(BQ) Part 2 book Thoracic imaging - Pulmonary and cardiovascular radiology has contents: The trachea, chronic obstructive pulmonary disease and emphysema, diffuse cystic lung diseases, the pleura and pleural disease,... and other contents.
Section Airway Abnormalities 1759 Four 1760 CHAPTER 22 The Trachea W RICHARD WEBB THE NORMAL TRACHEA The trachea extends from the inferior aspect of the cricoid cartilage (at the level of the sixth cervical vertebra) to the carina (at the level of the fifth thoracic vertebra) It measures from 10 to 12 cm in length The trachea is divided into extrathoracic and intrathoracic portions at the level it passes posterior to the manubrium; the extrathoracic trachea is to cm in length, while the intrathoracic trachea measures to cm in length From 16 to 22 horseshoe-shaped bands of hyaline cartilage support the anterior and lateral tracheal walls The incomplete posterior portion of these rings is bridged by a thin band of smooth muscle and fibrous tissue, the posterior tracheal membrane (Fig 22.1) 1761 1762 1763 FIG 22.1 The normal trachea A: HRCT through the normal trachea The tracheal wall (arrow) is outlined by mediastinal fat externally and usually is visible as a 1- to 2-mm soft tissue stripe The posterior tracheal membrane usually appears thinner than the anterior and lateral tracheal walls and is variable in shape due to its lack of cartilage At this level, it is partially obscured by the esophagus B: At the level of the aortic arch, the tracheal wall (arrows) is outlined by mediastinal fat and the right lung in the region of the right paratracheal stripe The tracheal wall appears thin C: Diagrammatic representation of the normal components of the tracheal wall The plain film appearance of the trachea is described in Chapter On CT, the trachea usually is round or oval in shape, but it can appear horseshoe shaped, triangular, or like an inverted pear in some normal patients The tracheal wall is delineated by air in its lumen internally and by mediastinal fat externally and is usually visible as a 1- to 2-mm soft tissue stripe The posterior tracheal membrane appears thinner than the anterior and lateral tracheal walls and is variable in shape due to its lack of cartilage; it can appear convex, concave, or flat The tracheal cartilages may appear calcified or slightly denser than adjacent soft tissue Calcification of cartilage is most common in older patients and is particularly common in women (Fig 22.2) In patients with calcified cartilage, little soft tissue is seen in the tracheal wall internal to the cartilage 1764 FIG 22.2 Normal calcification of tracheal cartilage in an elderly woman Discontinuous calcification of the tracheal wall reflects calcification of individual cartilage rings The tracheal wall appears thin Tracheal diameter varies widely in normal subjects In normal men, tracheal diameter averages 19.5 mm, with a range of 13 to 25 mm (mean ± SD) in the coronal plane and 13 to 27 mm in the sagittal plane In women, tracheal diameter is slightly smaller, averaging 17.5 mm and ranging from 10 to 21 mm in the coronal plane and 10 to 23 mm in the sagittal plane On CT performed during or after forced expiration, the posterior tracheal membrane bulges anteriorly, narrowing and, in some cases, nearly obliterating the tracheal lumen (Fig 22.3) The mean anterior-posterior diameter of the trachea decreases by 30% to 40% during 1765 forced expiration due to anterior bulging of the posterior membrane; the transverse diameter decreases by 10% to 20% The cross-sectional area of the trachea may diminish by more than 50% in normal subjects with forced expiration 1766 1767 FIG 22.3 Normal expiratory CT A: On inspiration, the trachea has a rounded appearance B: During a dynamic forced expiratory scan, there is marked anterior bowing of the posterior tracheal membrane (arrow) This appearance is normal Little side-to-side