High-flow hemangiomas might show relatively low signal intensity because of gadoxetic acid contrast uptake in the surrounding normal liver parenchyma during the equilibrium (3-minute delay) phase. Such findings are called pseudo washout and can mimic hypervascular hepatic tumors. However, high-flow hemangioma can be diagnosed by observing bright signal intensity on T2-weighted imaging, arterial phase-dominant enhancement, pseudo washout sign during the equilibrium phase, and isointense or slightly increased signal intensity on subtraction images.
• Gleason scores influence diagnostic performance of MRI for prostate cancer detection. • Addition of DWI does not improve low risk prostate cancer detection. • Combined T2WI and DWI may help select intermediate or high risk patients.
Objective: To determine the incidence, morphological characteristics and relevance of paratracheal air cysts (PTACs) with pulmonary emphysema, as seen on thoracic multidetector CT (MDCT). Methods: The CT images of 854 consecutive patients who underwent thoracic MDCT during a period of 2 months at our institution were reviewed. 538 of the patients were male and 316 were female. The incidence, size and shape of the PTACs and their relation to pulmonary emphysema were retrospectively analysed. Results: Among the 854 patients, 69 (8.1%) had PTACs. 37 (6.9%) of the 538 male patients and 32 (10.1%) of the 316 female patients had PTACs. The highest prevalence of PTACs (25 patients, 11.2%) was found in those who were in the sixth decade of life. 48 (69.6%) PTACs measured 3-10 mm at the longest diameter and 33 (47.8%) were elongated on the coronal section images. 12 (17.4%) patients with PTACs had underlying gross morphological emphysema. The relationship between the presence of PTACs and the presence of emphysema and the relationship between the presence of PTACs and the severity of emphysema were not statistically significant. The size of PTACs showed an inverse relation to the severity of emphysema. Conclusion: The incidence of PTACs was estimated to be much higher than that of previous studies. There was a slight female predilection for PTACs, most commonly found in the sixth decade of life; PTACs mostly measured 3-10 mm and were elongated in shape. The relation of PTACs to gross morphological emphysema was low. Advances in knowledge: PTACs are not correlated with the presence of emphysema on MDCT. Paratracheal air cysts (PTACs) are small air collections in the right paratracheal area at the level of the thoracic inlet. The histopathological diagnosis of PTACs in the reported surgically confirmed cases included tracheal diverticulum, tracheocele, lymphoepithelial cyst and bronchogenic cyst. In all of these cases, the cysts were lined with ciliated columnar epithelia and communicated with the trachea [1][2][3].Various causes of PTACs have been suggested [3][4][5][6][7][8][9][10][11][12], but only a few reports have mentioned the relationship of PTACs with pulmonary emphysema [8,13]. Goo et el [8] suggested that there is an association of PTACs with obstructive lung disease and emphysema that is caused by increased expiratory pressures, which results in weakness of the right posterior lateral wall of the trachea at the level of the thoracic inlet. By contrast, a recent study by Buterbaugh and Erly [13] found no association between the presence of emphysematous lung changes and PTACs. The relationship between PTACs and pulmonary emphysema is still a matter of debate.In daily practice, we occasionally see PTACs on CT scans. However, PTACs have been infrequently described in the radiological literature. Furthermore, the relationship between PTACs and pulmonary emphysema is still uncertain. The purpose of this study was to determine the incidence and morphological characteristics of PTACs seen on thoracic multidetector CT...
Dual marking with radiotracer and hookwire under CT fluoroscopy is a safe and not time-consuming procedure, and has made needlescopy-assisted lung resection for small and superficial nodules or ground-glass opacity lesions easier, more convenient, and less hazardous.
Acute fibrinous and organizing pneumonia is a histopathologic entity of lung injury with the hallmark feature of intra-alveolar fibrin “balls.” We report 2 cases of acute fibrinous and organizing pneumonia in patients without a significant medical history, who presented with cough and worsening dyspnea and experienced a fulminant course of disease progression with diffuse lung parenchymal abnormalities on chest computed tomography. These cases suggest that this rare histologic pattern of idiopathic interstitial pneumonias can be included in the differential diagnosis with other conditions leading to acute respiratory failure.
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