PURPOSE: To describe plain radiographic and thin-section CT findings of hematogenous candida pneumonia in major burn patients. MATERIAL AND METHOD: We reviewed nine cases of hematogenous candida pneumonia in major burn patients who had positive blood culture for candida and findings of pneumonia on plain chest radiograph. On five of nine cases, thin-section CT was done. We evaluated retrospectively nine cases for onset, the pattern, distribution, and size of lesions on plain chest radiograph and thin-section CT. RESULTS: On plain chest radiograph, randomly distributed 2-10mm nodules were seen in six cases(66%) and randomly distributed 10-15mm consolidations in remaining three cases{33% ). Lesion occured in 11th to 75th post-burn day{average, 34th post-burn day). Other findings were cardiomegaly in three cases, atelectasis in three cases, and pulmonary edema in one case. Thin-section CT showed variable shaped subpleural nodules in all five cases. The size of nodules were 1-5mm in two cases(40%) and 5-10mm(60% ) in three cases. Feeding vessel signs were seen in two cases. Other findings were atelectasis in three cases, cardiomegaly in three cases, ground-glass opacity and interlobular septal thickenings by pulmonary edema in two cases. CONCLUSION: Plain chest radiographic findings of hematogenous candida pneumonia in major burn patients are randomly distributed nodules or consolidations of variable size. Thin-section CT findings are variable shaped subpleural nodules less than 1 cm.
Burns* ; Candida* ; Cardiomegaly ; Humans ; Pneumonia* ; Pulmonary Atelectasis ; Pulmonary Edema ; Radiography, Thoracic* ; Retrospective Studies ; Thorax*

PURPOSE: To describe radiologic findings of burn-associated persistent candidemia of the thorax. MATERIALS AND METHODS: This study included 42 patients with major burns in whom blood culture had shown the presence for more than 24 hours of persistent candidemia. The duration of positive culture for candidiasis ranged from two to 67 days(mean, 15 days). Radiographic(n=42) and thin-section CT findings(n=13) were retrospectively analyzed. The onset, pattern, size, distribution and persistence of parenchymal abnormalities as well as the presence or absence of pleural effusions, mediastinal lymphadenopathy and cardiomegaly were assessed. RESULTS: On chest radiographs, positive findings were noticed in 61.9%(26/42) and on thin-section CT, in 76.9%(10/13). The most frequent radiographic finding was pulmonary nodule(s), observed in 14 patients(33.3%). in 13, these were bilateral. Bronchovascular bundle thickening(n=6, 14.3%), consolidation(n=4, 9.5%), cardiomegaly(n=6, 14.3%) and pleural effusion(n=4, 9.5%) were also observed. Those lesions appeared eight to 129 days(mean, 33days) after the burn. Radiographic abnormalities persisted for seven to 115 (mean, 35) days, regardless of the treatment. Thin-section CT showed parenchymal abnormalities in 10/13 patients(76.9%) and subpleural nodules of less than 1cm in diameter and without halo in all patients. Cardiomegaly, pleural effusion and mediastinal adenopathy were observed on CT in 5(38.5%), 4(30.8%) and 2(15.4%) of the 13 patients, respectively. CONCLUSION: In a high proportion of patients with burn-associated candidemia, chest radiograph and thin-section CT findings were positive. The most frequent radiographic parenchymal abnormality was multiple bilateral nodules.
Burns* ; Candidemia* ; Candidiasis ; Cardiomegaly ; Humans ; Lymphatic Diseases ; Pleural Effusion ; Radiography, Thoracic ; Retrospective Studies ; Thorax*

Cardiomegaly is a commonly encountered clinical presentation on simple chest radiographs, and it usually indicates the enlargement of one or more cardiac chambers. However, cardiomegaly less commonly comes from abnormalities in the structures adjacent to the heart, including pericardial effusion, enlarged great vessels, or mediastinal tumors. Pericardial lipoma is a rare primary cardiac tumor that can grow to a large size by the time of diagnosis and result in huge cardiomegaly because of a lack of symptoms. Here, we report a rare case of giant pericardial lipoma that presented as huge cardiomegaly on simple chest radiographs. Multi-modality cardiovascular imaging, including echocardiography and cardiac magnetic resonance imaging, played a key role in the diagnosis and development of a therapeutic treatment plan for the present case.
Cardiomegaly* ; Diagnosis ; Echocardiography ; Heart ; Heart Neoplasms ; Lipoma* ; Magnetic Resonance Imaging ; Pericardial Effusion ; Pericardium ; Radiography, Thoracic

