FRCR-RV-NOTES

Imaging characteristics of intra- and extra-lobar sequestration [124]

“ Type Intra-lobar Extra-lobar Percentage 75% of cases 25% of cases Presentation Presents in adulthood with pain, infection and haemoptysis40-50% are associated with congenital anomalies  Presents in infancy with feeding difficulties, respiratory distress, cyanosis and heart failure Venous drainage Central drainage (‘intra’ = ‘central’ drainage) Systemic drainage via inferior vena cava, azygos or hemiazygos Arterial supply …

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CYLINDRICAL BRONCHIECTASIS

“ Relatively uniform, mild airway dilatation with parallel bronchial walls. Most common and least severe. Causes include cystic fibrosis (pan-lobar), hypogammaglobulinaemia (lower lobe) and Japanese panbronchiolitis (pan-lobar). Plain film •  Tram-track appearance (en face dilated airways) or ring shadows (axial appearance of dilated airways) •  Bronchial wall thickening HRCT •  ‘ Signet ring’ sign describes the axial view …

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“SEVERE ACUTE RESPIRATORY SYNDROME”

“ Atypical pneumonia caused by a coronavirus. The imaging features are non-specific and indicative of diffuse alveolar damage. About 20% require intensive therapy unit (ITU) treatment; overall mortality about 10%. PLAIN FILM •  May be normal initially, progressing to airspace opacification. CT •  Ground-glass opacification/consolidation initially affecting the lower zones (commonly bilateral), then becoming widespread …

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DENTIGEROUS CYST?

“ Due to excessive fluid accumulation associated with the cap of unerupted molars (key to diagnosis). In total, 80% are mandibular and they rarely become malignant. The key features of cystic lesions in the maxilla and mandible are summarised in Table PLAIN FILM •  Well-corticated, unilocular cyst associated with an unerupted molar.•  Look for a fracture …

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“PULMONARY OEDEMA”

“ The accumulation of extravascular fluid in the lung. It is either due to increased fluid pressure (leading first to increased interstitial fluid, then to alveolar flooding) or to increased membrane permeability. PLAIN FILM •  Initially, there is vascular redistribution—‘upper lobe diversion’.•  Then, interstitial fluid and Kerley lines (Kerley A lines are 2-6 cm long, …

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VARICOSE BRONCHIECTASIS

“ Bronchial lumen assumes a beaded (‘string of pearls’) configuration with sequential dilatation and constriction. Causes include ABPA,Swyer- James syndrome.  Plain film •  Beaded airway dilatation with or without mucous impaction (‘finger in glove’). •  ABPA tends to affect the upper lobes. ” For Radiology Cases, Discussion join: Radiology Made Easy on Facebook  Subscribe to our …

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CHRONIC EOSINOPHILIC PNEUMONIA

“ Insidious onset of night sweats, pyrexia, cough and weight loss. More common in middle age and 50% have asthma. Mild blood eosinophilia and high eosinophilia on BAL. Responds to steroids. Plain film •  Bilateral, non-segmental, upper peripheral lobe airspace opacification (so-called ‘photographic negative of pulmonary oedema’ or ‘reverse bat’s wing’ appearance) HRCT •  Dense peripheral consolidation …

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ACUTE EOSINOPHILIC PNEUMONIA

“ Mean age of onset about 30 years, may be smoking related. Rapid onset of symptoms, fever and hypoxaemia. Marked eosinophilia on bronchoalveolar lavage (BAL)/pleural samples, but normal blood levels. Rapid response to steroids. Plain film •  Bilateral densities with effusions, with or without consolidation HRCT •  Bilateral, patchy, ground-glass opacities •  Interlobular septal thickening …

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“PULMONARY HYPERTENSION”

“ Divided into primary and secondary causes. Secondary pulmonary hypertension is due to either increased pulmonary blood flow (e.g. left to right shunt), decreased cross-sectional area of the pulmonary vasculature (e.g. pulmonary embolism) or increased resistance to pulmonary venous drainage (commonly due to left-sided heart disease). PLAIN FILM •  Look for an enlarged right descending …

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