narrowing occurs 1768 Rib(s) destruction , in actinomycosis Rickettsial infections Right middle vs lower lobes vs upper lobes Right middle lobe atelectasis Right upper lobe atelectasis RNA viral infections coronaviruses hantaviruses human metapneumovirus influenza virus measles virus parainfluenza virus respiratory syncytial virus togaviruses Roseola (herpesvirus-6) Round pneumonia Rounded atelectasis Roundworm infections Rouvière’s classification Rubella Rubeola (measles) S Saber-sheath trachea Salicylates, lung abnormalities from Salivary gland–type tumors adenoid cystic carcinoma MEC Sarcoidosis bronchial and bronchiolar abnormalities in cardiac abnormalities in lung disease in Sarcoidosis (Continued) ground-glass opacity in nodules in reticular opacity in lymph node abnormalities mediastinal masses pleural disease in radiography of stages of Sarcoma Kaposi’s sarcoma pulmonary artery Sarcomatoid carcinomas Satellite nodule 2978 bronchopulmonary neoplasms causes focal (round) pneumonia pulmonary, sarcoidosis SCC Squamous cell carcinoma (SCC) Scedosporium, Schistosomiasis Schwannoma Scimitar syndrome Scintigraphy Radionuclide studies SCLC Small cell lung carcinoma (SCLC) Scleroderma Segmental atelectasis Semi-invasive aspergillosis Seminoma Sepsis, ARDS in Septic embolism, in Staphylococcus aureus Sequestration, bronchopulmonary Bronchopulmonary sequestration Serpentine asbestos Serratia pneumonia Severe acute respiratory syndrome (SARS) Shaggy heart sign, in asbestosis Shrinking Lung syndrome Shunts, cardiac classification of left-to-right aorta to right-sided shunts atrial septal defect partial anomalous pulmonary venous connection ventricular septal defect right-to-left Siderosis Signet-ring sign Silhouette sign frontal radiograph lateral radiograph left lower lobe pneumonia left upper lobe pneumonia right lower lobe pneumonia right middle lobe pneumonia right upper lobe pneumonia Silicoproteinosis Silicosis computed tomography in conglomerate masses in radiography in 2979 small lung nodules in Silicotic nodule Simple pulmonary eosinophilia (Loeffler’s syndrome) Single ventricle, magnetic resonance imaging in Situs abnormalities Situs inversus Sjögren’s syndrome Skin, anthrax of Small cell lung carcinoma (SCLC) cause of chest radiograph CT immunohistochemical analysis staging system Small lymphocytic lymphoma (SLL) Solitary pulmonary nodule (SPN) attenuation contrast enhancement contrast opacification fat ground-glass opacity low water or fluid biopsy methods clinical evaluation definition differential diagnosis amyloidosis arteriovenous malformation aspergillosis atelectasis bronchiectasis bronchogenic cysts bulla Caplan’s syndrome carcinoid tumors carcinoma Churg-Strauss’ syndrome congenital cystic adenomatoid malformation conglomerate masses cyst endometrioma granulomas hamartoma hematoma and laceration infarction intrapulmonary lymph nodes 2980 lipoid pneumonia lung abscess lymphoma lymphoproliferative disease metastatic neoplasm mucoid impaction mycetoma papillomatosis paragonimiasis pneumatoceles pneumonia pulmonary artery aneurysms pulmonary gangrene pulmonary vein varix rheumatoid nodules sarcoidosis septic embolism sequestration Wegener’s granulomatosis evaluation strategy growth and doubling time definition lung cancer in heartworm in histoplasmosis lung cancers morphologic characteristics air bronchograms and pseudocavitation air-crescent sign air-fluid level cavitation edge appearance feeding vessel sign location satellite nodules shape size multiple nodules and masses in nocardiosis in nontuberculous mycobacterial infections positron emission tomography in rheumatoid arthritis single-photon emission computed tomography in tuberculosis South American blastomycosis (paracoccidioidomycosis) Spiculation, solitary pulmonary nodule 2981 Split-pleura sign Squamous carcinoma in situ (SCIS) Squamous cell carcinoma (SCC) Squamous