MATERIALS AND METHODS. The trauma registry at a level 1 trauma center was reviewed to find cases of ATAI occurring between March 1, 2005, and July 31, 2007. MDCT images were correlated with transcatheter angiograms when obtained. Surgical and clinical reports were reviewed to confirm abnormal and normal findings and the stability of the conditions of patients undergoing conservative treatment.

RESULTS. After level 1 or level 2 trauma, 1,344 patients underwent contrast-enhanced 64-MDCT. Twenty-four patients (1.79%) were found to have 25 aortic injuries. All patients had direct MDCT signs of ATAI. Ten catheter angiograms were obtained after MDCT. The presence of direct signs was confirmed in three cases. In five cases, indirect signs were found to be normal findings. In two cases, the findings remained equivocal after MDCT and conventional angiography. Fourteen patients underwent surgical repair of the aorta, six underwent conservative management, and four patients died of other injuries. No patient with equivocal or indirect findings needed surgical repair. The sensitivity of 64-MDCT was 96.0%; specificity, 99.8%; positive predictive value, 92.3%; negative predictive value, 99.9%; and accuracy, 99.8%.

CONCLUSION. Direct signs of ATAI on contrast-enhanced 64-MDCT scans do not have to be confirmed with catheter angiography. In our population, diagnostic transcatheter angiography was of limited value for clarifying equivocal or indirect MDCT findings.

MATERIALS AND METHODS. We retrospectively analyzed the chest radiographic and CT findings in four adults with chronic granulomatous disease during five episodes of lower respiratory tract infection.

RESULTS. Chest radiographic findings included areas of consolidation (60%), diffuse reticulonodular opacities (40%), pleural effusion (20%), and pulmonary artery enlargement (20%). CT findings included areas of consolidation (60%), pulmonary nodules in a random distribution (60%), centrilobular nodules (60%), tree-in-bud opacities (40%), areas of scarring and traction bronchiectasis (100%), emphysematous changes (75%), areas of decreased attenuation and vascularity associated with air trapping on expiratory CT (50%), mediastinal and/or hilar lymphadenopathy (60%), pulmonary artery enlargement (50%), and pleural effusion (20%). Areas of consolidation and nodules were the most prominent findings and at histologic examination were found to be associated with infection or granulomatous inflammation.

CONCLUSION. The pulmonary radiologic findings of chronic granulomatous disease include consolidation, nodules, areas of scarring, traction bronchiectasis, emphysema, air trapping, mediastinal and hilar lymphadenopathy, pulmonary artery enlargement, and pleural effusion.

MATERIALS AND METHODS. A review was performed of all consecutive patients undergoing MDCT and bronchoscopy for suspected complications of airway stents during an 18-month period. MDCT images were interpreted in a blinded fashion by an experienced thoracic radiologist before bronchoscopy was performed, and the accuracy of MDCT was determined using bronchoscopy as the gold standard. MDCT images were specifically assessed for the presence of the following complications: narrowing of stent lumen due to granulation tissue or secretions (or both), stent fracture, stent invasion by adjacent neoplasm, stent migration, and perforation of adjacent airways.

RESULTS. The study population was composed of 21 patients, with mean age of 48 years (range, 16–79 years), who underwent tracheal (n = 3), tracheobronchial (n = 7), or bronchial (n = 11) stent placement for benign (n = 13) or malignant (n = 8) airway disorders. Eleven of 21 stents were metallic and the remaining 10 were silicone. Thirty complications were detected in 21 patients, including stent luminal narrowing due to granulation tissue or secretions (or both) (n = 13), stent migration (n = 9), stent fracture (n = 4), stent invasion by adjacent neoplasm (n = 3), and tracheal perforation (n = 1). MDCT accurately detected 29 (97%) of the 30 complications diagnosed by bronchoscopy. There was one false-negative case in which MDCT failed to detect a stent fracture. There were no false-positive diagnoses of stent complications.

CONCLUSION. MDCT is highly accurate for detecting airway stent complications.

CONCLUSION. Time-resolved MRA is highly sensitive for the detection of abnormalities and is particularly useful in conjunction with static high-spatial-resolution MRA. However, several intrinsic limitations must be kept in mind.

MATERIALS AND METHODS. The cases of 100 patients with diffuse lung disease who underwent high-resolution CT and tissue diagnosis were studied. Three thoracic radiologists reviewed high-resolution CT images blindly and independently for patterns of abnormality, listing their three main diagnoses and level of confidence in the first choice. The effect of the findings on accuracy was analyzed.

RESULTS. For honeycombing, the accuracy of the main diagnosis was 96.6%, 92.2%, and 92.3% for the three readers, and that of the three main diagnoses was 96.6%, 96.1%, and 92.3%. For cysts, the accuracy of the main diagnosis was 88.9%, 80%, and 81.8% and of the three main diagnoses was 100%, 90%, and 90.9%. For bronchovascular thickening, the accuracy of the main diagnosis was 91.7%, 87.5%, and 90.9% and of the three main diagnoses was 91.7%, 100%, and 90.9%. For ground-glass opacification (GGO), the accuracy of the main diagnosis was 75.5%, 55%, and 44.2% and of the three main diagnoses was 89.8%, 75%, and 65.4%. Only combining honeycombing with GGO improved the accuracy of GGO. Anatomic craniocaudal distribution improved reader accuracy when GGO was predominantly present in the lower part of the lung. Interobserver agreement on the presence of major findings was a mean kappa value of 0.45 for honeycombing, 0.74 for lung cysts, 0.63 for bronchovascular thickening, and 0.56 for GGO. Agreement for the craniocaudal distribution of major findings was a mean kappa value of 0.48 for honeycombing, 0.52 for bronchovascular thickening, and 0.32 for GGO.

