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Abstract
Now in its 3rd Edition, this outstanding volume by Dr. Jo-Anne O. Shepard in the popular Requisites series thoroughly covers the fast-changing field of chest imaging. Ideal for residency, clinical practice, and board certification, it covers the full range of basic and advanced modalities used in thoracic imaging including digital radiography, chest fluoroscopy, CT, PET, and MRI. Compact and authoritative, Thoracic Imaging: The Requisites provides the up-to-date conceptual, factual, and interpretive information you need for success on exams and in clinical practice.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Half title page | i | ||
| The Requisites Series | ii | ||
| Thoracic Imaging The Requisites | iii | ||
| Copyright Page | iv | ||
| Dedication | v | ||
| Foreword | vi | ||
| Preface | vii | ||
| Contributors | viii | ||
| Table Of Contents | xi | ||
| Acknowledgments | xii | ||
| 1 Radiologic Techniques and Dose Reduction Strategies in Chest Imaging | 1 | ||
| Introduction | 1 | ||
| Conventional, Computed, and Digital Radiography | 1 | ||
| Chest Radiography: Projections and Views | 1 | ||
| Digital Subtraction Techniques in Chest Radiography | 3 | ||
| Chest Fluoroscopy | 4 | ||
| Digital Tomosynthesis in the Chest | 5 | ||
| Computed Tomography | 5 | ||
| Applications of Computed Tomography of the Chest | 6 | ||
| Dual-Energy Computed Tomography of the Chest | 7 | ||
| Dual-Energy Computed Tomography Techniques | 7 | ||
| Dual-Energy Computed Tomography Image Processing | 8 | ||
| Radiation Doses With Dual-Energy Computed Tomography | 9 | ||
| Clinical Applications of Dual-Energy Computed Tomography | 10 | ||
| Computed Tomography Protocols and Radiation Dose | 11 | ||
| Scan Parameters | 12 | ||
| Tube Current | 12 | ||
| Tube Potential | 12 | ||
| Gantry Rotation Time | 12 | ||
| Detector Configuration or Beam Collimation | 13 | ||
| Pitch | 13 | ||
| Scan Length | 13 | ||
| Number of Phases | 13 | ||
| Indication-Specific Chest Computed Tomography Protocols | 13 | ||
| Routine Chest Protocol | 14 | ||
| Pulmonary Embolism Protocol | 14 | ||
| Lung Nodule Follow-up Computed Tomography | 14 | ||
| Low-Dose Computed Tomography for Lung Cancer Screening | 14 | ||
| Tracheal or Airway Protocol Computed Tomography | 15 | ||
| High-Resolution Computed Tomography for Diffuse Lung Diseases | 16 | ||
| Contrast Usage in Chest Computed Tomography: Guidelines | 17 | ||
| Conclusions | 18 | ||
| Suggested Readings | 18 | ||
| 2 Normal Anatomy and Atelectasis | 19 | ||
| Normal Anatomy | 19 | ||
| Trachea and Main Bronchi | 19 | ||
| Lobar Bronchi and Bronchopulmonary Segments | 19 | ||
| Right Side | 19 | ||
| Left Side | 22 | ||
| Variants | 22 | ||
| Pulmonary Vessels | 23 | ||
| Pericardial Recesses | 23 | ||
| Fissures | 25 | ||
| The Diaphragm | 25 | ||
| Normal Mediastinal Contours: The Frontal Projection | 27 | ||
| Normal Mediastinal Contours: The Lateral Projection | 36 | ||
| The Hila: The Frontal Projection | 41 | ||
| The Hila: The Lateral Projection | 42 | ||
| Atelectasis | 47 | ||
