Micronodular lung pattern - Differential diagnosis
|
|
- Malcolm Nash
- 6 years ago
- Views:
Transcription
1 Micronodular lung pattern - Differential diagnosis Poster No.: P-0074 Congress: ESTI 2015 Type: Educational Poster Authors: P. Ninitas, F. Marinho, P. Campos, I. Távora ; Lisbon/PT, Funchal/PT, Cascais/PT Keywords: Education and training, Education, Diagnostic procedure, CT-High Resolution, CT, Lung DOI: /esti2015/P-0074 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 22
2 Learning objectives To recognize the micronodular lung pattern in a high-resolution CT (HRCT). To identify the predominant distribution of the micronodules: centrilobular, perilymphatic or random. To make a differential diagnosis based on the location of the micronodules. Know the diseases that may cause the diffuse micronodular lung disease and their predominant features. Background A pulmonary micronodule is a discrete, small, round, focal opacity with less than 3mm in diameter (1). The micronodular lung pattern consists of multiple pulmonary micronodules (1,2,3). The distribution is widespread but not necessarily uniform (1). On CT scans, the micronodular pattern may be classified based on their anatomic distribution: centrilobular, lymphatic, or random (1). For this purpose it is essential to understand the secondary lobular anatomy of the lung. The secondary pulmonary lobule is defined as the smallest unit of lung function marginated by connective tissue septa - the interlobular septa (1,2,3). The core or centrilobular structures include bronchioles, their accompanying pulmonary arterioles and lymphatic vessels (1,2). Within the secondary pulmonary lobule is the intralobular interstitium, a series of connective tissue fibers that suspend the various lobular structures (2). Investing the bronchi and pulmonary arteries it is the peribronchovascular interstitium that surrounds these structures in the perihilar lung - axial fiber system (3). The more peripheral continuum of this interstitial fiber system surrounds small centrilobular bronchioles and arteries (3). Pulmonary veins and lymphatics course in the periphery of the lobule within the interlobular septa (2). The peripheral interstitium extends over the surface of the lung beneath the visceral pleura and envelopes the lung in a fibrous sac from which the connective tissue septa penetrate the lung parenchyma (3). Secondary pulmonary lobules in the lung periphery are relatively large and are marginated by interlobular septa that are thicker and better defined than lobules in other parts of the lung, whereas the secondary lobules in the central lung zone are smaller and more irregular in shape (3). Page 2 of 22
3 Centrilobular micronodules are distributed primarily within the center of the secondary pulmonary lobule (2). They usually are positioned about 5 to 10 mm from the visceral pleural surface (2,4). When these micronodules are present it means that the structures in the center of the pulmonary lobule are affected: bronchiole, artery or the interstitium peribronchiolar or periarterial (2,4). Perilymphatic micronodules are found along the pulmonary lymphatics: in the interlobular septa, in the visceral pleura and within the center of the secondary lobule (2). Interlobular and subpleural micronodules are present in great number with very few centrilobular micronodules (2,4). Random micronodules are seen in the center of the lobule and in contact with interlobular septa and visceral pleural surfaces, like the perilymphatic ones (2). However, the distribution of the random micronodules is diffuse without a predominant topography (2). Images for this section: Page 3 of 22
4 Fig. 1: Secondary Pulmonary Lobule Page 4 of 22
5 Fig. 2: Centrilobular disease Page 5 of 22
6 Fig. 3: Perilymphatic disease Page 6 of 22
7 Fig. 4: Random distribution of the micronodules Page 7 of 22
8 Imaging findings OR Procedure details High-resolution computed tomography (HRCT) provides a more accurate vision of the lung parenchyma than chest radiographs in the presence of diffuse lung disease (5). HRCT reveals features that can clarify the diagnosis when chest radiograms are inconclusive due to its ability to evaluate the lung parenchyma in cross-section, eliminating the superimposition of densities (4,5). On thin-section CT scans, the three basic components of the lobule - the interlobular septa and septal structures, the central lobular region (centrilobular structures), and the lobular parenchyma-can be identified (1). Localizing nodules on HRCT begins first with assessing the nodules in contact with the visceral pleura surfaces or fissures (subpleural nodules). If there is a significant proportion of subpleural nodules it could be a perilymphatic or random distribution: the distinction is that the perilymphatic nodules are predominantly found along interlobular septa and visceral pleura (centrilobular nodules are scarce) and the random nodules are even distributed along the central components and the periphery of the secondary lobule without preference (2,4,5). On the other hand if there are absence or only a very few subpleural nodules it is a centrilobular distribution (2,4). Once one identifies a perilymphatic distribution it indicates that there is a disease involving preferentially the lymphatic structures. In this category, the main diseases to be considered are sarcoidosis and lymphangitic carcinomatosa. Other diagnoses for this pattern of disease are silicosis, coal worker pneumoconiosis, lymphocytic interstitial pneumonia, lymphoproliferative disorders and amyloidosis (2,4). In sarcoidosis the micronodules are found most often in the subpleural and peribronchovascular interstitium and less often in the interlobular septa. They usually have a bilateral and symmetric distribution, predominantly but not invariably in the upper and middle zones and are sharply defined (6,7). The most common tumors that spread within the pulmonary lymphatics (lymphangitic carcinomatosa) are carcinomas of the bronchus, breast, pancreas, stomach, colon, and prostate. CT shows a non-uniform, nodular, thickening of the interlobular septa and the bronchovascular bundles, often with patchy airspace opacities. The distribution of the Page 8 of 22
