal symptoms are uncommon. The patient is typically apyrexial with a normal leucocyte count. Clinical diagnosis is difficult. Previously diagnosed at laparotomy for presumed diverticulitis or appendicitis, and treated by ligation and excision of the appendage, it may now be diagnosed reliably on characteristic CT findings. PEA should be considered in the differential diagnosis of acute abdominal pain, particularly in young patients presenting with atypical features.

Cranial imaging in child abuse.

Serious head injury in children less than 2 years old is often the result of child abuse. The role of the different neuroimaging modalities in child abuse is reviewed. Skull X-ray and cranial CT are mandatory. Repeat or serial imaging may be necessary and brain MR imaging may contribute to the diagnostic work-up, particularly in the absence of characteristic CT findings. The radiologist plays an important role in accurately identifying non-accidental cranial trauma. The clinical presentation can be non-specific or misleading. The possibility should be considered of a combined mechanism, i.e., an underlying condition with superimposed trauma. In this context, the radiologist is in the front line to suggest the possibility of child abuse. It is therefore important to know the spectrum of, sometimes subtle, imaging findings one may encounter. Ophthalmological examination is of the greatest importance and is discussed here, because the combination of retinal hemorrhages and subdural hematoma is very suggestive of non-accidental cranial trauma.

CT findings of leukemic pulmonary infiltration with pathologic correlation.

The aim of this study was to demonstrate the characteristic CT findings of leukemic pulmonary infiltration based on the pathologic findings. The CT findings of 11 leukemic patients with leukemic pulmonary infiltration were compared with those of 22 leukemic patients with other diseases as a control group. Evaluated pulmonary parenchymal CT findings included thickening of bronchovascular bundles and interlobular septa, prominence of peripheral pulmonary arteries, ground-glass opacities, air-space consolidation, and nodules. The CT-pathologic correlations for leukemic infiltration were evaluated in 7 patients. Frequent parenchymal CT findings were thickening of bronchovascular bundles (81.8%), prominence of peripheral pulmonary arteries (81.8%), and non-lobular and non-segmental ground-glass opacities (90.9%). The first two findings were significantly more frequently observed in leukemic infiltration than in the control group, had good interobserver agreement, and corresponded pathologically to leukemic cell infiltration around the pulmonary arteries, bronchi, or bronchioles. Non-lobular and non-segmental ground-glass opacity corresponded to leukemic cell infiltration within alveolar spaces and septa adjacent to the pulmonary arteries or bronchi and also corresponded to hemorrhage, edema, or diffuse alveolar damage. Thickening of bronchovascular bundles and prominence of peripheral pulmonary arteries are CT findings suggestive for leukemic infiltration and correspond to peribronchovascular tumor extension.

Acute diverticulitis of the cecum and ascending colon: the value of thin-section helical CT findings in excluding colonic carcinoma.

The purpose of this study was to assess the value of characteristic thin-section helical CT findings of acute diverticulitis involving the cecum and ascending colon in excluding colonic carcinoma. Thin-section helical CT scans (5-mm collimation) of 19 consecutive patients with proven diverticulitis and 21 consecutive patients with surgically proven carcinoma involving the cecum and ascending colon were reviewed retrospectively. Two radiologists independently analyzed these parameters: degree of pericolic infiltration, mesenteric fluid, vascular engorgement, arrowhead-shaped wall thickening, air-filled diverticula, inflamed diverticula, and preserved enhancement pattern of involved colonic wall. Inter-observer agreement was assessed with a kappa statistical analysis, and the features that most distinguished diverticulitis from colonic carcinoma were selected with a stepwise logistic-regression analysis. The two CT findings of right-sided colonic diverticulitis that most distinguished it from colonic carcinoma were inflamed diverticula and the preservation of an enhancement pattern of the involved colonic wall. Excellent interobserver agreement (kappa > 0.60) was obtained for both findings. Inflamed diverticula (kappa = 0.80) had a mean sensitivity, specificity, and accuracy for diverticulitis of 86.8%, 92.9%, and 90.0%, respectively, in differentiating right-sided colonic diverticulitis from colonic carcinoma. Preserved wall enhancement pattern (kappa = 0.70) had a mean sensitivity, specificity, and accuracy of 89.5%, 95.3%, and 92.5%, respectively. On thin-section helical CT, an inflamed diverticula and a preserved enhancement pattern of the thickened colonic wall were the two most statistically significant CT findings of acute diverticulitis involving the cecum and ascending colon that distinguished diverticulitis from colonic carcinoma.

