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At least 1,279 records · Page 71Linked to original sources
PubMed1993

Hyperlucent thorax from rotation. Anatomic basis.

RATIONALE AND OBJECTIVES: The authors studied a large group of patients with a computed tomography (CT)-based model to evaluate the presence, significance, and anatomic basis of unilateral hyperlucency from patient rotation. METHODS: Chest CT sections at three levels in 65 consecutive patients undergoing routine diagnostic studies were read into a microcomputer. Radiographic transmittance data were calculated across each CT section at different degrees of rotation as well as for lateral decentering. Data were analyzed for the pattern of density variation both individually as well as in stratified subgroups. RESULTS: The data showed a trend of increasing radiographic transmission on the side opposite that of the anterior obliquity. The resulting optical density difference was small and was not clinically significant. Lateral decentering produced smaller changes than rotation. The anterior breast/pectoral structures are the etiology for the phenomenon. Optical density differences of 0.1 result from a difference in tissue thickness of 4 mm. CONCLUSIONS: The changes in radiographic transmission with rotation are small and are overshadowed by soft tissue compression. Rotation alone will result in decreased radiographic transmission on the side of anterior obliquity; thus, the left side will be more lucent in an right anterior oblique projection.

Adult↗
PubMed1979

Computed tomography of the thorax and standard radiographic evaluation of the chest: a comparative study.

Comparison of standard radiographic evaluation of the chest with computed tomography (CT) was carried out in 109 patients who were examined on a prototype EMI CT5000 scanner. Forty-eight patients had lung problems, and 61 were evaluated because of a mediastinal mass or widening, or for the detection of an occult thymoma in myasthenia gravis. Computed tomography was of value in the staging of bronchogenic carcinoma, particularly in the detection of direct mediastinal and pleural extension, and in evaluating patients with solitary or multiple nodules by detecting additional lesions and calcification. Thymomas not detected on conventional imaging modalities were visualized in 4 of 33 patients with myasthenia gravis or red cell aplasia. One of these was a false positive. In 28 patients with a mediastinal mass or widening on the chest roentgenogram, incremental information was noted on CT in 22. These included a definitive diagnosis of lesions composed of fat, evaluation of the isolated esophagus after colon by bypass surgery,and identification of the cause of paraspinal widening.

Anemia, Aplastic↗
PubMed1982

CT-guided aspiration biopsy of the thorax.

Percutaneous needle aspiration biopsy of thoracic lesions was performed under the guidance of computed tomography (CT) in 28 patients. The lesions chosen for CT guidance of needle placement were those not amenable to demonstration by biplane fluoroscopy: lesions in or adjacent to the mediastinum or hila; peripheral lesions; and small or ill-defined lesions, such as cavitary masses. The accuracy of the technique was assessed on the basis of pathological and radiographic confirmation of the cytologic diagnoses. The sensitivity of the technique was 84% (16/19), the specificity was 100% (6/6), and the overall accuracy was 88% (22/25). Inadequate specimens were obtained in two patients, and another patient could not complete the procedure. Pneumothorax, which developed in 17 patients, was remedied by intercostal tube drainage in three. There was one mild episode of hemoptysis, which resolved spontaneously. We recommended that CT-guided aspiration biopsy of thoracic lesions be used when the type, size, or position of the lesion makes fluoroscopic guidance of the needle unreliable.

Biopsy, Needle↗
PubMedDate not supplied

The value of opacification of the esophagus by low density barium paste in computer tomography of the thorax.

A 3% barium paste was used in the CT evaluation of 100 normal and 60 abnormal esophagi. Successful esophageal opacification occurred in 87% of both groups. In cases of extrinsic disease involving the esophagus the contrast medium administration assisted in separating the esophagus from adjacent mass lesions, as well as identifying displacement, compression, proximal dilatation, and length of involvement. In cases of esophageal carcinoma the contrast medium administration assisted in the measurement of wall thickness and length of the lesion as well as identification of the site of origin of the tumor. The contrast medium was simple to administer, well tolerated, and did not produce scan artifacts.

Adenocarcinoma↗
PubMedDate not supplied

Spectrum of neurogenic tumors in the thorax: CT and pathologic findings.

Neurilemomas and neurofibromas appear as round soft tissue masses at CT. Variable enhancement with either homogeneity or heterogeneity is seen in neurilemomas. Attenuation of the tumors on enhanced CT depends on histology: the extent of Antoni A or B tissue and the amount of myxoid or cystic degeneration or hemorrhage. Neurofibromas are usually homogeneous low attenuation lesions on unenhanced CT. They show homogeneous enhancement or early central blush on enhanced scan. The extent of enhancement depends on the proportions of tumor components: nerve sheath cells, collagen bundles, and areas of myxoid degeneration. Malignant nerve sheath tumors show variable attenuation. Bony destruction, pleural effusion, and metastatic pulmonary nodules may also occur. Ganglioneuromas appear as oblong homogeneous low attenuation lesions on both enhanced and unenhanced CT. This low attenuation is due to their pathologic components, with an abundant amount of myxoid matrices and a relatively small amount of ganglion cells. Neuroblastomas appear as aggressive soft tissue lesions with calcification. Ganglioneuroblastomas may appear with features in between those of ganglioneuromas and neuroblastomas. The typical location of the posterior mediastinum or the aortopulmonary window and high enhancement with administration of contrast medium at CT suggest the diagnosis of paragangliomas.