9 changes varies greatly: may involve all zones of both lungs or they may be centrally or peripherally predominant; sometimes they are confined to a lobe or one lung (8,9). Random micronodules don't have a definable distribution relative to the secondary pulmonary lobule: they are seen in the center of the lobule and in contact with interlobular septa and visceral pleural surfaces. Random micronodules, in contrast to perilymphatic ones, do not show a patchy distribution in the lung parenchyma and they are usually spread uniformly throughout the lung parenchyma in a bilaterally symmetric distribution (2). The differential diagnosis includes hematogenous metastases, infections (fungal, viral, tuberculosis) and less frequently, silicosis, coal-worker's pneumoconiosis, Langerhans cell histiocytosis, septic emboli and pulmonary vasculitides (2,5). Hematogenous metastases are frequently due to metastatic thyroid cancer, renal cancer, and melanoma; while larger less profuse metastases tend to be adenocarcinomas in adults, typically originating from the lung, breast, or the GI tract (4). Hematogenous metastases typically have a peripheral and basal predominance when limited in number but a uniform distribution when there are innumerable lesions and are relatively uniform in size (5,6). Hematogenous dissemination of tuberculosis, also called miliary tuberculosis, shows multiple micronodules with a random pattern. Ground-glass areas with a variable extension and patchy appearance could be present (5,6). Differentiation between infection and tumor may be impossible to determine by imaging features alone, in general, the clinical history renders these diagnoses relatively straightforward (4,5,6). The micronodules in silicosis have an upper and posterior predominance in mild disease. Centrilobular and subpleural micronodules are common. The complicated disease originates progressive massive fibrosis (6). Centrilobular micronodules can reflect the presence of either interstitial or airspace abnormalities, so they are most commonly seen in patients with disease that primarily affects centrilobular bronchioles and results in inflammation, infiltration or fibrosis of the surrounding interstitium and alveoli (3). On thin-section CT scans, they usually appear to be separated from the pleural surfaces, fissures, and interlobular septa by a distance of at least several millimeters, therefore they are seen to be related to centrilobular structures, even if they cannot be precisely localized to the centers of secondary lobules. Centrilobular micronodules may be dense and of homogeneous attenuation or of groundglass opacity (3). Page 9 of 22
10 Once nodules are identified as centrilobular, one should search for tree-in-bud - small centrilobular nodules of soft-tissue attenuation connected to multiple branching linear structures of similar caliber originating from a single stalk that end several millimeters distant from nearby pleural or fissural surfaces (3,4,5,10). The tree-in-bud sign usually reflects the presence of dilated centrilobular bronchioles with lumina that are impacted with mucus, fluid, or pus; it is often associated with peribronchiolar inflammation (3). The tree-in-bud sign is usually associated with other abnormal findings visible on thin-section CT scans: bronchiolar (dilatation and wall thickening are sometimes seen) and large-airways abnormalities (bronchial wall thickening or bronchiectasis) (3). Another frequently encountered finding in patients with bronchiolar disease is mosaic attenuation (4,10). Centrilobular micronodules with tree-in-bud sign is seen in infectious bronchiolitis (bacterial, viral, fungal, typical and atypical mycobacterial infections), allergic bronchopulmonary aspergillosis, cystic fibrosis, diffuse panbronchiolitis and endobronchial neoplasms (particularly adenocarcinoma in situ) (2,4,10). In patients with endobronchial spread of tuberculosis the presence of centrilobular micronodules and tree-in-bud is highly suggestive of active disease. Associated highresolution CT findings include bronchial wall thickening with or without bronchiectasis. Consolidation, cavitation, pleural effusion, and lymphadenopathy with central necrosis can also be seen (10). Infection with pulmonary nontuberculous mycobacteria has radiologic manifestations similar to those in patients with post primary tuberculosis in its classic form (10). Airway-invasive aspergillosis is a mycotic disease caused by Aspergillus species, usually A fumigatus. It is most commonly seen in immunocompromised neutropenic patients and patients with acquired immunodeficiency syndrome (AIDS). Bronchiolitis is characterized at thin-section CT by the presence of centrilobular nodules and linear branching opacities producing a tree-in-bud appearance (10). When centrilobular nodules are present but tree-in-bud morphology is absent, it indicates a disease that affect the centrilobular portion of the secondary lobule: the centrilobular bronchiole, peribronchiolar or perivascular (4). This includes diseases that primarily affect the centrilobular bronchiole, as well as those primarily peribronchiolar or perivascular in origin (4). The peribronchiolar distribution results in a pattern of diffuse, poorly defined ground-glass nodules and the differential Page 10 of 22
11 diagnosis encompasses several diseases: hypersensitivity pneumonitis, respiratory bronchiolitis (RB), Langerhans cell histiocytosis (LCH) and pneumoconiosis (especially silicosis and coal-worker's pneumoconiosis). Diseases related to bronchiolar lymphatics are also included in the differential diagnosis: lymphocytic interstitial pneumonitis (LIP) and mucosa-associated lymphoid tissue lymphoma (maltomas). The perivascular origin includes vasculitis, pulmonary edema and pulmonary hypertension (2,4,5). On thin-section CT, hypersensitivity pneumonitis appears acutely as small, ill-defined centrilobular nodules and bilateral airspace consolidation. In the subacute stage, there are patchy ground-glass opacities with ill-defined centrilobular nodules. Mosaic perfusion generally affects the middle and lower lung (4,5). RB typically produces faint micronodular nodules and patchy ground-glass opacities predominantly involving the upper lobes. Moderate centrilobular emphysema is common, given that most patients have a smoking history (5,10). Lymphocytic interstitial pneumonitis (LIP) is usually secondary to systemic diseases: Sjogren syndrome, human immunodeficiency virus infection, and variable immunodeficiency syndromes (10). Occasionally centrilobular nodules, septal thickening and ground-glass attenuation are identified, but most frequently thin-walled perivascular cysts are seen. Bilateral abnormalities are diffuse or have lower lung predominance (10). Images for this section: Page 11 of 22
