We presented a rare case of a 64-year-old man with a combined anomaly of the bronchus and pulmonary artery that was detected incidentally. Computed tomography showed a hyperlucent, aerated sequestered segment of the right lower lung with an independent ectopic bronchus, which had no connection to the other airway. The affected segment was supplied by its own aberrant pulmonary artery branch from the right pulmonary trunk. This anomaly cannot be classified with any of the previously reported anomalies.
Bronchi/pathology ; Bronchopulmonary Sequestration/*radiography ; Humans ; Lung/*radiography ; Male ; Middle Aged ; Pulmonary Artery/*radiography ; Tomography, X-Ray Computed

OBJECTIVE: We wanted to prospectively evaluate the interobserver agreement between radiology residents and expert radiologists for interpreting CT images for making the diagnosis of pulmonary embolism (PE). MATERIALS AND METHODS: We assessed 112 consecutive patients, from April 2007 to August 2007, who were referred for combined CT pulmonary angiography and indirect CT venography for clinically suspected acute PE. CT scanning was performed with a 64x0.5 collimation multi-detector CT scanner. The CT studies were initially interpreted by the radiology residents alone and then the CT images were subsequently interpreted by a consensus of the resident plus an experienced general radiologist and an experienced chest radiologist. RESULTS: Two of the 112 CTs were unable to be interpreted (1.7%). Pulmonary artery clots were seen on 36 of the thoracic CT angiographies (32%). The interobserver agreement between the radiology residents and the consensus interpretation was good (a kappa index of 0.73). All of the disagreements (15 cases) were instances of overcall by the resident on the initial interpretation. Deep venous thrombosis was detected in 72% (26 of 36) of the patients who had PE seen on thoracic CT. The initial and consensus interpretations of the CT venography images disagreed for two cases (kappa statistic: 0.96). CONCLUSION: It does not seem adequate to base the final long-term treatment of PE on only the resident's reading, as false positives occurred in 13% of such cases. Timely interpretation of the CT pulmonary angiography and CT venography images should be performed by experienced radiologists for the patients with suspected PE.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Observer Variation ; *Phlebography ; Pulmonary Artery/*radiography ; Pulmonary Embolism/*radiography ; *Tomography, X-Ray Computed ; Venous Thrombosis/*radiography ; Young Adult

Aneurysms of the pulmonary artery are rare, with mycotic aneurysms occurring most frequently. This latter type may also occur in association with a lung abscess or septicemia, particularly in drug addicts. As far as we are aware, the radiologic findings of mycotic aneurysm of the pulmonary artery have not been reported in Korea. We present the simple chest radiographs, as well as the CT and angiographic findings ,of a case of aneurysm of the pulmonary artery which was successfully embolized using a coil.
Aneurysm* ; Aneurysm, Infected ; Drug Users ; Humans ; Korea ; Lung Abscess ; Pulmonary Artery* ; Radiography, Thoracic ; Sepsis

Unilateral absence of a pulmonary artery (UAPA) is a rare congenital anomaly that is frequently associated with other cardiovascular anomalies first reported by Fraentzel in 1968. Most patients who have no associated cardiac anomalies have only minor or absent symptoms. We experienced a case of isolated UAPA in a young female presenting hemoptysis. The chest radiograph showed a small left lung volume and high resolutional CT of chest showed multiple subpleural nodules and centrilobular nodules in parenchyma. The video-assisted thoracoscopic biopsy revealed diffuse dilated vessels in visceral pleura. The pulmonary angiogram confirmed the absence of the left main pulmonary artery.
Biopsy ; Female ; Hemoptysis* ; Humans ; Lung ; Pleura ; Pulmonary Artery* ; Radiography, Thoracic ; Thorax

The chest radiographs and angiograms were retrospectively evaluated in 47 patients with pulmonary atresia (PA) and ventricular septal defect (VSD) to determine the characteristic findings of major aortopulmonary collateral arteries (MAPCSs) on the chest radiographs. Of 47 patients, 23 had MAPCAs and 24 had only PDA for blood supply of whole right and left lung. Chest radiographs enabled identification of 16 of 23 patients with MAPCAs. The most common finding of MAPCAs was inappropriately large peripheral pulmonary vasculature (n=16, 69.6%). The other findings were tortuosity of pulmonary vasculature (n=12, 52.2%), focal unevendistribution of pulmonary vasculature (n=12, 52.2%), and two descending pulmonary arteries (n=4, 17.4%). When chest radiographs showed two or more findings of MAPCAs, MAPCAs could be differentiated from PDA with statistical significance (p<0.005). It is concluded that chest radiographs may help to identify MAPCAs before angiography if two-dimensional echo ardiography suggests PA with VSD.
Angiography ; Arteries* ; Heart Septal Defects, Ventricular* ; Humans ; Lung ; Pulmonary Artery ; Pulmonary Atresia* ; Radiography, Thoracic ; Retrospective Studies ; Thorax*

Optical coherence tomography (OCT) is a new imaging technique capable of obtaining high-resolution intravascular images and has been used in interventional cardiology. However, an application of OCT in pulmonary arteries had seldom been documented. In this case, OCT imaging is performed in peripheral pulmonary arteries and shows mural red thrombi. Subsequently, the red thrombi are aspirated and confirmed by a histological examination. These findings suggest that OCT may be a useful tool to depict peripheral pulmonary artery thrombi.
Adult ; Angiography ; Humans ; Male ; Pulmonary Artery/*pathology/radiography ; Pulmonary Embolism/*diagnosis ; Tomography, Optical Coherence/*methods ; Tomography, X-Ray Computed

