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PubMed1982

Tracheobronchography in the evaluation of anomalous left pulmonary artery.

In three patients the diagnosis of an anomalous left pulmonary artery was confirmed when tracheobronchography demonstrated a discrete extrinsic impression on the proximal right bronchus. The diagnosis was unsuspected clinically in one patient with a hyperlucent left lung on conventional chest radiographs. In the other two patients there was a suspicion of a pulmonary sling, but findings on plain chest or airway radiographs were atypical. The tracheobronchogram can be a valuable procedure for diagnosing a pulmonary sling, detecting additional developmental anomalies of the bronchi, and predicting the post-operative clinical course.

Bronchography↗
PubMed2002

Bilateral Swyer-James (Macleod's) syndrome.

Swyer James syndrome (SJS) is a rare disorder. It is generally discovered on a chest radiograph as increased translucency involving one hemithorax with diminished vascular markings. We present a 5-year-old girl admitted for the treatment of recurrent bronchiolitis. She was diagnosed as having Swyer James syndrome from the results of CT scan and ventilation perfusion scintigraphy, which revealed unsuspected bilateral involvement. This condition should be considered as a differential diagnosis in a patient with Swyer James (Macleod's) syndrome without an obvious etiology.

Bronchiolitis↗
PubMed2001

Surgically treated Swyer-James syndrome.

Because patients with Swyer-James syndrome have almost always been treated conservatively, few reports exist of pathological findings of the lung in this syndrome. We report a case of this rare disease treated surgically and discuss pathological findings. A 36-year-old woman repeatedly contracted bronchitis and pneumothorax since adolescence, until April 26, 1997, when she reported chest pain and dyspnea. Chest X-ray on admission showed left pulmonary collapse with a slight deviation of the mediastinum toward the right. Chest computed tomography showed an apical bulla and emphysematous change in the left upper lobe. Pulmonary arteriography at age 17 showed hypoplasia of left pulmonary artery branches in the left upper lobe. Based on a diagnosis of Swyer-James syndrome, we conducted left upper lobectomy on May 2, 1997. Pathological examination of the resected left upper lobe showed marked emphysematous change, including an emphysematous bulla with destruction of alveolar structure and peribronchiolar fibrosis. No vascular abnormality was recognized in histology. Emphysematous change secondary to repeated bronchiolitis is believed to have led to her repeated pneumothorax.

Adult↗
PubMed2003

Swyer-James syndrome with myocardial bridge: a case report.

Swyer-James syndrome is an uncommon disease with unknown aetiology. It is generally discovered on a chest radiograph as increased translucency involving one hemithorax because of diminished vascular markings. Pulmonary vascularization on the affected side is greatly reduced leading to radiological translucency. Myocardial bridging describes an angiographic entity, which is any degree of systolic narrowing of a coronary artery observed in at least one angiographic projection. It is a congenital anomaly of the coronary artery and may occur in 5-12% of the human population. We report a patient suffering from chest tightness and with diagnosed Swyer-James syndrome also having myocardial bridge.

Adult↗
PubMed2002

Contrast-enhanced three-dimensional MR angiography of the pulmonary vascular tree.

Contrast-enhanced three-dimensional MR angiography has evolved into a promising technique in the study of the pulmonary vasculature. Both congenital and acquired entities can be now morphologically demonstrated in a non-invasive manner obviating the need for conventional pulmonary angiography. Due to spatial resolution limitations, however, it is still premature to routinely apply the method in the detection of small subsegmental emboli, in cases of suspected pulmonary embolism, and further technical developments will be required. In this paper we present a spectrum of congenital and acquired disorders affecting the pulmonary vascular tree as demonstrated with contrast-enhanced three-dimensional MR angiography.

Adult↗
PubMed1999

Macleod's syndrome presenting with spontaneous pneumothorax.

A 19-year-old woman with a recent history of recurrent bronchitis presented with a spontaneous left pneumothorax. Review of the chest radiographs revealed features of Macleod's syndrome on the same side, with unilateral lucency and hypoplastic hilar vessels. To our knowledge this is the first report of Macleod's syndrome presenting with spontaneous pneumothorax.

Adult↗
PubMedDate not supplied

Spectrum of manifestations of Swyer-James-MacLeod syndrome.

PURPOSE: The clinical and imaging findings of children with Swyer-James-MacLeod syndrome (SJMS) were reviewed to determine the incidence and type of bronchiectasis and analyze whether the clinical course of patients with bronchiectasis differed from that of patients without bronchiectasis. METHOD: Our study population consisted of 13 patients. All had inspiratory/ expiratory chest X-ray films, chest CT, and lung scans. Eight underwent pulmonary function test. The results of these studies at diagnosis and during follow-up were analyzed and compared with the clinical features. RESULTS: Bronchiectasis was demonstrated in nine patients, being saccular in five and cylindrical in four. Expiratory slices were helpful for demonstrating bilateral lung involvement that had not been suspected on inspiratory CT scans or conventional radiographs. The clinical features of the five patients with saccular bronchiectasis resembled those of patients with classic postviral bronchiectasis who suffered recurrent pulmonary infections; three of them underwent lobectomy. The remaining patients presented mild respiratory symptoms, with a spontaneous tendency toward improvement. CONCLUSION: SJMS should be considered as a spectrum disease. Bronchiectasis is not a universal finding. The presence and type of bronchiectasis will influence clinical manifestations and prognosis. Patients without bronchiectasis or with cylindrical bronchiectasis had a lower incidence of pneumonia episodes than those with saccular bronchiectasis.

