Radiology Notes

My notes during radiology residency, fellowship, and beyond…

Archive for the ‘chest’ Category

Wegener’s Granulomatosis

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  • necrotizing vasculitis
  • upper respiratory tracts, lungs, renal glomeruli
  • lungs
    • multiple pulmonary nodules; 50% cavitate, angiocentric
    • diffuse alveolar consolidation = hemorrhage
  • +cANCA
  • Rx: cyclophosphamide and steroids

Written by lmwong

January 19, 2010 at 7:54 pm

Congenital Cystic Adenomatoid Malformation

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  • Type 1
    • big cysts (2-10 cm)
  • Type 2
    • multiple small cysts
    • renal and cardiac anomalies
  • Type 3
    • solid
  • any lobe
  • alveoli replaced by adenomatoid
  • surgical resection
  • 70% present during 1st week of life
  • 10% diagnosed after 1st year
  • supplied by pulmonary artery; systemic supply rare
  • can involve entire lobe
  • prenatal diagnosis
    • polyhydramnios
    • fetal hydrops
    • solid or cystic mass in fetal thorax
  • excise affected lobe

read more

Written by lmwong

January 18, 2010 at 10:02 am

Increased Pulmonary Vascularity in kids

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  • Endocardial cushion defect
  • ASD
  • Patent Ductus arteriosus (enlarged LA and aorta)
  • VSD (enlarged LA and normal aorta)

Written by lmwong

January 16, 2010 at 10:58 am

Thin Walled Lung Cysts

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  • Eosinophilic granuloma
  • Lymphangioleiomyomatosis (LAM)
    • upper
    • uniform size
    • women in reproductive years
    • can rupture –> pneumothorax
  • Tuberous sclerosis
  • Neurofibromatosis
  • LIP

histiocytosis X

  • peribronchiolar distribution
  • nodules become cysts
  • ~ smoking
  • upper lobes
  • CPA spared
cystic lung disease

    Written by lmwong

    January 16, 2010 at 10:56 am

    Chest Buzz Words

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    • split pleura sign = empyema
    • Crazy paving = alveolar proteinosis
    • Bibasilar Honeycombing with traction bronchiectesis = UIP
    • Reverse indentation of esophagus = double aortic arch
    • Bronchovascular cyst = DIP
    • Head cheese sign = hypersensiivty pneumonitis
    • micronodular ground glass opacity = hypersensitivity pneumonitis
    • egg shell calcification of lymph nodes = sarcoid
    • ribbon deformity of ribs = neurofibromatosis
    • mosaic pattern = bronchiolitis obliterans
    • tulip bulb aorta = cystic medial necrosis
    • tree-bark calcification aorta = syphilitic aneurysm
    • 3 sign = coartation of aorta
    • boot-shaped heart = Tetralogy of Fallot
    • square-shaped heart = Ebstein’s anomaly
    • egg-on-string heart = transposition of great vessels
    • snowman heart = Total Anomalous Pulmonary Venous Return
    • flow-metabolism mismatch (NM) = viable myocardium
    • delayed hyperenhancement (MRI) = myocardial ischemia
    • atrialization of the right ventricle = Ebstein’s Anomaly
    • aortic nipple = left superior intercostal vein

    Written by lmwong

    January 16, 2010 at 10:54 am

    Posted in buzz, chest

    Pulmonary Diseases in Newborn

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    High volume, streaky

    1. meconium aspiration
    2. TTN
    3. neonatal PNA

    Low volume, granular

    1. surfactant deficiency
    2. beta-hemolytic streptococcal PNA

    Written by lmwong

    January 16, 2010 at 10:50 am

    Pulmonary Sequestration

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    • pulmonary tissue without normal connection to bronchial tree
    • anomalous arterial blood supply, from aorta; must document for surgery
    • recurrent PNA
    • solid to multiloculated cystic masses
    • MC in LLL
    • Intralobar
      • more common
      • no extra pleural covering
      • left side; 2/3 posterobasal segment LLL, adjacent to diaphragm
      • arterial supply from thoracic aorta
      • older children and adults
    • Extralobar
      • extra pleural covering
      • associated anomalies
      • arterial supply from abdominal aorta
      • infancy
      • presents as mass lesion

    Written by lmwong

    January 16, 2010 at 10:27 am

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