Postoperative findings following the Whipple procedure: determination of prevalence and morphologic abdominal CT features

This study was conducted to determine characteristic CT findings following the Whipple procedure and to evaluate the usefulness of CT in predicting tumor recurrence. Eighty-four postoperative abdominal CT scans and medical records of 43 patients were retrospectively reviewed. Perioperative histopathologic examinations revealed malignancy in 32 patients (74.4 %). Time interval between surgery and CT varied from 13 days to 6 years and 7 months. Common postoperative findings were unopacified anastomotic bowel loops in the porta hepatis (n = 69 scans), perivascular cuffing (n = 42 scans), pneumobilia (n = 40 scans), dilated intrahepatic bile ducts (n = 22 scans), reactive lymphadenopathy (n = 21 scans), and transient fluid collections (n = 20 scans). Postoperative complications were detected on 17 CT scans (20.2 %): generalized ascites (n = 8 patients), deep abscesses (n = 3 patients), wound abscess (n = 1 patient), pancreatitis (n = 1 patient), and pseudomembranous colitis (n = 1 patient). Tumor recurrence appeared in 15 patients (46.8 %) after a mean postoperative period of 11 months (1 month to 3 years): local (9 of 15), regional lymph nodes (9 of 15), and liver metastasis (8 of 15). Detection of generalized ascites more than 30 days after surgery was associated with tumor recurrence in 6 of 6 patients (100 %). Diffuse ascites (> 30 days after surgery) behaved as an early predictive sign of tumor recurrence. In our series CT accuracy for detecting recurrent tumor with CT was 93.5 %. No predilection site for disease recurrence could be determined.

Helical CT Finding of Carotid-Cavernous Fistula: A Sign of Early Enhancing Superior Ophthalmic Vein

Purpose: The purpose of this study was to determine the diagnostic value of a sign of early enhancing superior ophthalmic vein (SOV), as seen on helical CT images in patients with carotid-cavernous fistula (CCF). Materials and Methods: This study involved 16 patients with CCF and 28 control patients. Axial CT images with scanning delays of 30 seconds following bolus injection of contrast material (90 mL, 3 mL/sec) were ob-tained, and this procedure was followed by coronal CT imaging. To determine the presence or absence of ear-ly enhancement or, dilatation of the SOV, bulging of the cavernous sinus, and enlargement of extraocular muscle, CT images were analysed by three observers in a blinded, random manner. Early enhancement of SOV was determined to be present where enhancement of the SOV was similar to or stronger than that of the ipsi-lateral posterior cerebral artery. Results: A sign of early enhancing SOV was seen in 14 of the 16 patients with CCF but in no control patients (88% sensitivity and 100% specificity). The respective sensitivity and specificity of other CT features were 71% and 100% (dilatation of the SOV, as seen on axial images), 60% and 83% (dilatation of the SOV, as seen on coronal images), 71% and 89% (dilatation of the cavernous sinus), and 65% and 98% (enlargement of extraocu-lar muscle). Conclusion: A sign of early enhancing SOV is a characteristic and specific CT finding of CCF, and is useful for the diagnosis of CCF.