Adolescent↗
PubMedDate not supplied

Air-trapping zone surrounding sclerosing hemangioma of the lung.

We present two cases of sclerosing hemangioma of the lung with a peculiar radiologic finding: an air-trapping zone surrounding the tumor. On microscopic examinations, the tumor was of the hemangiomatous subtype, and the radiolucent zone corresponded to enlarged alveoli with septal destruction. A possible mechanism in the production of an air-trapping zone around a sclerosing hemangioma is bleeding from the highly vascular tumor followed by expectoration in communication with an airway. We reviewed the literature on the air meniscus sign in sclerosing hemangioma and concluded that although it is not a common finding, it could be of help in the confident diagnosis of sclerosing hemangioma and in differentiating it from other benign tumors of the lung.

Adult↗
PubMed2000

Correlation of aging and smoking with air trapping at thin-section CT of the lung in asymptomatic subjects.

PURPOSE: To assess the frequency and degree of air trapping at thin-section computed tomography (CT) of the lung in relation to age and smoking history in asymptomatic subjects. MATERIALS AND METHODS: Thin-section CT of the lung was performed prospectively at end inspiration and end expiration in 82 subjects (27 smokers, 55 nonsmokers) without any history of pulmonary diseases and without present pulmonary symptoms. The frequency and degree of air trapping were evaluated according to age and smoking status. RESULTS: The overall frequency of air trapping was 52% (43 of 82 subjects, kappa = 0.72). Air trapping was found in three of 13 (23%), seven of 17 (41%), nine of 18 (50%), 11 of 17 (65%), and 13 of 17 (76%) subjects aged 21-30, 31-40, 41-50, 51-60, and greater than or equal to 61 years, respectively. The frequency of air trapping increased with age (P < .05). The degree of air trapping had a significant correlation with age (r = 0.523, P < .001) and was higher in smokers with a smoking history of more than 10 pack-years (P < .05). CONCLUSION: Air trapping was found in approximately 50% of asymptomatic subjects. The frequency of air trapping increased with age, and its severity increased with age and smoking.

Adult↗
PubMed1999

Computer recognition of regional lung disease patterns.

We have developed an objective, reproducible, and automated means for the regional evaluation of the pulmonary parenchyma from computed tomography (CT) scans. This method, known as the Adaptive Multiple Feature Method (AMFM) assesses as many as 22 independent texture features in order to classify a tissue pattern. In this study, the six tissue patterns characterized were: honeycombing, ground glass, bronchovascular, nodular, emphysemalike, and normal. The lung slices were evaluated regionally using 31 x 31 pixel regions of interest. In each region of interest, an optimal subset of texture features was evaluated to determine which of the six patterns the region could be characterized as. The computer output was validated against experienced observers in three settings. In the first two readings, when the observers were blinded to the primary diagnosis of the subject, the average computer versus observer agreement was 44.4 +/- 8.7% and 47.3 +/- 9.0%, respectively. The average interobserver agreement for the same two readings were 48.8 +/- 9.1% and 52.2 +/- 10.0%, respectively. In the third reading, when the observers were provided the primary diagnosis, the average computer versus observer agreement was 51.7 +/- 2.9% where as the average interobserver agreement was 53.9 +/- 6.2%. The kappa statistic of agreement between the regions, for which the majority of the observers agreed on a pattern type, versus the computer was found to be 0.62. For regional tissue characterization, the AMFM is 100% reproducible and performs as well as experienced human observers who have been told the patient diagnosis.

Diagnosis, Computer-Assisted↗
PubMed2006

Detection of air trapping on inspiratory and expiratory phase images obtained by 0.3-second cine CT in the lungs of free-breathing young children.

OBJECTIVE: The objective of our study was to evaluate whether 0.3-second cine CT can be used to detect air trapping in the lungs of young children. SUBJECTS AND METHODS: In 30 children (mean age, 25 months), 0.3-second cine CT was performed at six levels during 3 seconds of quiet breathing. The study population was divided into an air trapping group (n = 24) and a no-air trapping group (n = 6). Lung density was measured at an abnormal area (with or without air trapping) and an adjacent normal area on inspiratory and expiratory phase images. Lung density differences between inspiration and expiration were calculated and compared in abnormal areas (with or without air trapping) and in normal areas. Their percentages were calculated and compared between the two groups. In addition, lung density differences between abnormal and adjacent normal areas were calculated and compared between the two groups. RESULTS: Lung density differences between inspiration and expiration were smaller in areas with air trapping (mean +/- SD, -19 +/- 34 H) than in abnormal areas without air trapping (138 +/- 36 H) (p < 0.001) or in normal areas (111 +/- 49 H) (p < 0.001). Their percentages were smaller in the group with air trapping (-27% +/- 54%) than in the group with no air trapping (120% +/- 87%) (p < 0.001). In the group with air trapping, lung density differences were larger at the expiratory phase (260 +/- 77 H) than at the inspiratory phase (129 +/- 69 H) (p < 0.001), but did not change through the respiratory cycle in the group with no air trapping (p > 0.05). CONCLUSION: Air trapping can be accurately detected in the lungs of free-breathing young children using 0.3-second cine CT.

Bronchi↗