Ultrasound is an excellent technique for evaluation of normal anatomy, diagnosis, and follow-up of patients with nail unit diseases. This is an alternative for other imaging methods and may be used for an accurate diagnosis approach.
Pulmonary hypertension (PH) is a condition characterized by increased pressure in the pulmonary circulation. It may be idiopathic or arise in the setting of other clinical conditions. Patients with PH tend to present with nonspecific cardiovascular or respiratory symptoms. The clinical classification of PH was recently revised at the World Health Organization symposium in Nice, France, in 2013. That consensus statement provided an updated classification based on the shared hemodynamic characteristics and management of the different categories of PH. Some features seen at computed tomography (CT) can suggest a subtype or probable cause of PH that may facilitate placing the patient in the correct category. These features include findings in the pulmonary arteries (peripheral calcification, peripheral dilatation, eccentric filling defects, intra-arterial soft tissue), lung parenchyma (centrilobular nodules, mosaic attenuation, interlobular septal thickening, bronchiectasis, subpleural peripheral opacities, ground-glass opacities, diffuse nodules), heart (congenital lesions, left heart disease, valvular disease), and mediastinum (hypertrophied bronchial arteries). An approach based on identification of these CT features in patients with PH will allow the radiologist to play an important role in diagnosis and help guide the clinician in management of PH. RSNA, 2018.
Total anomalous pulmonary venous return (TAPVR), also known as total anomalous pulmonary venous connection, is a congenital cardiovascular malformation that presents itself in the neonatal period, with cyanosis and tachypnea. There are 4 types of TAPVR with the mixed type being the least common. Any type of TAPVR may be associated with obstruction as result of flow redirection through the liver parenchyma before it may return to the heart, but infracardiac is the most common one.We report a case of a 10-hour-old female, with a mixed (cardiac and infracardiac) TAVPR with obstruction, that showed drainage to the coronary sinus and the portal vein, as the other classic findings in TAVPR, made with computed tomography angiography and echocardiogram. The patient was taken to surgical repair, but unfortunately died during the procedure because of multiple complications.
Tracheal disorders can create clinical and imaging challenges. They are often misdiagnosed as other pulmonary disorders. Chest radiography has low sensitivity and specificity for proper identification of tracheal disorders. Multidetector-row CT (MDCT) has the inherent advantage of being able to provide high-quality multiplanar reformations, 3D volume-rendered images, virtual bronchoscopy, and minimum intensity projections. These can serve as a roadmap for bronchoscopy or surgical planning. The most important imaging sign of tracheal disease is thickening of the tracheal wall, and the most relevant sign to be evaluated for differential diagnosis is the distribution and appearance of wall thickening. Tracheal abnormalities may be classified based on the tracheal dimensions into increased diameter or decreased diameter to reduce the differential diagnosis. Increased diameter tracheal diseases may be subclassified into diffuse or focal diseases based on the area of involvement, thereby providing a more specific diagnosis.
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