A CASE OF INTERNAL HERNIA OF THE SUPRAVESICAL FOSSA SUCCESSFULLY DIAGNOSED BY LAPAROSCOPY

A 70-year-old woman complaining of upper abdominal pain and vomiting was admitted to the hospital with a diagnosis of intestinal obstruction. Abdominal CT scan revealed that the dilated small intestine oppressed the bladder with caliber change in the small intestine at the same portion. Internal hernia was suspected and an emergency operation was perfomed. Laparoscopic observation revealed that the hernia opening was situated at the supravesical fossa and the small intestine protruded through the opening and necrosed. The definite diagnosis of strangulated ileus due to impaction of the small intestine into the internal hernia of the supravesical fossa was made. So a small incision was made at an appropriate location that enabled us to perform a laparotomy. Operative procedures included a partial excision of the small intestine, a rerection of the hernia sac, and suture of the hernia opening. Internal hernia of the supravesical fossa is an extremely rare entity and there have been no case reports which were diagnosed preparatively. This paper presents a case of the disease in which characteristic CT findings offered a clue for diagnosis and then laparoscopic exploration contributed to diagnosis and treatment, together with some bibliographical comments.

CT and MR Findings of Bronchial Anthra cofibrosis

Purpose : To evaluate the CT and MR findings of bronchial anthracofibrosis. Materials and Methods : Forty-one patients with ronchoscopically confirmed bronchial anthracofibrosis were included in this study. Thirty-six were female and five were male, and all were aged between 53 and 89 (mean, 70) years. The CT (n=41) and MR findings (n=5) were retrospectively analysed with regard to bron-chostenosis, atelectasis, air-space consolidation, lymph node enlargement, calcified lymph node, mass and bronchial wall thickening, as seen on CT, and signal intensity of the mass and lymph nodes, as seen on MR. Results : CT scans revealed the presence of bronchostenosis (n=34, 83 %), atelectasis (n=24, 59 %), pneumonic consolidation (n=26, 63 %), enlarged mediastinal lymph node (n=39, 95 %), calcified lymph node (n=22, 54 %), mass (n=4,10 %), and thickening of bronchial wall (n=1, 2.4 %). Multifocal involvement of bron-chostenosis, atelectasis, and air-space consolidation occurred in 61%, 50 % and 30 % of cases, retrospectively. MR imaging showed low signal intensity of mass (n=3) and lymph nodes (n=10) on T1WI and T2WI. but in one case, mass and lymph node showed central high signal intensity on T2WI. Conclusion : A multiplicity of bronchostenosis, atelectasis, air-space consolidation and enlarged mediastinal lymph nodes were characteristic CT findings of bronchial anthracofibrosis. Most MR findings included relatively low signal intensity of masses and lymph nodes on T2WI, possibly indicating the benign nature of the diseases

Clinical features of non-specific interstitial pneumonia

The clinical features of 24 patients with non-specific interstitial pneumonia (NIP) were evaluated. The patients consisted of seven men and 17 women, with a median age of 60 years. In seven patients, the disease was idiopathic and eight had collagen vascular diseases. Cough, dyspnoea and fever were frequently observed. The time interval between the onset of symptoms and open lung biopsy was 3 months. Mild increases of IgG, CRP, and LDH were also frequently observed. The average per cent VC was 65·1 ± 3·2% and the average PaO 2 was 71·3 ± 2·4 Torr. Bronchoalveolar lavage was done in 20 patients, and a moderate increase in lymphocytes (27·8 ± 6·7%) with a low CD4 CD8 ratio (0·86 ± 0·22) was observed. Multiple patchy infiltration or diffuse interstitial shadows, located predominantly in the lower fields of both lungs were the characteristic chest CT findings. Lung biopsies in this group were characterized by varying proportions of chronic interstitial inflammation and fibrosis which was temporarily uniform. Patients were given steroid pulse therapy or oral steroids. The results were mild to marked improvements in chest roentgenographic findings and lung functions. Four patients (16·7%) died because of respiratory failure caused by NIP. This is the first report to describe clinical features of NIP since the original report by Katzenstein and Fiorelli.