Scrub typhus (Tsutsugamushi disease)is an acute febrile systemic illness caused by Rickettsia tsutsugamushi that is transmitted to humans by the bite of larval-stage trombiculid mites (chiggers). The authors analyzed chest radiographic findings of scrub typhus in 160 patients in Ulsan area. One hundred and eight (67.5%) of160 patients showed abnormal findings which included lung lesions in 108 patients (67.5%), cardiomegaly in 37 patients (23.1%), lymphadenopathy in 25 patients (15.6%) and pleural effusion in 11 patients (6.9%). Among the lung lesions, interstitial patterns were seen in 107 patients (66.9%), mostly fine or medium reticulonodular, and air-space patterns in 14 patients(8.8%) and combined interstitial and air-space patterns in 13 patients (8.1%). Sixty-four patients(40%) had combined chest radiographic findings. The typical chest radiographic findings of scrub typhus would be helpful in evaluation of the causes of acute febrile illness that occur during late fall in the endemic area.
Cardiomegaly ; Humans ; Lung ; Lymphatic Diseases ; Orientia tsutsugamushi ; Pleural Effusion ; Radiography, Thoracic* ; Scrub Typhus* ; Thorax* ; Trombiculidae ; Ulsan*

We experienced a case of transient right-sided heart failure after angioplasty of membranous obstruction of the inferior vena cava confirmed by sonography and an inferior vena cavogram. Angioplasty involved the use of a self-expandable metallic stent, but after successful recanalization of the obstruction , the patient became dyspneic. Chest radiography revealed mild cardiomegaly with pulmonary congestion, but this was resolved spontaneously. For the prevention of serious heart failure, we recommend preprocedural evaluation of cardiac function.
Angioplasty* ; Cardiomegaly ; Estrogens, Conjugated (USP) ; Heart Failure* ; Humans ; Radiography ; Stents ; Thorax ; Vena Cava, Inferior*

PURPOSE: To determine computed tomography (CT) criteria for cardiomegaly. MATERIALS AND METHODS: We analyzed posteroanterior chest radiographs and CT scans of 200 patients (M:F=130:70, mean age 49 years old) that were performed on the same day. On plain radiographs, the cardiothoracic ratio (R) was calculated using a standard method. On CT, we measured the maximal cardiac width (D(c)) and the maximal thoracic width of a patient (D(t1)). A second thoracic width was measured at the same scan level of D(c). Thus, two cardiothoracic ratios were derived in one patient-D(c)/D(t1) (R(1)) and D(c)/D(t2) (R(2)). We analyzed the appropriateness of R(1) and R(2) in the diagnosis of cardiomegaly to establish criteria for the use of the cardiothoracic ratio (ROC curve). RESULTS: When cardiomegaly was defined as a value of R that was greater than 0.5, both R(1) and R(2) were useful indicators of cardiomegaly. For a cut-off value of 0.5 for the cardiothoracic ratio for cardiomegaly, the sensitivity of R(1) and R(2) was 84% and 68%, respectively, and the specificity of R(1) and R(2) was 72% and 86%, respectively. CONCLUSION: The cardiothoracic ratio on CT can be easily obtained by measurement of the maximal cardiac width divided by the maximal thoracic width at the same scan level. When the cardiothoracic ratio on CT is over 0.5, the presence of cardiomegaly can be suggested.
Cardiomegaly* ; Diagnosis ; Heart ; Humans ; Radiography, Thoracic ; Sensitivity and Specificity ; Tomography, X-Ray Computed

A thymic cyst in the middle mediastinum adjacent to the right pericardium is extremely rare. We report a case of a large thymic cyst in the right cardiophrenic angle, compressing the right atrium, which was presented as a cardiomegaly on the chest radiograph and a pericardial cyst on the echocardiography. The definitive diagnosis was confirmed using surgical resection and biopsy.
Biopsy ; Cardiomegaly ; Diagnosis ; Echocardiography ; Heart Atria ; Magnetic Resonance Imaging ; Mediastinal Cyst* ; Mediastinum* ; Pericardium ; Radiography, Thoracic

OBJECTIVE: We observed patients in whom the fluid collection in the right lateral portion of the superior aortic recess on computed tomography (CT) scans mimicked a right anterior mediastinal mass on chest PA radiographs. The purpose of this study was to assess chest PA and CT features of these patients. MATERIALS AND METHODS: All chest PA radiographs and CT scans in 9 patients were reviewed by two radiologists on a consensus basis; for the presence of pleural effusion, pulmonary edema and heart size on chest PA radiographs. For the portion of the fluid collection in the superior aortic recess (SAR), a connection between the right lateral portion of the SAR (rSAR) and posterior portion of the SAR (pSAR) on CT scans, and the distance between the right lateral margin of the rSAR and the right lateral margin of the superior vena cava. RESULTS: Fluid collection in the rSAR on CT scans caused a right anterior mediastinal mass or a bulging contour on chest PA radiographs in all women patients. All patients showed cardiomegaly, five patients had pleural effusion, and two patients had mild pulmonary edema. Further, eight patients showed a connection between the rSAR and the pSAR. CONCLUSION: The characteristic features of these patients are the right anterior mediastinal mass-like opacity due to fluid collection in the rSAR, are bulging contour with a smooth margin and cardiomegaly regardless of pulmonary edema on the chest PA radiographs, and fluid connection between the rSAR and the pSAR on CT scans.
Aged ; Aged, 80 and over ; Aorta, Thoracic/*radiography ; Cardiomegaly/radiography ; Contrast Media/diagnostic use ; Diagnosis, Differential ; Female ; Humans ; Mediastinal Diseases/*radiography ; Middle Aged ; Pleural Effusion/*radiography ; Pulmonary Edema/*radiography ; Radiography, Thoracic/*methods ; Retrospective Studies ; Tomography, X-Ray Computed/*methods