Adult↗
PubMed1982

The biomechanical response of the thorax to nonpenetrating impact with particular reference to cardiac injuries.

Sternal injury, gross cardiac pathology, and cardiac dysrhythmias following nonpenetrating impact by a variety of impactors to the sternum of experimental animals are described. The biomechanical response of the chest wall to the impact and the associated transient pressure changes within the heart are presented, and a correlation between injury severity and chest wall displacement is demonstrated. A simple model is then developed to predict chest wall displacement if the mass, velocity, and dimensions of an impactor are known. The model demonstrates the dependence of chest-wall displacement upon preimpact kinetic energy, impact diameter, and target size.

Animals↗
PubMed1998

Predicting the rates of success and complications of computed tomography-guided percutaneous core-needle biopsies of the thorax from the findings of the preprocedure chest computed tomography scan.

The authors attempted to determine whether the anatomic characteristics of thoracic lesions and the surrounding lung field, as assessed by the preprocedure chest computed tomography (CT) scan, can assist in predicting the yield of complications or positive results of pathologic examination resulting from percutaneous core-needle biopsies (PCNB). The pathologic diagnoses and procedural complications of 50 consecutive thoracic PCNBs (43 men, age range 19-81 years) performed under the guidance of a single operator (J.A.M.) were recorded. Prebiopsy chest CT findings, including the size, depth, location, and border appearance of the lesion, as well as presence or absence of adjacent emphysema, interstitial fibrosis, bullae, pleural effusions, and the age and smoking history of the patient were correlated with the biopsy results and any ensuing complications. The pathologic analysis in 42 patients (84%) was specific enough to positively impact patient management, with 29 malignant and 13 benign entities. The imaging variables that predicted obtaining adequate tissue for pathologic diagnosis were most importantly large size (especially >35 mm), although irregular lesion margins and increased depth were significant as well. Seven patients (14%) experienced a pneumothorax, only one of which (2%) was symptomatic and required thoracostomy. All patients experiencing a pneumothorax had CT evidence of emphysema or interstitial fibrosis and all biopsied masses in these individuals had spiculated borders, with six (86%) in an anterior location and only one involving the pleural surface. We conclude that the preprocedure CT scan can delineate several characteristics of both the patient and the lesion to be biopsied that can assist in predicting the rates of successful tissue retrieval or pneumothorax during PCNBs.

Adult↗
PubMed1984

Ultrasonography in the diagnosis and management of empyema of the thorax.

Ultrasonic examination is useful to detect and localize empyema within the thoracic cavity in order to perform fine-needle aspiration. In six cases in which we used these procedures no complications were detected. Three of them are presented to illustrate the usefulness of ultrasonographically guided fine-needle aspiration of thoracic empyema in the clinical management of such patients. Ultrasonography provides a safe and rapid method for early detection and diagnosis of thoracic empyema so that appropriate therapy may be initiated.

Adult↗
PubMed2003

Estimating volumetric motion in human thorax with parametric matching constraints.

In radiotherapy (RT), organ motion caused by breathing prevents accurate patient positioning, radiation dose, and target volume determination. Most of the motion-compensated trial techniques require collaboration of the patient and expensive equipment. Estimating the motion between two computed tomography (CT) three-dimensional scans at the extremes of the breathing cycle and including this information in the RT planning has been shyly considered, mainly because that is a tedious manual task. This paper proposes a method to compute in a fully automatic fashion the spatial correspondence between those sets of volumetric CT data. Given the large ambiguity present in this problem, the method aims to reduce gradually this uncertainty through two main phases: a similarity-parametrization data analysis and a projection-regularization phase. Results on a real study show a high accuracy in establishing the spatial correspondence between both sets. Embedding this method in RT planning tools is foreseen, after making some suggested improvements and proving the validity of the two-scan approach.

Algorithms↗
PubMedDate not supplied

Radiographic findings in the thorax of dogs with leptospiral infection.

Thoracic radiographs of 4 dogs with confirmed and 1 dog with suspected leptospirosis were reviewed. In all dogs a reticulonodular pulmonary opacity was noted, affecting the entire lung in 3 and predominantly the caudodorsal lung field in 2 dogs. The radiographic lung pattern described is associated with pulmonary hemorrhage probably due to endothelial damage and vasculitis. Pulmonary manifestations in dogs with leptospirosis may be misinterpreted and attributed to neoplasia, pneumonia, edema, hemorrhage due to disseminated intravascular coagulopathy, adult respiratory distress syndrome and pulmonary thromboembolism.

Animals↗