12 Fig. 5: Diagnostic Algorithm - micronodular disease. Adapted from 2,4 and 11 Fig. 6: Diferential diagnosis of the perilymphatic diseases Page 12 of 22
13 Fig. 7: Sarcoidosis. Perilymphatic distribution of micronodules - along the fissures and peribronchovascular interstitium. Page 13 of 22
14 Fig. 8: Sarcoidosis. Perilymphatic distribution of micronodules - perihilar interstitial micronodules Page 14 of 22
15 Fig. 9: Lymphangitic Carcinomatosa. Thickening of the interlobular septa and the bronchovascular bundles with patchy airspace opacities. Fig. 10: Random micronodular pattern - differential diagnosis Page 15 of 22
16 Fig. 11: Miliary tuberculosis. Innumerable micronodules spread uniformly throughout the lung parenchyma symmetrically without a definable distribution. Fig. 12: Diferential diagnosis of the centrilobular diseases with tree-in-bud Page 16 of 22
17 Fig. 13: Endobronchial tuberculosis. Centrilobular nodules and micronodules. Page 17 of 22
18 Fig. 14: Infectious bronchiolitis. Centrilobular micronodules and linear branching opacities with tree-in-bud sign. Page 18 of 22
19 Fig. 15: Diferential diagnosis of the centrilobular diseases without tree-in-bud Page 19 of 22
20 Fig. 16: Hypersensitivity micronodules. pneumonitis. Ill-defined ground-glass centrilobular Fig. 17: Respiratory bronchiolitis. Centrilobular micronodules and patchy ground-glass opacities. Page 20 of 22
21 Conclusion The differential diagnosis of the micronodular lung pattern includes an extensive list of diseases. Identifying the predominant distribution of the micronodules in HRCT, with the help of the clinical history and eventually other radiological findings is possible narrow or even make an etiologic diagnosis. References 1. Hansell DM, Bankier AA, MacMahon H, McLoud TC, Muller NL, Remy J. Fleischner Society: Glossary of Terms for Thoracic Imaging. Radiology: Volume 246: Number 3-March Michael B. Gotway, Gautham P. Reddy, W. Richard Webb, Brett M. Elicker, Jessica W.T. Leung. High-Resolution CT of the Lung: Patterns of Disease and Differential Diagnoses. Radiol Clin N Am 43 (2005) Webb R. Thin-Section CT of the Secondary Pulmonary Lobule: Anatomy and the Image- The 2004 Fleischner Lecture. Radiology: Volume 239: Number 2-May Raoof S, Amchentsev A, Vlahos I, Goud A, Naidich DP. Pictorial Essay: Multinodular Disease A High-Resolution CT Scan Diagnostic Algorithm. (CHEST 2006; 129: ) 5. Andreu J, Mauleón S, Pallisa E, Majó J, Martinez-Rodriguez, Cáceres J. Miliary Lung Disease Revisited. Curr Probl Diagn Radiol 2002;31: Boitsios G, Bankier AA, Eisenberg RL. Diffuse Pulmonary Nodules. AJR 2010; 194:W354-W Criado E, Sánchez M, Ramírez J, Arguis P, Caralt TM, Perea RJ, Xaubet A. Pulmonary Sarcoidosis: Typical and Atypical Manifestations at High- Resolution CT with Pathologic Correlation. RadioGraphics 2010; 30: Christina Mueller-Mang, Claudia Grosse, Katharina Schmid, Leopold Stiebellehner, Alexander A. Bankier, What Every Radiologist Should Know about Idiopathic Interstitial Pneumonias, RadioGraphics 2007; 27: Johkoh T, Ikezoe J, Tomiyama N, et al. CT findings in lymphangitic carcinomatosis of the lung: correlation with histologic findings and pulmonary function tests. AJR Am J Roentgenol 1992; 158: Santiago Enrique Rossi, Tomas Franquet, Mariano Volpacchio, Ana Gimenez, Gabriel Aguilar, Tree-in-Bud Pattern at Thin-Section CT of the Lungs: Radiologic-Pathologic Overview, RadioGraphics 2005; 25: Gruden J, Webb R, Naidich D, McGuinness G. Multinodular Disease: Anatomic Localization at Thin-Section CT-Multireader Evaluation of a Simple Algorithm. Radiology 1999; 210: Page 21 of 22
22 Personal Information Page 22 of 22
HRCT in Diffuse Interstitial Lung Disease Steps in High Resolution CT Diagnosis. Where are the lymphatics? Anatomic distribution
Steps in High Resolution CT Diagnosis Pattern of abnormality Distribution of disease Associated findings Clinical history Tomás Franquet MD What is the diagnosis? Hospital de Sant Pau. Barcelona Secondary
More informationCT findings in multifocal or diffuse non-mucinous bronchioloalveolar carcinoma (BAC)
CT findings in multifocal or diffuse non-mucinous bronchioloalveolar carcinoma (BAC) Poster No.: C-2192 Congress: ECR 2014 Type: Educational Exhibit Authors: I. Sandu, A. R. Popita, I.-A. Brumboiu; Cluj-Napoca/RO
More informationCT findings in multifocal or diffuse non-mucinous bronchioloalveolar carcinoma (BAC)
CT findings in multifocal or diffuse non-mucinous bronchioloalveolar carcinoma (BAC) Poster No.: C-2192 Congress: ECR 2014 Type: Educational Exhibit Authors: I. Sandu, A. R. Popita, I.-A. Brumboiu; Cluj-Napoca/RO
More informationCryptogenic Organizing Pneumonia Diagnosis Approach Based on a Clinical-Radiologic-Pathologic Consensus
Cryptogenic Organizing Pneumonia Diagnosis Approach Based on a Clinical-Radiologic-Pathologic Consensus Poster No.: C-1622 Congress: ECR 2012 Type: Scientific Exhibit Authors: C. Cordero Lares, E. Zorita
More informationAcute and Chronic Lung Disease
KATHOLIEKE UNIVERSITEIT LEUVEN Faculty of Medicine Acute and Chronic Lung Disease W De Wever, JA Verschakelen Department of Radiology, University Hospitals Leuven, Belgium Clinical utility of HRCT To detect
More informationWhen to suspect Wegener Granulomatosis: A radiologic review
When to suspect Wegener Granulomatosis: A radiologic review Poster No.: P-0038 Congress: ESTI 2015 Type: Educational Poster Authors: A. Tilve Gómez, R. Díez Bandera, P. Rodríguez Fernández, M. Garcia Vazquez-Noguerol,
More informationCT Findings in the Elderly Lung
CT Findings in the Elderly Lung Poster No.: C-2498 Congress: ECR 2015 Type: Educational Exhibit Authors: P. Ananias, R. Coelho, H. M. R. Marques, O. Fernandes, M. Simões, L. Figueiredo; Lisbon/PT Keywords:
More informationExcavated pulmonary nodule: steps to diagnosis?