CT Findings of the Angiomatous Polyp in the Nasal Cavity and Paranasal Sinus

Purpose : To assess the characteristic CT findings of the angiomatous polyp. Materials and Methods : Fivecases of pathologically-proven angiomatous polyp were retrospectively evaluat-ed. All underwent CT scanning, butin only four cases were postcontrast CT scans obtained. In analysing CT findings we focused on adjacent bonychange, and the extent and enhancement pattern of the mass. Results : All but one case involved the maxillarysinus, showing thickening of the posterolateral wall and ero-sion or destruction of the medial wall. As forinvolvement of the anterior wall of this sinus, bony destruction was seen in one case, and thickening in three. Infour cases the tumor involved the maxillary sinus and nasal cavity, and two cases showed nasopharyngeal extension.No case involved the pterygopalatine fossa, however. On contrast enhanced CT scans(n=4), all cases showedenhancement as strong as blood vessels, and a multiple focal punctate or tubular pattern. Conclusion : Angiomatouspolyp tends to show bone thickening rather than bone destruction, not to involve the pterygopalatine fossa, and toreveal a strong punctate or tubular enhancement pattern. These findings may be helpful in the differentialdiagnosis of angiomatous polyp from other tumors such as maxillary cancer, an-giofibroma and nasal polyp

Computed tomography in the diagnosis of maxillofacial mass lesions in younger children.

To evaluate the CT findings of maxillofacial mass lesions in younger children and to discuss the effectiveness of CT in their differential diagnosis. CT findings of 17 patients (age range, 0 years 5 months to 3 years 3 months) with histopathologically proven maxillofacial mass lesions were retrospectively evaluated. About two-thirds (11/17) comprised congenital lesions or more common lesions in infancy or younger children. Hemangiomas, dermoid cysts and ranulas in this age group presented characteristic CT findings in common with those occurring in adults. Two invasive lesions (melanotic neuroectodermal tumor and aggressive fibromatosis) had irregular margins and the latter also showed aggressive bone destruction. Two angiomas had irregular margins. A fibrosarcoma showed expansile bone destruction but had a regular margin. CT was useful in demonstrating the extent of maxillofacial mass lesions in children and for surgical treatment planning. Although some invasive lesions could be correctly diagnosed on the basis of CT, its diagnostic value in differentiating malignant from benign maxillofacial lesions in younger children was limited.

Clinical and pathologic variants of appendiceal disease: CT features.

M ost cases of appendicitis have characteristic clinical, pathologic, and CT findings: variants of appendiceal disease are occasionally encountered. Some appendiceal variants are incidental, and others have implications for patient care. This pictorial essay describes and illustrates the CT appearance of several uncommon clinical and pathologic variants of appendiceal disease. with emphasis on clinically relevant features. Acute Appendicitis The CT features of typical acute appendicitis include an abnormal appendix, periappendiceal inflammation, and changes in the cecal apex [1 ]. The abnormal appendix fails to fill completely with contrast material, measures greater than 6 mm in diameter, shows wall thickening and enhancement after administration of IV contrast material, and often contains one or more appendoliths. Periappendiceal inflammatory changes include fat stranding, phlegmon, fluid, free air bubbles, abscess, and adenopathy. Changes in the cecal apex include focal cecal apex thickening, an arrowhead sign, and a cecal bar. Typically, three or more CT signs of appendicitis are present for each case of appendicitis (Fig. 1).

Primary epiploic appendagitis: US and CT findings.

A retrospective review is presented of seven cases of epiploic appendagitis, with surgical confirmation in one case. The main clinico-analytical data and the US and CT findings are described, as well as the histopathologic features in the sole case that underwent surgical resection. We also calculated the frequency of this entity in patients undergoing emergency abdominal US on clinical suspicion of diverticulitis. In all seven cases the clinico-analytical evidence was nonspecific (localized acute abdominal pain and slight leukocytosis), mimicking in six cases the clinical presentation of sigmoid diverticulitis and in one case that of acute appendicitis. US imaging findings were characteristic: a hyperechoic mass localized under the point of maximum pain, adjacent to the anterior peritoneal wall and fixed during deep breathing. In none of the cases did color Doppler US show flow. CT findings were also typical and showed a mass with a peripheral hyperattenuated rim surrounding an area of fatty attenuation. Overall 7.1 % of patients investigated to exclude sigmoid diverticulitis finally showed findings of primary epiploic appendagitis. Primary epiploic appendagitis thus shows characteristic US and CT findings that allow its diagnosis and follow-up. This entity is much more frequent than previously reported, especially in patients referred for US to exclude sigmoid diverticulitis.

