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Direct Detection of Angioinvasive Pulmonary Aspergillosis in Immunosuppressed Patients: Preliminary Results with High-Resolution 16-MDCT Angiography

¹ Department of Radiology, University Hospitals Basel, Petersgraben 4, Basel CH-4031, Switzerland.
² Department of Pneumology, University Hospitals Basel, Basel CH-4053, Switzerland.
³ Department of Hematology, University Hospitals Basel, Basel CH-4053, Switzerland.

View larger version (117K): [in a new window]   Fig. 1A. —50-year-old man with acute myeloid leukemia and histologically proven invasive pulmonary aspergillosis in left upper lobe. Contrast-enhanced axial CT scan of chest obtained at lung window settings shows nodule with peripheral ground-glass opacity, representing halo sign.

View larger version (158K): [in a new window]   Fig. 1B. —50-year-old man with acute myeloid leukemia and histologically proven invasive pulmonary aspergillosis in left upper lobe. Contrast-enhanced 30-mm coronal maximum-intensity-projection image with clear depiction of peripheral pulmonary arteries shows interruption of peripheral segmental pulmonary artery at level of halo surrounding nodule, corresponding to vascular occlusion (arrow).

View larger version (138K): [in a new window]   Fig. 1C. —50-year-old man with acute myeloid leukemia and histologically proven invasive pulmonary aspergillosis in left upper lobe. Magnified contrast-enhanced 30-mm coronal maximum-intensity-projection image confirms interruption of same peripheral segmental pulmonary artery (arrow) at level of halo surrounding nodule.

View larger version (123K): [in a new window]   Fig. 1D. —50-year-old man with acute myeloid leukemia and histologically proven invasive pulmonary aspergillosis in left upper lobe. Magnified contrast-enhanced 30-mm axial maximum-intensity-projection image shows same occluded pulmonary artery (arrow).

View larger version (154K): [in a new window]   Fig. 2A. —47-year-old man with non-Hodgkin's lymphoma and histologically proven atypical Mycobacterium consolidation in left lower lobe. Contrast-enhanced axial CT scan of chest obtained at lung window settings shows focal area of air-space consolidation in posterior basal segment of left lower lobe.

View larger version (147K): [in a new window]   Fig. 2B. —47-year-old man with non-Hodgkin's lymphoma and histologically proven atypical Mycobacterium consolidation in left lower lobe. Contrast-enhanced 30-mm coronal maximum-intensity-projection image shows patent arteries (arrowheads) inside focal consolidation in posterior basal segment of left lower lobe without any evidence of occluded vessels.

View larger version (140K): [in a new window]   Fig. 2C. —47-year-old man with non-Hodgkin's lymphoma and histologically proven atypical Mycobacterium consolidation in left lower lobe. Magnified contrast-enhanced 30-mm coronal maximum-intensity-projection image shows patent arteries inside focal consolidation in posterior basal segment of left lower lobe without any evidence of occluded vessels.

View larger version (147K): [in a new window]   Fig. 2D. —47-year-old man with non-Hodgkin's lymphoma and histologically proven atypical Mycobacterium consolidation in left lower lobe. Magnified contrast-enhanced 30-mm coronal-oblique maximum-intensity-projection image confirms patent arteries throughout air-space consolidation in posterior basal segment of left lower lobe.

View larger version (117K): [in a new window]   Fig. 3A. —34-year-old man with cough and fever of unknown origin and biopsy-proven mediastinal diffuse large cell lymphoma extending into lung parenchyma. Contrast-enhanced axial CT scan of chest obtained at mediastinal settings shows large solid lesion in middle lobe in contact with pleural surface.

View larger version (101K): [in a new window]   Fig. 3B. —34-year-old man with cough and fever of unknown origin and biopsy-proven mediastinal diffuse large cell lymphoma extending into lung parenchyma. Contrast-enhanced 30-mm axial maximum-intensity-projection (MIP) image shows patent, tapering, and partially irregular vessels within solid parts of lesion.

View larger version (123K): [in a new window]   Fig. 3C. —34-year-old man with cough and fever of unknown origin and biopsy-proven mediastinal diffuse large cell lymphoma extending into lung parenchyma. Magnified contrast-enhanced 30-mm axial MIP image shows patent, tapering, and partially irregular vessels (arrowheads) within solid lesion. No vascular occlusion was detected in peripheral area of lesion.

View larger version (134K): [in a new window]   Fig. 3D. —34-year-old man with cough and fever of unknown origin and biopsy-proven mediastinal diffuse large cell lymphoma extending into lung parenchyma. Magnified contrast-enhanced 30-mm oblique-sagittal MIP image confirms patent, tapering, and partially irregular vessels (arrowheads).

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