Excavated pulmonary nodule: steps to diagnosis? Poster No.: C-1044 Congress: ECR 2014 Type: Authors: Keywords: DOI: Educational Exhibit W. Mnari, M. MAATOUK, A. Zrig, B. Hmida, M. GOLLI; Monastir/ TN Metastases,
More informationPulmonary changes induced by radiotherapy. HRCT findings
Pulmonary changes induced by radiotherapy. HRCT findings Poster No.: C-2299 Congress: ECR 2015 Type: Educational Exhibit Authors: R. E. Correa Soto, M. Albert Antequera, K. Müller Campos, D. 1 2 4 3 1
More informationARDS - a must know. Page 1 of 14
ARDS - a must know Poster No.: C-1683 Congress: ECR 2016 Type: Authors: Keywords: DOI: Educational Exhibit M. Cristian; Turda/RO Education and training, Edema, Acute, Localisation, Education, Digital radiography,
More informationPictorial essay of unusual radiologic manifestations of pulmonary and airway metastasis at initial presentation of lung cancer
Pictorial essay of unusual radiologic manifestations of pulmonary and airway metastasis at initial presentation of lung cancer Poster No.: C-2297 Congress: ECR 2012 Type: Educational Exhibit Authors: Y.
More informationRadiological features of Legionella Pneumophila Pneumonia
Radiological features of Legionella Pneumophila Pneumonia Poster No.: E-0048 Congress: ESTI 2012 Type: Scientific Exhibit Authors: M. Vinciguerra, L. Stefanetti, E. Teti, G. Argentieri, L. G. 1 1 1 1 1
More informationRadiological Manifestations of Common Variable Immuodeficiency Sydrome (CVID) and associated complications
Radiological Manifestations of Common Variable Immuodeficiency Sydrome (CVID) and associated complications Poster No.: P-0034 Congress: ESTI 2014 Type: Educational Poster Authors: A. Wallis, C. Ball, K.
More informationThoracic sarcoidosis: Pictoral review of typical and atypical findings
Thoracic sarcoidosis: Pictoral review of typical and atypical findings Poster No.: C-0804 Congress: ECR 2010 Type: Educational Exhibit Topic: Chest Authors: A. Ferreira, J. Calha; Lisbon/PT Keywords: Sarcoidosis,
More informationEosinophilic lung diseases - what the radiologist needs to know
Eosinophilic lung diseases - what the radiologist needs to know Poster No.: C-0803 Congress: ECR 2014 Type: Authors: Keywords: DOI: Educational Exhibit E.-M. Heursen, R. Reina Cubero, F. Japon Sola; Cádiz/ES
More informationThe crazy-paving pattern: A radiological-pathological correlated and illustrated overview
The crazy-paving pattern: A radiological-pathological correlated and illustrated overview Poster No.: C-0827 Congress: ECR 2010 Type: Educational Exhibit Topic: Chest Authors: W. F. M. De Wever, J. Coolen,
More informationDiffuse Alveolar Hemorrhage: Initial and Follow-up HRCT Features
Diffuse Alveolar Hemorrhage: Initial and Follow-up HRCT Features Poster No.: E-0037 Congress: ESTI 2012 Type: Authors: Keywords: Scientific Exhibit M. Y. Kim; Seoul/KR Lung, CT-High Resolution, CT, Computer
More informationTypical and atypical findings of pulmonary sarcoidosis at high resolution CT
Typical and atypical findings of pulmonary sarcoidosis at high resolution CT Poster No.: C-0169 Congress: ECR 2013 Type: Educational Exhibit Authors: L. Raposo Rodríguez, C. Mejía, B. Escobar Mallada,
More informationCase 1 : Question. 1.1 What is the intralobular distribution? 1. Centrilobular 2. Perilymphatic 3. Random
Interesting case Case 1 Case 1 : Question 1.1 What is the intralobular distribution? 1. Centrilobular 2. Perilymphatic 3. Random Case 1: Answer 1.1 What is the intralobular distribution? 1. Centrilobular
More informationImaging findings in Hypersensitivity Pneumonitis - a pictorical review.
Imaging findings in Hypersensitivity Pneumonitis - a pictorical review. Poster No.: C-1655 Congress: ECR 2014 Type: Educational Exhibit Authors: B. M. Araujo, A. F. S. Simões, M. S. C. Rodrigues, J. Pereira;
More informationMicronodular Lung Disease an algorithm
Micronodular Lung Disease an algorithm H. Page McAdams, MD Department of Radiology Duke University Medical Center Durham, NC USA page.mcadams@duke.edu Question Which of the following lung diseases is MOST
More informationAn Image Repository for Chest CT
An Image Repository for Chest CT Francesco Frajoli for the Chest CT in Antibody Deficiency Group An Image Repository for Chest CT he Chest CT in Antibody Deficiency Group is an international and interdisciplinary
More informationLung cancer in patients with chronic empyema
Lung cancer in patients with chronic empyema Poster No.: P-0025 Congress: ESTI 2015 Type: Scientific Poster Authors: Y. Lee, C.-K. Park; Guri/KR Keywords: Neoplasia, Biopsy, PET-CT, CT, Thorax, Lung DOI:
More informationPurpose. Methods and Materials
Thin-section CT findings in peripheral lung cancer of 3 cm or smaller: are there any characteristic features for predicting tumor histology or do they depend only on tumor size? Poster No.: C-1893 Congress:
More informationThoracic lung involvement in rheumatoid arthritis: Findings on HRCT
Thoracic lung involvement in rheumatoid arthritis: Findings on HRCT Poster No.: C-2488 Congress: ECR 2015 Type: Educational Exhibit Authors: R. E. Correa Soto, M. J. Martín Sánchez, J. M. Fernandez 1 1
More informationPneumocystis jirovecci pneumonia: from mild disease to a real disaster. A pictorial review of the different radiologic patterns in acute settings
Pneumocystis jirovecci pneumonia: from mild disease to a real disaster. A pictorial review of the different radiologic patterns in acute settings Poster No.: C-1425 Congress: ECR 2017 Type: Educational
More informationPostmortem Computed Tomography Finding of Lungs in Sudden Infant Death.