We report a case of a 29-year-old female with a history of asthma, post-partumARDS, and pulmonary hypertension who presents with severe shortness of breath. The patient describes her shortness of breath as progressive over the past 10 years. Chest radiography and CT angiography of the thorax showed findings consistent with fibrosing mediastinitis with severe stenosis of the left main pulmonary artery. This resulted in appearance of unilateral absent left lung perfusion on quantitative Tc-99-MAA perfusion and Xe-133 ventilation (V/Q) scan.
Adult ; Angiography ; Asthma ; Constriction, Pathologic ; Dyspnea ; Female ; Histoplasma ; Humans ; Hypertension, Pulmonary ; Lung ; Mediastinitis ; Perfusion ; Pulmonary Artery ; Radiography ; Thorax ; Ventilation

Unilateral absence of a pulmonary artery is an uncommon anomaly, which presents as an isolated lesion or in combination with other congenital heart disease such as TOF or PD^. We encountered three cases of isolated unilateral absence of a pulmonary artery;one was left pulmonary artery agenesis with right sided aortic arch and the others were right pulmonary artery agenesis with left sided aortic arch. Plain chest radiograph showed considerable loss of unilateal lung volume and lack of ipsilateral hilar shadow. Pulmonary angiogram which was done in two cases, revealed proximal interruption of a pulmonary artery. Chest CT was done in only one case, on which right pulmonary artery was absent and was replaced by adipose tissue. CT with its clean demonstration pulmonary artery without any evidence of aquired obstruction of a pulmonary artery by pulmonary embolism or tumor invasion, maybe a valuable method for evaluaton of the unilateral absence of a pulmonary artery.
Adipose Tissue ; Aorta, Thoracic ; Heart Defects, Congenital ; Lung ; Pulmonary Artery* ; Pulmonary Embolism ; Radiography, Thoracic ; Tomography, X-Ray Computed

This study assessed main pulmonary artery diameter of patients with anthracofibrosis. Patients with anthracofibrosis and CT scans were evaluated after exclusion of patients with co-existing disease. We measured the diameter of the main pulmonary artery (PAD) and ascending aorta (AD) and calculated the pulmonary artery to aorta ratio (APR). The upper reference limit for comparison of PAD was 29 mm. Cut-off values for PAD and APR indicating pulmonary hypertension were 33 mm and 1. We correlated the CT parameters with echocardiographic results. Total 51 patients were included in the analysis. The mean PAD, AD, and APR were 33 mm, 38 mm, and 0.87 respectively. The PAD was larger than the upper reference limit, 29 mm (P<0.001). The PAD was >33 mm in 30 (65%) and the APR was >1 in 9 patients (18%). Of 21 patients with echocardiography, 11 (52%) were found to have pulmonary hypertension. There was no statistical difference in the diagnosis of pulmonary hypertension between echocardiography and CT (P=1.000). In conclusion, main pulmonary artery is dilated in patients with anthracofibrosis more than in the healthy population.
Aged ; Aged, 80 and over ; Aorta, Thoracic/*radiography ; Bronchi/pathology ; Bronchoscopy ; Dilatation ; Female ; Fibrosis ; Humans ; Hypertension, Pulmonary/*diagnosis/ultrasonography ; Male ; Pulmonary Artery/*radiography ; Tomography, X-Ray Computed

OBJECTIVE: To assess perfusion patterns on a dual-energy pulmonary CT angiography (DECTA) of pulmonary hypertension (PHT) with variable causes and to assess whether the extent of perfusion defect can be used in the severity assessment of PHT. MATERIALS AND METHODS: Between March 2007 and February 2011, DECTA scans of 62 consecutive patients (24 men, 38 women; mean age, 58.5 +/- 17.3 [standard deviation] years; range, 19-87 years) with PHT were retrospectively included with following inclusion criteria; 1) absence of acute pulmonary thromboembolism, 2) maximal velocity of tricuspid regurgitation jet (TR Vmax) above 3 m/s on echocardiography performed within one week of the DECTA study. Perfusion patterns of iodine map were divided into normal (NL), diffuse heterogeneously decreased (DH), multifocal geographic and multiple peripheral wedging patterns. The extent of perfusion defects (PD), the diameter of main pulmonary artery (MPA) and the ratio of ascending aorta diameter/MPA (aortopulmonary ratio, APR) were measured. Pearson correlation analysis was performed between TR Vmax on echocardiography and CT imaging parameters. RESULTS: Common perfusion patterns of primary PHT were DH (n = 15) and NL (n = 12). The perfusion patterns of secondary PHT were variable. On the correlation analysis, in primary PHT, TR Vmax significantly correlated with PD, MPA and APR (r = 0.52, r = 0.40, r = -0.50, respectively, all p < 0.05). In secondary PHT, TR Vmax significantly correlated with PD and MPA (r = 0.38, r = 0.53, respectively, all p < 0.05). CONCLUSION: Different perfusion patterns are observed on DECTA of PHT according to the causes. PD and MPA are significantly correlated with the TR Vmax.
Adult ; Aged ; Aged, 80 and over ; Aorta/physiopathology ; Aortography ; Female ; Humans ; Hypertension, Pulmonary/physiopathology/*radiography ; Male ; Middle Aged ; Pulmonary Artery/physiopathology/*radiography ; Pulmonary Circulation/physiology ; Retrospective Studies ; Tomography, X-Ray Computed/*methods ; Tricuspid Valve Insufficiency/physiopathology/radiography ; Young Adult