PURPOSE: To describe HRCT findings in five patients with pathologically proved acute interstitial pneumonia MATERIALS AND METHODS: This study included 5 patients with pathological and clinical diagnosis of acute interstitial pneumonia. Mean age of the patients was 40(range, 31-53 years). CT scans were reviewed by two chest radiologists retrospectively. CT scans were assessed for the presence and distribution of ground-glass attenuation, air-space consolidation, interlobular septal thickening, honeycombing, and pleural effusion. RESULTS: The area of ground-glass attenuation and air-space consolidation were seen at HRCT in all 5 patients. These lesions were distributed diffusely in both lungs, but involved predominantly subpleural lungs in 2 patients and posterior lungs in 3 patients. Three patients had mild interlobular septal thickening. None of them showed honeycombing. Three of the 5 patients died within 52 days of initial manifestation. CONCLUSION: Acute interstitial pneumonia differs from the more chronic form of idiopathic interstitial pneumonia in their HRCT findings.
Diagnosis ; Humans ; Idiopathic Interstitial Pneumonias ; Lung ; Lung Diseases, Interstitial* ; Pleural Effusion ; Retrospective Studies ; Thorax ; Tomography, X-Ray Computed

PURPOSE: To date, the high spatial frequency algorithm (HSFA) which reduces image smoothing and increases spatial resolution has been used for the evaluation of parenchymal lung diseases in thin-section high-resolution CT. In this study, we compared the ultrahigh spatial frequency algorithm (UHSFA) with the high spatial frequency algorithm in the assessment of thin section images of the lung parenchyma. METHODS AND MATERIALS: Three radiologists compared the UHSFA and HSFA on identical CT images in a line-pair resolution phantom, one lung specimen, 2 patients with normal lung and 18 patients with abnormal lung parenchyma. RESULTS: Scanning of a line-pair resolution phantom demonstrated no difference in resolution between two techniques but it showed that outer lines of the line pairs with maximal resolution looked thicker on UHSFA than those on HSFA. Lung parenchymal detail with UHSFA was judged equal or superior to HSFA in 95% of images. Lung parenchymal sharpness was improved with UHSFA in all images. Although UHSFA resulted in an increase in visible noise, observers did not found that image noise interfered with image interpretation. The visual CT attenuation of normal lung parenchyma is minimally increased in images with HSFA. The overall visual preference of the images reconstructed on UHSFA was considered equal to or greater than that of those reconstructed on HSFA in 78% of images. CONCLUSION: The ultrahigh spatial frequency algorithm improved the overall visual quality of the images in pulmonary parenchymal high-resolution CT.
Humans ; Lung Diseases ; Lung* ; Noise

PURPOSE: To evaluate the findings and the role of CT in plexiform neuro-fibromatosis of the mediastinum. MATERIALS AND METHODS: We retropectively reviewed the CT scans of five patients with plexiform neurofibromatosis of the mediastinum. The CT scans were reviewed with attention to the distribution of the lesions, appearance and attenuation of mediastinal lesions, enhancement pattern after intravenous contrast infusion and associated findingssuch as intercostal neurofibroma. RESULTS: In all five patients CT scans demonstrated fusiform low attenuated masses which were oriented longitudinally and extended over multiple contiguous scans along the distribution of major mediastinal nerves. In four patients, mediastinal lesions appeared infiltrative, obliterating adjacent mediastinal fat plane. One patient had well defined fusiform masses along the major mediastinal nerves. Postcontrast enhanced CT scans revealed slight central enhancement in two patient and no contrast enhancement in three patients. Associated findings such as neurofibromas of intercostal nerves and sympathetic trunk, or subcutaneous neurofibromas were detected on CTscans in all five patients. CONCLUSION: Characteristic CT findings of low attenuation masses along the major mediastinal nerves are helpful to differentiate plexiform neurofibromatosis from mediastinal lymphadenopathy and to prevent from misreading as a malignant disease.
Humans ; Intercostal Nerves ; Lymphatic Diseases ; Mediastinum* ; Neurofibroma ; Neurofibromatoses* ; Tomography, X-Ray Computed

PURPOSE: The purpose of this study was to evaluate the high-resolution CT features of Swyer-James syndrome with special attention to the airway lesions and to determine the clinical utility of high-resolution CT compared with that of chest radiography. MATERIALS AND METHODS: In seven patients with Swyer-James syndrome, we retrospectively reviewed chest radiographs obtained during inspiration and expiration and high-resolution CT scans obtained in inspiration. The high-resolution CT appearance was evaluated and compared with that of chest radiography. RESULTS: On both chest radiographs and high-resolution CT, the affected lung volume was relatively diminished in four patients and normal in three patients. In all seven patients, chest readiographs showed hyperlucency of the lung which was unilateral in four and bilateral in three patients. Unilateral small hilum was seen in six patients and bronchiectasis was demonstrated in one patient on chest radiographs. The hyperlucent lung volume was not diminished on expiratory radiographs in all seven patients. In all patients, high-resolution CT demonstrated low attenuation regions of the lung either bilaterally(n=5) or unilaterally(n=2). Pulmonary vessels were markedly decreased in size and number in the lung parenchyma with low attenuation. Six patients had bronchiectasis on high-resolution CT, which were cylindrical or varicose in five and cystic in one. Bronchiolectasis was observed in three patients on high-resolution CT. CONCLUSION: The high-resolution CT findings are characteristic of Swyer-James syndrome. High-resolution CT is more sensitive than chest radiography in detecting regions of low attenuation and bronchiectasis and may be useful for the diagnosis of Swyer-James syndrome. Our results suggest that bronchiectasis is a frequently associated airway lesion of Swyer-James syndrome and bronchiolectasis may be associated in some cases.
Bronchiectasis ; Diagnosis ; Humans ; Lung ; Lung, Hyperlucent* ; Radiography ; Radiography, Thoracic ; Retrospective Studies ; Thorax ; Tomography, X-Ray Computed