Postmortem Computed Tomography Finding of Lungs in Sudden Infant Death. Poster No.: C-1147 Congress: ECR 2013 Type: Educational Exhibit Authors: Y. Kawasumi, A. Usui, Y. Hosokai, M. Sato, A. Nakajima,
More informationRadiofrequency ablation combined with conventional radiotherapy: a treatment option for patients with medically inoperable lung cancer
Radiofrequency ablation combined with conventional radiotherapy: a treatment option for patients with medically inoperable lung cancer Poster No.: C-0654 Congress: ECR 2011 Type: Scientific Paper Authors:
More informationSmall airway disease: semiological and radiological evaluation. A pictorial review.
Small airway disease: semiological and radiological evaluation. A pictorial review. Award: Magna Cum Laude Poster No.: C-3028 Congress: ECR 2018 Type: Educational Exhibit Authors: K. N. Nieto, A. Cerpa,
More informationSlowly growing malignant nodules and rapidly growing benign nodules: Evaluation of the value of volume doubling time
Slowly growing malignant nodules and rapidly growing benign nodules: Evaluation of the value of volume doubling time Poster No.: C-208 Congress: ECR 2009 Type: Educational Exhibit Topic: Chest Authors:
More informationIdiopathic dilatation of the pulmonary artery : radiographic and MDCT features in 6 cases
Idiopathic dilatation of the pulmonary artery : radiographic and MDCT features in 6 cases Poster No.: P-0075 Congress: ESTI 2014 Type: Authors: Educational Poster J. J. Woo 1, K. Y. Lee 2, Y. Cho 1, J.
More informationRadiologic and pathologic correlation of non-mass like breast lesions on US and MRI: Benign, high risk, versus malignant
Radiologic and pathologic correlation of non-mass like breast lesions on US and MRI: Benign, high risk, versus malignant Poster No.: C-1161 Congress: ECR 2013 Type: Educational Exhibit Authors: J. Kwak,
More informationRadiologic and pathologic correlation of non-mass like breast lesions on US and MRI: Benign, high risk, versus malignant
Radiologic and pathologic correlation of non-mass like breast lesions on US and MRI: Benign, high risk, versus malignant Poster No.: C-1161 Congress: ECR 2013 Type: Educational Exhibit Authors: J. Kwak,
More informationComparison of High-resolution CT Findings between Miliary Metastases and Miliary Tuberculosis 1
Comparison of High-resolution CT Findings between Miliary Metastases and Miliary Tuberculosis 1 Chan Sung Kim, M.D., Ki-Nam Lee, M.D., Jin Hwa Lee, M.D. Purpose: To compare the findings of high-resolution
More informationPulmonary CT Findings of Visceral Larva Migrans due to Ascaris suum
Pulmonary CT Findings of Visceral Larva Migrans due to Ascaris suum Poster No.: E-0038 Congress: ESTI 2012 Type: Scientific Exhibit Authors: K. Honda, F. Okada, Y. Ando, A. Ono, S. Matsumoto, H. Mori;
More informationCase 1: Question. 1.1 What is the main pattern of this HRCT? 1. Intralobular line 2. Groundglass opacity 3. Perilymphatic nodule
HRCT WORK SHOP Case 1 Case 1: Question 1.1 What is the main pattern of this HRCT? 1. Intralobular line 2. Groundglass opacity 3. Perilymphatic nodule Case 1: Question 1.2 What is the diagnosis? 1. Hypersensitivity
More informationCavitary lung lesion: Two different diagnosis with similar appearence
Cavitary lung lesion: Two different diagnosis with similar appearence Poster No.: P-0043 Congress: ESTI 2015 Type: Educational Poster Authors: M. Yesildag, H. Kalkan, K. Ödev; Konya/TR Keywords: Infection,
More informationSmoking-related Interstitial Lung Diseases: High-Resolution CT Findings
Smoking-related Interstitial Lung Diseases: High-Resolution CT Findings Poster No.: C-2358 Congress: ECR 2013 Type: Educational Exhibit Authors: V. Cuartero Revilla, M. Nogueras Carrasco, P. Olmedilla
More informationA pictorial review of normal anatomical appearences of Pericardial recesses on multislice Computed Tomography.
A pictorial review of normal anatomical appearences of Pericardial recesses on multislice Computed Tomography. Poster No.: C-1787 Congress: ECR 2012 Type: Educational Exhibit Authors: N. Ahmed 1, G. Avery
More informationLow-dose computed tomography (CT) protocol in the screening of patients with social exposure to asbestos
Low-dose computed tomography (CT) protocol in the screening of patients with social exposure to asbestos Poster No.: C-3032 Congress: ECR 2010 Type: Scientific Exhibit Topic: Radiographers Authors: P.
More informationThe small subsolid pulmonary nodules. What radiologists need to know.
The small subsolid pulmonary nodules. What radiologists need to know. Poster No.: C-1250 Congress: ECR 2016 Type: Educational Exhibit Authors: L. Fernandez Rodriguez, A. Martín Díaz, A. Linares Beltrán,
More informationRole of Chest Low-dose Computed Tomography in Elderly Patients with Suspected Acute Pulmonary Infection in the Emergency Room
Role of Chest Low-dose Computed Tomography in Elderly Patients with Suspected Acute Pulmonary Infection in the Emergency Room Poster No.: C-1461 Congress: ECR 2014 Type: Authors: Keywords: DOI: Scientific
More informationRadiological and clinical characteristics of plastic bronchitis complicated with H1N1 influenza viral pneumonia in children
Radiological and clinical characteristics of plastic bronchitis complicated with H1N1 influenza viral pneumonia in children Poster No.: C-1727 Congress: ECR 2012 Type: Scientific Exhibit Authors: H. Fujisawa,
More informationPulmonary manifestations of Rheumatoid Arthritis: what is there waiting to be found?