cell papilloma Squamous dysplasia (SD) Squamous papilloma (SP) Staging method, lung cancer TNM system, lung cancer staging Stannosis Staphylococcus agalactiae pneumonia Staphylococcus aureus pneumonia Staphylococcus faecalis pneumonia Staphylococcus pyogenes pneumonia Staphylococcus viridans pneumonia Steeple sign, in parainfluenza virus infections Stenosis specific heart valves CT image, coronary artery disease tracheal Stereotactic ablative radiotherapy (SABR) Streak artifacts Streptococcus pneumoniae pneumonia Streptococcus pyogenes Stress testing, in ischemic heart disease Stripes paratracheal paravertebral posterior junction line posterior tracheal band retrosternal Strongyloidiasis Subcarinal lymph node Subcarinal space, anatomy Subclavian artery(ies) anomalous aortic arch with aberrant left magnetic resonance imaging central venous catheter misolacement in Subclavian artery interface, left, anatomy Subclavian vein, central venous catheter placement in Subpleural edema, in pulmonary edema Subvalvular aortic stenosis Superior sulcus cancers Superior vena cava anatomy lung cancer persistent, central venous catheter in Superior vena cava interface 2982 Superior vena cava syndrome Supraaortic mediastinum, anatomy Supravalvular stenosis Surveillance imaging, Aorta aortic neoplasms aortitis thoracic aortic aneurysm Swyer-James syndrome (SJS) Systemic lupus erythematosus (SLE) drug-induced pericardial disease pleural and pericardial disease pulmonary disease pulmonary hemorrhage in Systemic sclerosis (scleroderma) Systemic vasculitis T T descriptor (primary), lung cancer staging chest wall invasion classification ipsilateral lung nodules mediastinal invasion tracheal and central bronchial lesions Taenia solium infections TAI Traumatic aortic injury (TAI) Takayasu’s arteritis Talc pleurodesis Talcosis Tapeworm infections TAVR Transcatheter aortic valve repair (TAVR) T-cell lymphoblastic lymphoma Telangiectasia Teratoma Terminal bronchiole Tetralogy of Fallot atrioventricular valve, atresia of cyanotic heart disease magnetic resonance imaging with right ventricular outflow tract transannular patch TEVAR Thoracic endovascular aortic repair (TEVAR) Thoracentesis, reexpansion pulmonary edema after Thoracic aorta Aorta Thoracic aortic aneurysm Thoracic endovascular aortic repair (TEVAR) periprocedural imaging 2983 Thoracic lymphoma AIDS-related primary effusion primary mediastinal NHL primary pulmonary NHL Thoracic splenosis Thoracolith Thymic sail sign Thymic wave sign Thymolipoma Thymoma Thymus anatomy Hodgkin’s disease lymphoid follicular hyperplasia Thyroid gland anatomy mediastinal masses TNM system, lung cancer staging classification groups M descriptor, metastases distant metastases pleural effusion and pleural nodules tumor nodules N descriptor, lymph node metastases CT assessment hilar lymph node mediastinoscopy positron emission tomography stage and resectability T descriptor (primary) chest wall invasion classification ipsilateral lung nodules mediastinal invasion tracheal and central bronchial lesions Tocolytic drugs, lung abnormalities from Togavirus infections Total anomalous pulmonary venous connection atrioventricular valve, atresia of congenital heart lesions cyanotic heart disease pulmonary edema Toxocariasis Toxoplasmosis 2984 Trachea adenoid cystic carcinoma of amyloidosis of diverticulum of enlargement of intubation of metastases to narrowing of specific diseases papillomatosis in relapsing polychondritis of saber-sheath stenosis of tracheobronchomegaly of tracheobronchopathia osteochondroplastica tuberculosis of tumors of weakness of (tracheomalacia) Wegener granulomatosis Tracheal bronchus Tracheal carcinoma Tracheal diverticulum Tracheal scleroma Tracheal stenosis Tracheobronchial lymph nodes Tracheobronchial papillomatosis Tracheobronchitis Tracheobronchomalacia (TBM) Tracheobronchomegaly Mounier-Kuhn syndrome Tracheobronchopathia