A total of 171 sets of chest radiographs chosen randomly were reviewed independently by two residents in their second year of training, and two experienced radiologists. The degree of interobserver agreement in an overall assessment of pulmonary venous hypertension and in the assessment of five signs, indicative of pulmonary venous hypertension was determined by kappa statistics. The average level of agreement was moderate (0.51-0.56) for the overall assessment and the signs of perivascular clouding, perihilar haze and pleural effusion, and poorer (0.31-0.38) for flow shift and Kerley lines. In the overall assessment agreement between experienced radiologists was slightly better (0.63) than average. Multiple reader interpretation is recommended for the assessment of low-grade pulmonary venous hypertension.

Adolescent↗

PubMedDate not supplied

Computed tomography in opportunistic lung infections.

Chest radiography in two teenage boys, one with Wiscott-Aldrich's syndrome and one with acute lymphatic leucemia in remission showed increased interstitial pattern. In both computed tomography (CT) of the lungs showed heavy interstitial pneumonia, rather different in appearance but in both cases equal to the CT findings in opportunistic lung infections known from immunoincompetent patients with for instance pneumocystis carinii and/or cytomegalo virus infections. In both patients the CT findings led to lung biopsy establishing the etiologic agent.

Adolescent↗

PubMedDate not supplied

Computed tomography of the lungs in acquired immunodeficiency syndrome. An early indicator of interstitial pneumonia.

Computed tomography of the chest was performed on 42 occasions as part of the diagnostic work-up in 26 homosexual men with, or suspected of the acquired immunodeficiency syndrome (AIDS). In 17 cases both the chest radiographs and the lung scans were abnormal, and bronchoscopy and/or lung biopsy established an etiologic diagnosis in the majority of these cases. In 9 cases CT of the lungs revealed unequivocal interstitial infiltration in the presence of a normal chest radiograph, and subsequently an etiologic agent was demonstrated in all these cases. In 9 cases, patients with symptoms indicative of pulmonary infection had both a normal chest radiograph and a normal lung scan, and in none of these cases did the clinical course or additional diagnostic procedures indicate the presence of current opportunistic lung infection. CT of the lungs seems to identify accurately those patients with severe HIV-related diseases in whom invasive diagnostic procedures such as bronchoalveolar lavage and/or lung biopsy should be done.

Acquired Immunodeficiency Syndrome↗