Pulmonary manifestations of Rheumatoid Arthritis: what is there waiting to be found? Poster No.: C-1795 Congress: ECR 2015 Type: Educational Exhibit Authors: M. S. C. Rodrigues, R. Correia, A. Carvalho,
More informationRadiologic Approach to Smoking Related Interstitial Lung Disease
Radiologic Approach to Smoking Related Interstitial Lung Disease Poster No.: C-1854 Congress: ECR 2013 Type: Educational Exhibit Authors: K.-N. Lee, J.-Y. Han, E.-J. Kang, J. Kang; Busan/KR Keywords: Toxicity,
More informationIntracystic papillary carcinoma of the breast
Intracystic papillary carcinoma of the breast Poster No.: C-1932 Congress: ECR 2011 Type: Educational Exhibit Authors: V. Dimarelos, F. TZIKOS, N. Kotziamani, G. Rodokalakis, 1 2 3 1 1 1 2 T. MALKOTSI
More informationResidents Section Pattern of the Month
Residents Section Pattern of the Month Gosset et al. Tree-In-Bud Pattern Residents Section Pattern of the Month Residents inradiology Natacha Gosset 1 Alexander A. Bankier Ronald L. Eisenberg Gosset N,
More informationAetiologies of normal CT main pulmonary arterial (PA) measurements in patients with right heart catheter (RHC) confirmed pulmonary hypertension (PH)
Aetiologies of normal CT main pulmonary arterial (PA) measurements in patients with right heart catheter (RHC) confirmed pulmonary hypertension (PH) Poster No.: C-0964 Congress: ECR 2010 Type: Scientific
More informationIsolated anthracosis: benign but neglected cause of bronchial stenosis and obstruction
Isolated anthracosis: benign but neglected cause of bronchial stenosis and obstruction Poster No.: C-0143 Congress: ECR 2013 Type: Scientific Exhibit Authors: S. Kahkouee, R. Pourghorban, M. Bitarafan,
More informationThe solitary pulmonary nodule: Assessing the success of predicting malignancy
The solitary pulmonary nodule: Assessing the success of predicting malignancy Poster No.: C-0829 Congress: ECR 2010 Type: Scientific Exhibit Topic: Chest Authors: R. W. K. Lindsay, J. Foster, K. McManus;
More informationHyperechoic breast lesions can be malignant.
Hyperechoic breast lesions can be malignant. Poster No.: C-0041 Congress: ECR 2015 Type: Educational Exhibit Authors: G. Babu, R. bradley; Edinburgh/UK Keywords: Breast, Ultrasound, Biopsy, Cancer DOI:
More informationRadiologic-pathologic correlation of pulmonary diseases
The 1578 th Chest Conference/ 3 rd Biennial Clinical- Radiologic-Pathologic Correlation Radiologic-pathologic correlation of pulmonary diseases Harumi Itoh, M.D. University of Fukui, Japan Centriacinar
More informationContribution of high resolution computed tomography (HRCT) imaging in positive and differential diagnosis of pulmonary sarcoidosis.
Contribution of high resolution computed tomography (HRCT) imaging in positive and differential diagnosis of pulmonary sarcoidosis. Poster No.: C-1954 Congress: ECR 2017 Type: Educational Exhibit Authors:
More informationPleural Plaques: Appearances, Mimics and Clinical implications
Pleural Plaques: Appearances, Mimics and Clinical implications Poster No.: P-0108 Congress: ESTI 2014 Type: Educational Poster Authors: D. J. Martin, K. J. Litton, H. Adams; Cardiff/UK Keywords: Occupational
More informationCharacterisation of cervical lymph nodes by US and PET-CT
Characterisation of cervical lymph nodes by US and PET-CT Poster No.: C-1807 Congress: ECR 2010 Type: Educational Exhibit Topic: Head and Neck Authors: J. I. Garcia Gomez; Mexico City/MX Keywords: cervical
More informationTomodensitometric detection in pneumoconiosis due to amorphous silica: correlation between conditions of exposure and radiological patterns.
Tomodensitometric detection in pneumoconiosis due to amorphous silica: correlation between conditions of exposure and radiological patterns. Poster No.: C-1590 Congress: ECR 2011 Type: Scientific Exhibit
More informationCurious case of Misty Mesentery
Curious case of Misty Mesentery Poster No.: C-1385 Congress: ECR 2015 Type: Authors: Keywords: DOI: Educational Exhibit T. Simelane 1, H. Khosa 2, N. Ramesh 2 ; 1 Dublin/IE, 2 Portlaoise/IE Abdomen, Anatomy,
More informationLung sonography in the diagnosis of pneumothorax.
Lung sonography in the diagnosis of pneumothorax. Poster No.: C-0526 Congress: ECR 2011 Type: Educational Exhibit Authors: K. Stefanidis, K. Vintzilaios, D. D. Cokkinos, E. Antypa, S. Dimopoulos, S. Nanas,
More informationCT evaluation of small bowel carcinoid tumors
CT evaluation of small bowel carcinoid tumors Poster No.: C-0060 Congress: ECR 2015 Type: Educational Exhibit Authors: N. V. V. P. Costa, L. Nascimento, T. Bilhim ; Estoril/PT, PT, 1 2 3 1 2 3 Lisbon/PT
More informationPulmonary infarction semiology in CT. Revision of 80 cases.
Pulmonary infarction semiology in CT. Revision of 80 cases. Poster No.: C-0369 Congress: ECR 2012 Type: Scientific Exhibit Authors: M. González Vázquez, D. Castellon, J. Calatayud, N. Silva 1 2 1 1 1 1
More informationImaging characterization of renal clear cell carcinoma
Imaging characterization of renal clear cell carcinoma Poster No.: C-0327 Congress: ECR 2011 Type: Educational Exhibit Authors: S. Ballester 1, A. Gaser 2, M. Dotta 1, M. F. CAPPA 1, F. Hammar 1 ; 1 2
More informationA time-honored but almost forgotten sign of COPD: sabersheath trachea as a marker of severe airflow obstruction
A time-honored but almost forgotten sign of COPD: sabersheath trachea as a marker of severe airflow obstruction Poster No.: C-0958 Congress: ECR 2013 Type: Scientific Exhibit Authors: F. Ciccarese, A.
