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Primary Interpretation of Thoracic MDCT Images Using Coronal Reformations

Sharon W. Kwan1, Bernhard L. Partik2, Steven E. Zinck3, Frandics P. Chan1, Stephen T. Kee1, Ann N. Leung1, Martin Voracek4 and Geoffrey D. Rubin1

1 Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr., S-072B, Stanford, CA 94305-5105.



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  		Fig. 1A —Solitary pulmonary nodule in 45-year-old man detected at reference standard interpretation and missed by all three observers on reconstructed 5-mm-thick transverse and coronal images. Contrast-enhanced transverse 1.25-mm reconstructed CT image (4 x 1 mm collimation) used only for reference standard interpretation depicts nodule (arrow) in right upper lobe of lung.

 


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  		Fig. 1B —Solitary pulmonary nodule in 45-year-old man detected at reference standard interpretation and missed by all three observers on reconstructed 5-mm-thick transverse and coronal images. Same scan as A reconstructed into 5-mm-thick transverse sections shows lesion (arrow) less clearly defined.

 


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  		Fig. 1C —Solitary pulmonary nodule in 45-year-old man detected at reference standard interpretation and missed by all three observers on reconstructed 5-mm-thick transverse and coronal images. Same scan as A reformatted into 5-mm-thick coronal sections depicts same nodule (arrow).

 


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  		Fig. 2A —Pulmonary nodule detected by all observers in transverse and missed by all observers in coronal display in 60-year-old man with history of lung cancer and lobectomy. Transverse 5-mm reconstructed CT image (4 x 1 mm collimation) depicts pulmonary nodule (arrow) in right middle lobe.

 


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  		Fig. 2B —Pulmonary nodule detected by all observers in transverse and missed by all observers in coronal display in 60-year-old man with history of lung cancer and lobectomy. Same CT scan as A reformatted into 5-mm-thick coronal sections shows same nodule in right middle lobe (arrow) as that visible in A; this finding was missed by all observers.

 


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  		Fig. 3A —Bochdalek's hernia in 80-year-old woman that was detected in transverse display by two of three observers and missed in coronal display by all three observers. Transverse 5-mm reconstructed CT image (4 x 1 mm collimation) depicts left-sided diaphragmatic hernia (arrow).

 


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  		Fig. 3B —Bochdalek's hernia in 80-year-old woman that was detected in transverse display by two of three observers and missed in coronal display by all three observers. Same CT scan as A reformatted into 5-mm-thick coronal sections shows same hernia (arrow).

 


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  		Fig. 4A —80-year-old man with mediastinal lymphadenopathy detected by all observers in transverse display and missed by all observers in coronal display. Transverse 5-mm reconstructed CT image (4 x 1 mm collimation) depicts enlarged mediastinal lymph node (arrow).

 


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  		Fig. 4B —80-year-old man with mediastinal lymphadenopathy detected by all observers in transverse display and missed by all observers in coronal display. Same CT scan as A reformatted into 5-mm-thick coronal sections shows same lymph node (arrow).

 


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  		Fig. 5A —Cardiac motion artifacts in 67-year-old man with history of throat cancer and multiple pulmonary nodules. Nodule in lingula was detected by all three observers in transverse and coronal displays. Transverse 5-mm reconstructed CT image (4 x 1 mm collimation) depicts pulmonary nodule in lingula (solid arrow). Note artifacts (open arrow) due to cardiac motion.

 


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  		Fig. 5B —Cardiac motion artifacts in 67-year-old man with history of throat cancer and multiple pulmonary nodules. Nodule in lingula was detected by all three observers in transverse and coronal displays. Same CT scan as A reformatted into 5-mm-thick coronal sections depicts motion artifacts along cardiac contour (black arrows). Nodule in lingula (white arrows) shows lobulated appearance due to transmitted motion artifacts. Note second nodule in upper lobe (open arrow) and anterior pleural junction line (arrowheads).

 

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