Importance of Intrapulmonary Lymph Nodes in the Differential Diagnosis of Small Pulmonary Nodular Shadows

The objectives of the present study were to evaluate the importance of intrapulmonary lymph nodes (IPLNs) in the differential diagnosis of small pulmonary nodules and to review the CT findings of IPLNs. Retrospective analysis of patient records. Chest Disease Research Institute Hospital, Kyoto University. Between January 1991 and May 1996, we examined 26 patients with pulmonary nodular shadows smaller than 1 cm in diameter that could not be diagnosed before surgery. All patients (19 men, 7 women) underwent chest CT (28 to 72 years old; mean, 52.3 years). The pathologic diagnoses were IPLNs in 46.2% (12/26), pulmonary hamartoma in 23.1% (6/26), lung cancer in 11.5% (3/26), pulmonary tuberculoma in 11.5% (3/26), and metastatic lung tumor in 7.7% (2/26). IPLNs were located in the lower lobe in 72%. The characteristic CT findings of IPLNs were a clear border and location close to the pleura. Two of them resembled lung cancer. The CT features in these two IPLNs and in three small lung cancers overlapped. In the present study, we investigated small nodular shadows <1 cm in diameter and found that IPLNs located underneath the pleura are important to consider in the differential diagnosis of lung cancer. The CT scan findings of IPLNs were not necessarily specific and sometimes resembled those of lung cancer. Because of their location, video-assisted thoracic surgery is useful in making a definite diagnosis.

Pulmonary involvement in polymyositis and dermatomyositis: sequential evaluation with CT.

The characteristic findings of pulmonary involvement in polymyositis (PM) or dermatomyositis (DM) and the change in findings before and after treatment were evaluated with sequential high-resolution CT studies. CT images of pulmonary involvement in 19 patients with PM or DM were reviewed. During a period of 2-61 months, 17 of these patients underwent sequential CT before and after treatment with corticosteroids, immunosuppressants, or both. Findings of the initial CT studies included pleural irregularities and prominent interlobular septa (n = 19), ground-glass attenuation (n = 19), patchy consolidation (n = 19), parenchymal bands (n = 15), irregular peribronchovascular thickening (n = 15), and subpleural lines (n = 7). Honeycombing was not detected on any CT images. These findings were more remarkable in the lower portion and the subpleural area of the lungs. In 16 of the 17 patients who underwent sequential CT conditions such as patchy consolidation, parenchymal bands, and irregular peribronchovascular thickening improved, becoming pleural irregularities and prominent interlobular septa, ground-glass attenuation, and subpleural lines on follow-up CT scans. Consolidation with patchy and subpleural distribution, parenchymal bands, and irregular peribronchovascular thickening were characteristic and reversible CT findings in patients with PM or DM.

Traumatic thoracolumbar facet instability: characteristic imaging findings.

To review imaging patterns and injury mechanisms in patients with thoracolumbar facet instability (TFI). Imaging studies for thoracolumbar osseous injuries over a 2-year period were reviewed. Imaging findings, injury pattern and reported mechanism of injury were established for patients with TFI. One hundred and ten patients with thoracolumbar acute, osseous injuries were studied. Eleven of 68 (16.2%) unstable thoracolumbar injuries demonstrated TFI. Seven (64%) of the eleven TFI patients were unrestrained occupants in a motor vehicle accident (MVA) and the remainder were involved in injuries dominated by blunt impact to the back. Only two (18%) had serious, permanent neurological deficits. TFI is a common injury pattern, particularly for unrestrained occupants in MVAs. Characteristic radiographic, CT and MRI findings are presented and correlated with the injury mechanism and clinical findings.