More informationCT Signs of Solitary Pulmonary Lesions: Revisited
CT Signs of Solitary Pulmonary Lesions: Revisited Poster No.: C-1764 Congress: ECR 2015 Type: Educational Exhibit Authors: H. Hayashi, K. Ashizawa, Y. Ogihara, A. Nishida, T. Tanaka, 1 1 2 1 1 1 1 1 2
More informationCystic Lung Disease. Cristopher A. Meyer, MD
Cystic Lung Disease Cristopher A. Meyer, MD Air filled structure with definable wall typically less than 1 mm thick Cris A. Meyer, M.D. Professor of Radiology University of Wisconsin School of Medicine
More informationDiffuse high-attenuation within mediastinal lymph nodes on non-enhanced CT scan: Usefulness in the prediction of benignancy
Diffuse high-attenuation within mediastinal lymph nodes on non-enhanced CT scan: Usefulness in the prediction of benignancy Poster No.: C-1785 Congress: ECR 2012 Type: Authors: Keywords: DOI: Scientific
More informationCierny-Mader classification of chronic osteomyelitis: Preoperative evaluation with cross-sectional imaging
Cierny-Mader classification of chronic osteomyelitis: Preoperative evaluation with cross-sectional imaging Poster No.: C-590 Congress: ECR 2009 Type: Topic: Educational Exhibit Musculoskeletal Authors:
More informationHigh density thrombi of pulmonary embolism on precontrast CT scan: Is it dangerous?
High density thrombi of pulmonary embolism on precontrast CT scan: Is it dangerous? Poster No.: C-1753 Congress: ECR 2013 Type: Authors: Keywords: DOI: Scientific Exhibit B. Y. Lee, H. R. KIM, J. I. Jung,
More informationIdentification and numbering of lumbar vertebrae using various anatomical landmarks on MRI of lumbosacral spine
Identification and numbering of lumbar vertebrae using various anatomical landmarks on MRI of lumbosacral spine Poster No.: C-2125 Congress: ECR 2015 Type: Authors: Scientific Exhibit S. patil 1, A. M.
More informationI have no relevant conflicts of interest to disclose
I have no relevant conflicts of interest to disclose Diffuse parenchymal lung disease (DPLD) and its associations Secondary lobular anatomy DPLD History, clinical findings, temporal evolution, and exposures
More informationSonographic and Mammographic Features of Phyllodes Tumours of the Breast: Correlation with Histological Grade
Sonographic and Mammographic Features of Phyllodes Tumours of the Breast: Correlation with Histological Grade Poster No.: C-0046 Congress: ECR 2014 Type: Authors: Keywords: DOI: Scientific Exhibit C. Y.
More informationRadiologists toolbox to differentiate alveolar versus interstitial lung diseases
Radiologists toolbox to differentiate alveolar versus interstitial lung diseases Dr Sumer Shikhare, Dr Trishna Shimpi, Dr Ashish Chawla Khoo Teck Puat Hospital Singapore. Relevant financial disclosures
More informationSilicosis: Radiographic findings and the use of the International Labour Organization Classification 2011
Silicosis: Radiographic findings and the use of the International Labour Organization Classification 2011 Poster No.: C-1055 Congress: ECR 2015 Type: Educational Exhibit Authors: V. de Lara Bendahan, C.
More informationPictorial Essay: Multinodular Disease* A High-Resolution CT Scan Diagnostic Algorithm
CHEST Chest Imaging for Clinicians Pictorial Essay: Multinodular Disease* A High-Resolution CT Scan Diagnostic Algorithm Suhail Raoof, MD, FCCP; Alexey Amchentsev, MD; Ioannis Vlahos, MD; Ajay Goud, MD;
More informationBI-RADS 3 category, a pain in the neck for the radiologist which technique detects more cases?
BI-RADS 3 category, a pain in the neck for the radiologist which technique detects more cases? Poster No.: B-0966 Congress: ECR 2013 Type: Scientific Paper Authors: J. Etxano Cantera, I. Simon-Yarza, G.
More informationCT Fluoroscopy-Guided vs Multislice CT Biopsy ModeGuided Lung Biopies:a preliminary experience
CT Fluoroscopy-Guided vs Multislice CT Biopsy ModeGuided Lung Biopies:a preliminary experience Poster No.: C-0097 Congress: ECR 2016 Type: Scientific Exhibit Authors: A. Casarin, G. Rech, C. Cicero, A.
More informationUsual Interstitial pneumonia and Nonspecific Interstitial Pneumonia. Nitra and the Gangs.
Usual Interstitial pneumonia and Nonspecific Interstitial Pneumonia Nitra and the Gangs. บทน ำและบทท ๓, ๑๐, ๑๒, ๑๓, ๑๔, ๑๕, ๑๗ Usual Interstitial Pneumonia (UIP) Most common & basic pathologic pattern
More informationRadiologic characterization of emphysema's pattern of distribution - a subjective approach
Radiologic characterization of emphysema's pattern of distribution - a subjective approach Poster No.: C-0866 Congress: ECR 2014 Type: Educational Exhibit Authors: J. Praia, C. Maciel, J. Pereira, J. Albuquerque,
More informationLesions of the pancreaticoduodenal groove, a pictorial review
Lesions of the pancreaticoduodenal groove, a pictorial review Poster No.: C-2131 Congress: ECR 2013 Type: Educational Exhibit Authors: E. Ni Mhurchu, L. Lavelle, I. Murphy, S. Skehan ; IE, Dublin/ IE Keywords:
More informationThe predicament of cancer presenting during pregnancy
The predicament of cancer presenting during pregnancy Poster No.: C-3001 Congress: ECR 2010 Type: Educational Exhibit Topic: Radiographers Authors: D. O'Mahony, G. Murphy, G. Wilson, M. T. Keogan; Dublin/IE
More informationTriple-negative breast cancer: which typical features can we identify on conventional and MRI imaging?
