Variability of measurements was reduced with the computer-assisted perimeter method compared with the diameter method, which suggests that changes in volume can be detected more accurately with the perimeter method. The differences between these techniques seem large enough to have an impact on grading the response to therapy.

BackgroundWe report a case of severe upper airway obstruction due to a retropharyngeal hematoma that presented nearly one day after a precipitating traumatic injury. Retropharyngeal hematomas are rare, but may cause life-threatening airway compromise.Case presentationA 50 year-old man developed severe dyspnea with oropharyngeal airway compression due to retropharyngeal hematoma 20 hours after presenting to the emergency department. The patient also had a fractured first cervical vertebra and was diagnosed with a left brachial plexopathy. The patient underwent emergent awake fiberoptic endotracheal intubation to provide a definitive airway.ConclusionRetropharyngeal hematoma with life-threatening airway compromise can develop hours or days after a precipitating injury. Clinicians should be alert to the potential for this delayed airway collapse, and should also be prepared to rapidly secure the airway in this patient population likely to have concomitant cervical spinal or head injuries.

High-quality, thin-section (3-mm) T1-weighted imaging can be readily performed at 3 T using a short TE 2-D GRE technique. This approach offers superior SNR and CNR with reduced motion artifacts and scan time as compared with imaging at 1.5 T and is advocated for routine brain imaging at 3 T. It is robust (used in over 1500 patients to date) and does not experience significant specific absorption ratio limitations, poor tissue contrast, or accentuated motion artifacts like encountered with spin echo T1-weighted imaging at 3 T.

eight long-answer questions, four yes/no questions, and three checkbox questions focused on IgG measurement and HG treatment practices pre-and post-lung transplant. We sent the survey to 50 physicians at 40 transplant centers internationally using Google Forms on February 4 th , 2020. Results: There were 24 (48%, 24/50) respondents from 19 lung transplant centers. Responses were tabulated for individual respondents as answers varied within centers. Respondents reported routinely measuring IgG levels in 54% (13/24) of pre-transplant patients and 38% (9/24) of post-transplant patients, with time points for checking IgG levels varying widely. In post-transplant patients with frequent infections, respondents reported routinely measuring IgG levels (83%, 20/24), routinely not measuring (13%, 3/24), or not having a protocol (4%, 1/24). Reported criteria for initiating IgG replacement therapy (IgG-RT) were infection frequency only (n=2), IgG level only (n=6), or some combination of the two (n=9). IgG level cutoffs utilized to initiate IgG-RT ranged from <300 mg/dL to <600 mg/dL. Despite 41% (9/22) of respondents reporting they did not feel HG patients were being successfully identified and treated, 50% (11/22) reported patients were never referred to allergy/immunology. Reported barriers to screening and management centered around insurance-related issues (32%, 7/22), IgG-RT shortages (14%, 3/22), and distribution issues (14%, 3/22), and lack of evidence-based treatment protocols (32%, 7/22). Conclusion: HG screening and management practices in lung transplant recipients vary greatly, potentially leaving patients vulnerable to worse clinical outcomes. Reported barriers include lack of guidance regarding HG treatment criteria and difficulties obtaining IgG-RT. Involving immunologists in screening and treatment decision-making could mitigate some of these barriers.