PURPOSE: Endobronchial tuberculosis and bronchogenic cancer are common causes of atelectasis or obstructive pneumonitis in Korea. Differntiation between endobronchial tuberculosis and bronchogenic carcinoma is important for the treatment and prognosis but it is sometimes difficult to differentiate these two lesions with radiologic examinations. The purpose of this study was to find the differential points between endobronchial tuberculosis and bronchogenic carcinoma associated with atelectasis or obstructive pneumonitis. MATERIALS AND METHODS: Forty patients in whom atelectasis or obstructive pneumonitis was detected on chest radiographs comprised the study. A definite mass opacity was not observed on chest radiographs in all patients. In these patients, the causes of obstruction were endobronchial tuberculosis (n=20) and bronchogenic cancer (n=20) which were microbiologically or pathologically confirmed. RESULTS: Double obstructive lesions were more frequently found in endobronchial tuberculosis (8/20) than in bronchogenic cancer (1/20). Multiple calcifications along the bronchial wall and severe distortion of bronchi were observed only in endobronchial tuberculosis (4/20) and associated low density mass at obstruction site was only observed in bronchogenic cancer (6/20). Bronchial dilatation (11/20) and parenchymal calcifications (14/20) distal to obstruction site, air containing bronchogram at post obstructive bronchus (14/20) were more frequently found in endobronchial tuberculosis. Contour bulging at obstruction site (14/20), and only mucus bronchogram at post obstructive bronchus (14/20) were more frequently found in bronchogenic carcinoma. CONCLUSION: In patients with atelectasis or obstructive pneumonitis, endobronchial tuberculosis is characterized by double obstructive lesion, multiple calcifications at the bronchial wall, and severe distortion of the bronchi. Endobronchial carcinoma is characterized by a low density mass at the obstructive site.
Bronchi ; Carcinoma, Bronchogenic* ; Dilatation ; Humans ; Korea ; Mucus ; Pneumonia* ; Prognosis ; Pulmonary Atelectasis* ; Radiography, Thoracic ; Tuberculosis*

PURPOSE: To evaluate the clinical significance of the screening mammography in the detection of the breast diseases, especially breast carcinoma. MATERIALS AND METHODS: We analyzed 1,800 cases of mammography retrospectively. The mammography was done as a part of routine check in Health Counselling Center, Korea University Medical Center, during 9 months from November 1993 to July 1994. The age range was from 23 years to 76 years, mean 49.8 years, and the largest age group was 6th decade(31.4%). According to the mammographic findings, we divided the subjects into three groups; normal group, abnormal group in need of follow up study, abnormal group requiring biopsy. RESULT: On mammography, the normal group consisted of 1,534 cases(85%), and the abnormal group consisted of 266 cases(15%). The abnormal findings were benign-looking calcification(n=140), fibroadeno ma (n=29), fibrocystic changes (n=27), cyst(n=23), malignant lesion(n=15), lipoma(n=7), and others. In four of 15 cases, which were suspected to be malignant on mammograms, breast carcinoma was confirmed pathologically. In four cases of breast carcinoma, one was under 40 and the other 3 were over 50 years of age. All of the breast cancers were under 3cm in size, and the mammographic findings of breast cancer included spiculated margin(n=3), parenchymal disortion(n=3), malignant calcification(n=2) and enlarged axillary node (n=l). CONCLUSION: Screening mammogram is helpful for early detection of non-palpable breast cancer, especially for women over 50 years of age.
Academic Medical Centers ; Biopsy ; Breast Diseases* ; Breast Neoplasms ; Breast* ; Female ; Follow-Up Studies ; Humans ; Korea ; Mammography* ; Mass Screening* ; Retrospective Studies