CONCLUSION. The predominant findings of honeycombing and bronchovascular thickening are associated with more than 90% accuracy in the first-choice diagnosis of diffuse lung disease; the finding of lung cysts has 80–89% accuracy. GGO as a predominant pattern had unreliable accuracy, but the accuracy improved when GGO was combined with either honeycombing or lower-lung distribution.

MATERIALS AND METHODS. From the records of the national hospital for pneumoconiosis, we retrospectively identified patients with chronic interstitial pneumonia who were under surveillance between 1986 and 2006. All patients occasionally underwent chest CT for evaluation of silicosis or exclusion of possible complications. Patients were included in this study only if the initial CT examination did not show obvious chronic interstitial pneumonia. Fourteen patients (all men; median age at initial CT, 58 years) were identified as meeting the inclusion criterion. Two independent reviewers randomly reviewed the CT scans of the study patients to score the extent of ground-glass opacity, reticulation, and honeycombing; to provide a summation of all interstitial opacities (fibrosis score); and to assess coarseness.

RESULTS. Autopsy findings were available for eight of the 14 patients and confirmed the usual interstitial pneumonia (UIP) pattern seen on CT. The median follow-up period was 15.4 years, and none of the patients experienced acute exacerbation. One hundred two CT scans were reviewed. The earliest CT abnormalities included faint ground-glass opacity limited to the lung bases (n = 13) or only coarse reticular opacity (n = 1). In 13 patients, fibrosis and coarseness progressed linearly, whereas the other opacities did not. The annual increase of the fibrosis score and coarseness ranged from 0.306% to 4.633% and 0.179 to 0.479, respectively. Honeycombing developed in all patients over a median period of 12.1 years (range, 3.7–19.1 years).

CONCLUSION. The coarseness best represented the progression of chronic interstitial pneumonia in dust-exposed patients. The earliest CT finding of a UIP pattern in dust-exposed patients was indistinguishable from other types of chronic interstitial pneumonia.

CONCLUSION. MDCT is an invaluable tool in the diagnosis, evaluation, and posttreatment assessment of central airway and vascular complications in lung transplant recipients. Advanced postprocessing techniques provide complementary information that is visually accessible and anatomically meaningful for the clinician.

CONCLUSION. Advances in MDCT and PET and the potential contribution of fast-imaging MRI sequences and computer applications should continue to improve our evaluation of the solitary pulmonary nodule.

MATERIALS AND METHODS. From January 2005 through December 2005, we identified 47 patients (mean age, 58 ± 13 years; age range, 24–72 years; male–female ratio, 11:36) with the nodular bronchiectatic form of MAC pulmonary disease who underwent both high-resolution CT and PFTs. High-resolution CT findings were reviewed retrospectively in terms of the presence and extent of bronchiectasis, cellular or inflammatory bronchiolitis (centrilobular small nodules and tree-in-bud signs), cavity, nodule, and other findings. The extent of the abnormalities seen on high-resolution CT was scored by modifying the cystic fibrosis scoring system proposed by Helbich and coworkers. The scores were correlated with PFT results using Spearman's correlation coefficient.

RESULTS. On high-resolution CT, the three most frequently observed patterns of parenchymal abnormalities were, in decreasing order of frequency, cellular bronchiolitis (n = 47, 100%), bronchiectasis (n = 46, 98%), and consolidation (n = 27, 57%). The total CT score showed a significant correlation with the residual volume–total lung capacity (RV/TLC) ratio (r = 0.572, p < 0.001), forced expiratory volume in 1 second (FEV₁) value (r = –0.426, p = 0.003), forced vital capacity (FVC) value (r = –0.360, p = 0.013), peak expiratory flow value (r = –0.352, p = 0.015), and peak expiratory flow between 25% and 75% of the forced vital capacity (FEF_25–75%) (r = –0.289, p = 0.049).

CONCLUSION. CT scoring of pulmonary abnormalities correlates with measures of functional impairment in patients with MAC pulmonary disease.

MATERIALS AND METHODS. Fifty-eight chest CT examinations were performed with a 16-MDCT scanner. Two acquisitions were performed with different tube current–exposure time settings (50 and 150 mAs, 120 kVp). Four series of lung images were prepared from two sets of raw data with and without application of a 3D adaptive filter (50 mAs, 50 mAs with filter, 150 mAs, 150 mAs with filter). Three blinded readers using a 5-point scale from 1 (nondiagnostic) to 5 (excellent) independently evaluated image quality in five lobes and the lingula. A set of images was considered acceptable when scores in all six regions were 3 (acceptable) or higher. The SD of attenuation was calculated in 24 regions of interest.

RESULTS. The overall mean image quality scores were 3.09, 3.53, 4.02, and 4.38 for the 50 mAs, 50 mAs with filter, 150 mAs, and 150 mAs with filter sets, respectively. Scores were significantly better with filter application (p < 0.001). A significant decrease in SD of attenuation was observed with filter application (p < 0.001). Among the respective series of images, 18, 52, 50, and 58 sets were judged acceptable with no significant difference in acceptability between images obtained at 50 mAs with a filter and at 150 mAs (p = 0.72). With filter application, the acceptability of 50-mAs images became comparable with that of 150-mAs images, making dose reduction to 50 mAs practical.

CONCLUSION. Use of a 3D adaptive raw-data filter improved the quality of lung images, making dose reduction to 50 mAs attainable with use of the filter.