Triple-negative breast cancer: which typical features can we identify on conventional and MRI imaging? Poster No.: C-1862 Congress: ECR 2013 Type: Educational Exhibit Authors: V. Bertani 1, A. Gualano
More informationComputed tomography and Modified RECIST criteria for assessment of response in malignant pleural mesothelioma
Computed tomography and Modified RECIST criteria for assessment of response in malignant pleural mesothelioma Poster No.: C-0729 Congress: ECR 2013 Type: Scientific Exhibit Authors: A. Marin, I. Pozek,
More informationExtrapulmonary Manifestations of Tuberculosis: A Radiologic Review
Extrapulmonary Manifestations of Tuberculosis: A Radiologic Review Poster No.: C-1958 Congress: ECR 2014 Type: Authors: Educational Exhibit J. Isern 1, S. Llaverias Borrell 1, A. Olarte 1, E. Grive 1,
More informationMimics in chest disease: interstitial opacities
Insights Imaging (2013) 4:9 27 DOI 10.1007/s13244-012-0207-7 PICTORIAL REVIEW Mimics in chest disease: interstitial opacities Anastasia Oikonomou & Panos Prassopoulos Received: 19 June 2012 / Revised:
More informationCombined pulmonary fibrosis and emphysema; prevalence and follow up among health-care personnel
Combined pulmonary fibrosis and emphysema; prevalence and follow up among health-care personnel Poster No.: C-0698 Congress: ECR 2013 Type: Scientific Exhibit Authors: K. Chae, G. Jin, S. Chon, Y. Lee;
More informationAnatomical Variations of the Levator Scapulae Muscle - an MR Imaging Study
Anatomical Variations of the Levator Scapulae Muscle - an MR Imaging Study Poster No.: R-0016 Congress: 2015 ASM Type: Scientific Exhibit Authors: J. Au, A. Webb, G. Buirski, P. Smith, M. Pickering, D.
More informationPULMONARY TUBERCULOSIS RADIOLOGY
PULMONARY TUBERCULOSIS RADIOLOGY RADIOLOGICAL MODALITIES Medical radiophotography Radiography Fluoroscopy Linear (conventional) tomography Computed tomography Pulmonary angiography, bronchography Ultrasonography,
More information64-MDCT imaging of the pancreas: Scan protocol optimisation by different scan delay regimes
64-MDCT imaging of the pancreas: Scan protocol optimisation by different scan delay regimes Poster No.: C-051 Congress: ECR 2009 Type: Scientific Exhibit Topic: Abdominal and Gastrointestinal Authors:
More informationCT appearance of radiation injury of the lung after stereotactic body radiation therapy (SBRT) for lung cancers: a pictorial review
CT appearance of radiation injury of the lung after stereotactic body radiation therapy (SBRT) for lung cancers: a pictorial review Award: Certificate of Merit Poster No.: C-210 Congress: ECR 2009 Type:
More informationSubpleural micronodular pattern at CT and radiopathologic correlation
Subpleural micronodular pattern at CT and radiopathologic correlation Poster No.: C-0876 Congress: ECR 2012 Type: Educational Exhibit Authors: G. Cabrera, E. Romá de Villegas, M. L. Domingo, C. P. 1 2
More informationThe "whirl sign". Diagnostic accuracy for intestinal volvulus.
The "whirl sign". Diagnostic accuracy for intestinal volvulus. Poster No.: C-0670 Congress: ECR 2014 Type: Scientific Exhibit Authors: M. Pire, M. Marti, A. Borobia, A. Verón; Madrid/ES Keywords: Abdomen,
More informationComputed tomography for pulmonary embolism: scan assessment of a one-year cohort and estimated cancer risk associated with diagnostic irradiation.
Computed tomography for pulmonary embolism: scan assessment of a one-year cohort and estimated cancer risk associated with diagnostic irradiation. Award: Poster No.: E-0004 Certificate of Merit Congress:
More informationQuantitative imaging of hepatic cirrhosis on abdominal CT images
Quantitative imaging of hepatic cirrhosis on abdominal CT images Poster No.: C-0556 Congress: ECR 2013 Type: Authors: Keywords: DOI: Scientific Exhibit S. Kido, A. Nakamura, Y. Hirano; Ube/JP Cirrhosis,
More informationBreast calcification: Management and Pictorial Review
Breast calcification: Management and Pictorial Review Poster No.: C-0692 Congress: ECR 2014 Type: Educational Exhibit Authors: V. de Lara Bendahan, M. F. Ramos Solis, A. Amador Gil, C. 1 2 3 2 4 4 Gómez
More informationEthanol ablation of benign thyroid cysts and predominantly cystic thyroid nodules: factors that predict outcome.
Ethanol ablation of benign thyroid cysts and predominantly cystic thyroid nodules: factors that predict outcome. Poster No.: C-0322 Congress: ECR 2014 Type: Authors: Keywords: DOI: Scientific Exhibit J.
More informationPneumo-esophageal 64-MDCT technique for gastric cancer evaluation
Pneumo-esophageal 64-MDCT technique for gastric cancer evaluation Poster No.: C-1627 Congress: ECR 2010 Type: Scientific Exhibit Topic: GI Tract Authors: M. Ulla, E. Gentile, E. Levy, D. Cavadas, J. Ithurralde
More informationPleomorphic carcinoma of the lung: which CT findings predict poor prognosis?
Pleomorphic carcinoma of the lung: which CT findings predict poor prognosis? Poster No.: C-1887 Congress: ECR 2015 Type: Scientific Exhibit Authors: A. Fujisaki, T. Aoki, S. Kinoshita, Y. Hayashida, Y.
More informationPurpose. Methods and Materials. Results
Prevalence and significance of hypoattenuating hepatic lesions deemed too small to characterise: How are we following up these lesions and what are the outcomes? Poster No.: C-014 Congress: ECR 2009 Type:
More informationImaging Small Airways Diseases: Not Just Air trapping. Eric J. Stern MD University of Washington
Imaging Small Airways Diseases: Not Just Air trapping Eric J. Stern MD University of Washington What we are discussing SAD classification SAD imaging with MDCT emphasis What is a small airway? Airway with
More informationHow to identify interstitial pneumonias.
How to identify interstitial pneumonias. Poster No.: C-0804 Congress: ECR 2014 Type: Educational Exhibit Authors: S. claret loaiza, M. C. Cañete Moslero, R. Carreño Gonzalez, C. de la Torre; Malaga/ES
More informationSpectrum of findings of sclerosing adenosis at breast MRI.
Spectrum of findings of sclerosing adenosis at breast MRI. Poster No.: C-0738 Congress: ECR 2012 Type: Scientific Exhibit Authors: F. Vasselli 1, F. Pediconi 2, M. Telesca 2, M. Luciani 2, V. Casali 2,
More information