PURPOSE: Recent trials of preventive dexamethasone therapy in preterm neonates at high risk of developing bronchopulmonary dysplasia(BPD) have required the objective criteria for prediction of BPD in the early neonatal period. The purpose of this study is to determine whether a chest radiographic scoring system at 7 days of age can be used to predict BPD. MATERIALS AND METHODS: Chest radiographs taken at 7 days and 28 days of age in 59 preterm neonates(gestational age of less than 33 weeks) were scored prospectively according to the consensus of two radiologists. The 7-day radiographs were scored according to a system derived from Yuksel's method : endotracheal tube insertion, degree of lung inflation, lung opacification, interstitial changes and cardiomegaly were measured. The radiographs taken at 28 days were scored according to a modification of Toce's method. The BPD group was defined as consisting of patients who needed oxygen therapy for more than 28 days and showed abnormality on chest radiographs. Scores were analysed to determine whether there were any statistical differences between the BPD and non-BPD groups, whether there was a significant correlation between scores at 7 days and 28 days, and whether there was any relationship between scores at 7 days of age and the development of BPD. We tried to determine which factors, as indicated by the scores at 7 days, significantly contributed to the development of BPD. RESULTS: The mean scores at 7 days of age in the BPD group (n=18) were 4.3+/-1.5 (2-7), and those in the non-BPD group (n=41) were 2.2+/-1.2 (0-4). The differences were statistically significant(p<.0001). Significant correlation was found between scores at 7 days and at 28 days of age (r:0.57, p<.0001). Analysis showed that endotracheal tube insertion, cardiomegaly, and degree of interstitial change, as seen on radiographs at 7 days, were factors which significantly contributed to the development of BPD(p<0.05 each). All neonates with a score of 5 or more developedBPD(7/7), while those with a score of less than 2 did not (0/11). CONCLUSION: The chest radiographic scoring system used at 7 days of age can be helpful in predicting the development of BPD. We believe that this system can be used to indicate the need for early preventive steroid therapy.
Bronchopulmonary Dysplasia* ; Cardiomegaly ; Consensus ; Dexamethasone ; Humans ; Infant, Newborn ; Inflation, Economic ; Lung ; Oxygen ; Prospective Studies ; Radiography, Thoracic* ; Thorax*

PURPOSE: Recent trials of preventive dexamethasone therapy in preterm neonates at high risk of developing bronchopulmonary dysplasia(BPD) have required the objective criteria for prediction of BPD in the early neonatal period. The purpose of this study is to determine whether a chest radiographic scoring system at 7 days of age can be used to predict BPD. MATERIALS AND METHODS: Chest radiographs taken at 7 days and 28 days of age in 59 preterm neonates(gestational age of less than 33 weeks) were scored prospectively according to the consensus of two radiologists. The 7-day radiographs were scored according to a system derived from Yuksel's method : endotracheal tube insertion, degree of lung inflation, lung opacification, interstitial changes and cardiomegaly were measured. The radiographs taken at 28 days were scored according to a modification of Toce's method. The BPD group was defined as consisting of patients who needed oxygen therapy for more than 28 days and showed abnormality on chest radiographs. Scores were analysed to determine whether there were any statistical differences between the BPD and non-BPD groups, whether there was a significant correlation between scores at 7 days and 28 days, and whether there was any relationship between scores at 7 days of age and the development of BPD. We tried to determine which factors, as indicated by the scores at 7 days, significantly contributed to the development of BPD. RESULTS: The mean scores at 7 days of age in the BPD group (n=18) were 4.3+/-1.5 (2-7), and those in the non-BPD group (n=41) were 2.2+/-1.2 (0-4). The differences were statistically significant(p<.0001). Significant correlation was found between scores at 7 days and at 28 days of age (r:0.57, p<.0001). Analysis showed that endotracheal tube insertion, cardiomegaly, and degree of interstitial change, as seen on radiographs at 7 days, were factors which significantly contributed to the development of BPD(p<0.05 each). All neonates with a score of 5 or more developedBPD(7/7), while those with a score of less than 2 did not (0/11). CONCLUSION: The chest radiographic scoring system used at 7 days of age can be helpful in predicting the development of BPD. We believe that this system can be used to indicate the need for early preventive steroid therapy.
Bronchopulmonary Dysplasia* ; Cardiomegaly ; Consensus ; Dexamethasone ; Humans ; Infant, Newborn ; Inflation, Economic ; Lung ; Oxygen ; Prospective Studies ; Radiography, Thoracic* ; Thorax*