Idiopathic interstitial pneumonias (IIP), a heterogeneous group of diffuse parenchymal lung diseases, include seven clinicopathologic entities: idiopathic pulmonary fibrosis (IPF), nonspecific interstitial pneumonia (NSIP), cryptogenic organizing pneumonia (COP), acute interstitial pneumonia (AIP), respiratory bronchiolitis (RB)-associated interstitial lung disease (ILD), desquamative interstitial pneumonia (DIP), and lymphoid interstitial pneumonia (LIP). Each of these entities has a typical histologic pattern that correlates well with imaging features. Thus, imaging plays an essential role in classifying and differentiating this group of diseases. The characteristic HRCT findings of IPF are reticular opacity with honeycombing and traction bronchiectasis in a predominantly basal and peripheral distribution. NSIP manifests as basal ground-glass opacity and reticular opacity. Honeycombing is rare. COP is characterized by patchy peripheral or peribronchovascular consolidation. AIP appears as extensive, mixed ground-glass opacity and consolidation. RB-ILD and DIP are smoking-related diseases associated with CT features of poorly defined centrilobular nodules and ground-glass opacity. LIP is a rare disease characterized by ground-glass opacity sometimes associated with perivascular cysts. Although some of idiopathic interstitial pneumonias may show diagnostic CT features, the final diagnosis of IIPs is usually made by means of evaluation of all the combined clinical, radiologic, and pathologic findings.
Bronchiectasis ; Bronchiolitis ; Cryptogenic Organizing Pneumonia ; Idiopathic Interstitial Pneumonias ; Idiopathic Pulmonary Fibrosis ; Lip ; Lung Diseases, Interstitial ; Rare Diseases ; Traction

PURPOSE: To present CT findings of benign mass-like nodular lesions associated with chronic tuberculousempyema. MATERIALS AND METHODS: We retrospectively reviewed the CT scans of nine patients with mass-like lesions associated with chronic tuberculous empyema, which were pathologically (operation=4, US-guided biopsy=3) or clinically (n=2) confirmed as benign lesions. Shape, number, size, presence of calcification and enhancement pattern of mass-like lesions were assessed. RESULTS: In all patients, chest CT showed unilateral calcified pleural thickening, with mass-like nodular lesions. Fluid within the pleural cavity was observed in eight patients. CT findings of mass-like lesions were multiple and nodular (n=9). Calcification was demonstrated within the lesions in four patients. In each case, the size of the largest nodules was 1-3cm in diameter. In contrast, CTshowed mild (n=6) to moderate (n=2) enhancement compared with adjacent muscles. The pathologic results ofmass-like lesions were chronic inflammation (n=3) and necrosis (n=4). CONCLUSION: Benign mass-like lesions associated with chronic tuberculous empyema appeared as multiple nodules varying in size from 1 to 3cm in diamter, with slight enhancement.
Empyema, Tuberculous* ; Humans ; Inflammation ; Muscles ; Necrosis ; Pleural Cavity ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary

Metastatic pulmonary calcification refers to calcium deposition in the normal pulmonary parenchyma and this deposition is secondary to abnormal calcium metabolism. The most common radiologic manifestation consists of poorly-defined nodular opacities that are mainly seen in the upper lung zone. We present here a case of metastatic pulmonary calcification that manifested as atypical, dense, calcium deposition in airspaces within the previously existing consolidation in the bilateral lower lobes, and this process was accelerated by pneumonia-complicated sepsis in a patient with hypercalcemia that was due to hyperparathyroidism.
Calcinosis/*radiography ; Female ; Humans ; Hypercalcemia/etiology ; Hyperparathyroidism/complications/surgery ; Lung Diseases/*radiography ; Middle Aged ; Parathyroidectomy ; Pneumonia/complications ; Shock, Septic/microbiology ; Tomography, X-Ray Computed/methods

PURPOSE: To determine whether preoperative CT is helpful in predicting the development of recurrent tumor following surgical resection in patients with esophageal cancer. MATERIALS AND METHODS: Thirty patients with esophageal cancer in whom preoperative CT of the chest had been performed were included in the study. All had undergone esophagectomy, esophagogastrostomy and lymph node dissection at our institution between 1995 and 1997. They were divided into two groups according to the development of tumor recurrence during the follow-up period of three years. Sixteen patients (group I) suffered tumor recurrence, while the other 14 (group II) remained tumor-free after surgery. In each group, a review of the preoperative CT scans indicated the length, thickness, location and margin of the tumor, and the presence or absence of lymphadenopathy in the mediastinum and/or upper abdomen. Differences in preoperative CT findings between the two groups were assessed by statistical testing. RESULTS: Lymphadenopathy of the mediastinum and/or upper abdomen was seen in 11 (69%) of 16 patients in group I and three (21%) of 14 in group II (p<.05). The tumor margin was indistinct in seven patients (44%) in group I and in one (7%) in group II (p<.05). The average length and thickness of esophageal tumors were 5.2 and 1.4 cm, respectively, in group I, and 3.5 and 1.5 cm, respectively, in group II (p>.05). In group I, five esophageal tumors were located in the middle esophagus and eleven in the lower esophagus. In group II, such tumor was located one in the upper esophagus, six in the middle esophagus, and seven in the lower esophagus (p>.05). CONCLUSION: Patients with preoperative CT findings of lymphadenopathy and/or an indistinct primary tumor margin are more likely to develop tumor recurrence following surgical resection than those without these findings.
Abdomen ; Esophageal Neoplasms ; Esophagectomy ; Esophagus ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymphatic Diseases ; Mediastinum ; Recurrence* ; Thorax ; Tomography, X-Ray Computed