osteochondroplastica Tracheomalacia Tracheostomy tubes Traction bronchiectasis in diffuse infiltrative lung disease in hypersensitivity pneumonitis in interstitial pneumonia in pulmonary fibrosis in sarcoidosis in scleroderma in systemic lupus erythematosus Traction, in asbestosis Transcatheter aortic valve repair (TAVR) Transcatheter aortic valve replacement Transesophageal echocardiography (TEE), thoracic aorta Transplant rejection, myocardial vasculitis Transposition of great arteries, magnetic resonance imaging in Transvenous pacemakers 2985 Traumatic aortic injury (TAI) Tree-in-bud pattern in bronchiectasis in bronchopneumonia centrilobular Tricuspid atresia cyanotic heart disease with Fontan Tricuspid regurgitation heart disease magnetic resonance imaging radiography Tricuspid stenosis etiology magnetic resonance imaging radiography Tricuspid valve atresia of in Ebstein’s malformation magnetic resonance imaging in regurgitation stenosis Tricyclic antidepressants, lung abnormalities from Tropical eosinophilia Truncus arteriosus Tube(s) aortic balloon pump central venous catheters ECMO endotracheal enteric LVADs pleural drainage pulmonary artery catheters tracheostomy transvenous pacemakers Tuberculoma Tuberculosis active AIDS and bronchitis in inactive mediastinal masses miliary postprimary (reactivation) primary 2986 primary progressive risk factors tracheal transmission of Tuberous sclerosis Tularemia Tumors vs clot computed tomography lung Lung cancer magnetic resonance imaging benign primary cardiac tumors malignant cardiac tumors secondary cardiac tumors techniques thrombus tracheal Typhoidal form of tularemia U Ulcerated plaque Ulcerative colitis Ulceroglandular form of tularemia Ultrasmall superparamagnetic iron oxide (USPIO) particles Ultrasonography, deep venous thrombosis Undifferentiated connective tissue disease Unilateral pulmonary edema Unilateral pulmonary vein atresia Union Internationale Contre le Cancer (UICC), lymph node numeric system Univentricular atrioventricular connection, magnetic resonance imaging in Upper extremity venous thrombosis Upward tipped apex, right ventricular enlargement Uremia, pleural effusion in Usual interstitial pneumonia computed tomography in histology of radiography in V Valley fever (coccidioidomycosis) Valvular aortic stenosis Valvular heart disease aortic regurgitation etiology inherited syndromes magnetic resonance imaging radiography aortic stenosis 2987 aortic valve orifice area classification magnetic resonance imaging radiography subvalvular aortic stenosis valvular aortic stenosis ascending aorta evaluation echocardiography goals of magnetic resonance imaging aortic stenosis identification valve gradient mitral regurgitation etiology of magnetic resonance imaging radiography mitral stenosis magnetic resonance imaging radiography pulmonary regurgitation pulmonary stenosis etiology magnetic resonance imaging radiography tricuspid regurgitation tricuspid stenosis etiology magnetic resonance imaging radiography Varicella-Zoster virus infections Vascular disorders Vascular pedicle Vascular system abnormalities, hilar pulmonary artery narrowing pulmonary vein hilar, computed tomography tumors enhancing masses hemangioma lymphangioma Vasculitis, pulmonary classification consolidation drug-induced focal 2988 large-vessel vasculitis lung nodules manifestations medium-sized vessel vasculitis patchy small-vessel vasculitis tracheobronchial involvement Veillonella infections Ventilation-perfusion scintigraphy interpretation and obstructive lung disease pulmonary anatomy and physiology technique Ventricles double-inlet double-outlet morphologic features Ventricular ablation, procedure Ventricular arrhythmias cardiac magnetic resonance causes of complications image interpretation implanted cardioverter-defibrillators ventricular ablation procedure Ventricular loop Ventricular septal defect (VSD) left-to-right, cardiac shunts pulmonary atresia with Viability, myocardial, magnetic resonance imaging Viral infections specific viruses bronchiolitis tracheobronchitis Visceral larval migrans Visceral pleural thickening Visceroatrial situs W Waldenström’s macroglobulinemia Wall-to-wall heart Water lily (camalote) sign Water, solitary pulmonary nodule Water-bottle appearance, in pericardial effusion Wegener’s granulomatosis in trachea Westermark’s sign Whooping cough 2989 Williams-Campbell syndrome Wuchereria bancrofti, X Xenon-133, ventilation-perfusion scintigraphy Y Yellow nail lymphedema syndrome Yersinia pestis infections Young’s syndrome Z Zygomycosis 2990 Mục lục Half Title Title Copyright Dedication Contributors Preface Contents SECTION ONE The Basics 10 13 Lobar Anatomy, Air-space Consolidation, the Silhouette Sign, and Atelectasis The Normal Mediastinum The Pulmonary Hila 15 143 240 SECTION TWO Neoplasms, Masses, and Focal Lung Abnormalities 329 Lung Cancer and Bronchopulmonary Neoplasms Metastatic Tumor Lymphoma and Lymphoproliferative Disease The Mediastinum: Mediastinal Masses Congenital Lung Abnormalities and Pulmonary Vascular Malformations Solitary and Multiple Nodules, Masses, Cavities, and Cysts SECTION THREE Diffuse and Multifocal Lung Diseases 10 Plain Film and Computed Tomographic Assessment of Diffuse Lung Disease 11 Pulmonary Edema, the Acute Respiratory Distress Syndrome, and Radiology in the Intensive Care Unit 12 Pulmonary Infections 13 The Idiopathic Interstitial Pneumonias 14 Collagen Vascular Diseases 15 Sarcoidosis 16 Allergic Lung Diseases: Hypersensitivity Pneumonitis and Eosinophilic Lung Disease 17 Iatrogenic Lung Diseases: Drug-induced Lung Disease and Radiation Pneumonitis 18 Pneumoconioses 19 Pulmonary Vasculitis and Diffuse Alveolar Hemorrhage 20 Diffuse Lung Disease Associated with Lipid: Exogenous Lipid Pneumonia and Alveolar Proteinosis 21 Diffuse Lung Diseases Associated with Calcification SECTION FOUR Airway Abnormalities 331 495 549 637 847 952 1064 1066 1156 1249 1389 1464 1517 1554 1596 1635 1676 1714 1733 1759 22 The Trachea 23 Airway Disease: Bronchiectasis, Chronic Bronchitis, and Bronchiolitis 1761 1846 SECTION FIVE Copd, Emphysema, and Cystic Lung Diseases 1939 2991 24 Chronic Obstructive Pulmonary Disease and Emphysema 25 Diffuse Cystic Lung Diseases SECTION SIX Pleural Abnormalities 26 The Pleura and Pleural Disease 1941 1980 2026 2028 SECTION SEVEN Great Arteries 2149 27 Pulmonary Thromboembolic Disease 28 Pulmonary Hypertension 29 CT and MRI of the Thoracic Aorta 2151 2210 2249 SECTION EIGHT Radiography of Heart Disease 30 Radiography of Acquired Heart Disease 31 Radiography of Congenital Heart Disease SECTION NINE Acquired Non-ischemic Heart Disease 32 Valvular Heart Disease 33 Myocardial Diseases 34 Pericardial Diseases 35 Cardiac and Paracardiac Masses 2288 2290 2354 2433 2435 2475 2539 2609 SECTION TEN Congenital Heart Disease 36 Magnetic Resonance Imaging of Congenital Heart Disease SECTION ELEVEN Ischemic Heart Disease 37 Magnetic Resonance Imaging of Ischemic Heart Disease 38 Computed Tomography of Coronary Arteries and Ischemic Heart Disease SECTION TWELVE Cardiac Arrhythmias 39 Atrial and Ventricular Arrhythmias 2678 2680 2757 2759 2785 2862 2864 Index 2904 2992 ... older patients and is particularly common in women (Fig 22 .2) In patients with calcified cartilage, little soft tissue is seen in the tracheal wall internal to the cartilage 1764 FIG 22 .2 Normal calcification... involved (see Figs 4.37 and 4.38 in Chapter 4) Adenoid cystic carcinoma originates from tracheal mucous glands and is most common in the upper trachea (Figs 22 .4 and 22 .5) It is less common than... thickening of the mucosa and submucosa is absent or mild, and deformity of the tracheal cartilage or posterior tracheal membrane accounts for narrowing of the lumen (Figs 22 . 12 and 22 .13) The area of