| Mechanisms of Atelectasis | 47 | ||
| Patterns of Atelectasis | 47 | ||
| Rounded Atelectasis | 47 | ||
| Total Collapse of the Lung | 47 | ||
| Lobar Collapse | 49 | ||
| Right Upper Lobe Atelectasis | 49 | ||
| Left Upper Lobe Atelectasis | 49 | ||
| Right Middle Lobe Atelectasis | 51 | ||
| Lower Lobe Atelectasis | 51 | ||
| Combined Right Upper and Right Middle Lobe Atelectasis | 52 | ||
| Combined Right Middle and Right Lower Lobe Atelectasis | 52 | ||
| Subsegmental Atelectasis | 52 | ||
| Suggested Readings | 60 | ||
| 3 Thoracic Magnetic Resonance Imaging | 61 | ||
| Introduction | 61 | ||
| Uses of Thoracic Magnetic Resonance Imaging | 61 | ||
| Problem Solving | 61 | ||
| Full Chest Imaging and Screening | 61 | ||
| Strengths of Magnetic Resonance Imaging Over Computed Tomography | 62 | ||
| No Ionizing Radiation | 62 | ||
| Better Soft Tissue Contrast | 62 | ||
| Impact on Clinical Decision Making | 63 | ||
| Value | 63 | ||
| Tissue Characterization and Magnetic Resonance Imaging Interpretation | 63 | ||
| Cyst Versus Solid | 64 | ||
| Blood Products | 68 | ||
| Calcification | 68 | ||
| Macroscopic Fat | 68 | ||
| Microscopic Fat | 68 | ||
| Chemical Shift Ratio Region-of-Interest Placement and Calculation | 69 | ||
| Signal Intensity Index Region-of-Interest Placement and Calculation | 72 | ||
| Lymph Nodes, Acute Inflammatory Lesions, and Most Thoracic Neoplasms | 73 | ||
| Fibrous Tissue | 73 | ||
| Cartilage | 74 | ||
| Smooth Muscle | 74 | ||
| Lesion Vascularity | 76 | ||
| Restricted Diffusion | 76 | ||
| Concept of Matching Lesions | 76 | ||
| Lesion Measurement | 76 | ||
| Detection of Pulmonary Nodules | 76 | ||
| THORACIC Magnetic Resonance Protocoling and Performance | 82 | ||
| Goals | 82 | ||
| Successful Breath-Hold Imaging | 82 | ||
| Free-Breathing Techniques | 84 | ||
| The Magnetic Resonance Sniff Test | 84 | ||
| Cardiac Gating | 84 | ||
| Slice Thickness Selection | 84 | ||
| Basic Thoracic Magnetic Resonance Protocol | 84 | ||
| Rationale for Each Pulse Sequence in the Protocol | 84 | ||
| T1-Weighted Imaging | 84 | ||
| T2-Weighted Imaging | 85 | ||
| Dynamic Contrast-Enhanced Imaging | 85 | ||
| Optional Pulse Sequences | 85 | ||
| Suggested Readings | 86 | ||
| 4 PET-CT and PET-MRI | 88 | ||
| Introduction | 88 | ||
| Technique | 88 | ||
| PET-CT | 88 | ||
| PET-MR | 89 | ||
| Advantages | 89 | ||
| Pitfalls | 92 | ||
| Suggested Readings | 96 | ||
| 5 The Mediastinum | 97 | ||
| Introduction | 97 | ||
| Mediastinal Landmarks | 97 | ||
| Mediastinal Compartments and Their Associated Lesions | 97 | ||
| The Prevascular Compartment or Anterior Mediastinum | 97 | ||
| The Visceral Compartment or Middle Mediastinum | 97 | ||
| The Paravertebral Compartment or Posterior Mediastinum | 98 | ||
| Multicompartment Lesions | 98 | ||
| Imaging Workup | 99 | ||
| Chest Radiography | 99 | ||
| Fluoroscopy | 99 | ||
| Computed Tomography | 99 | ||
| Magnetic Resonance Imaging | 100 | ||
| Positron Emission Tomography | 101 | ||
| Mediastinal Masses | 103 | ||
| Prevascular and Anterior Mediastinal Masses | 103 | ||
| Thymic Lesions | 103 | ||
| Normal Thymus. | 103 | ||
| Thymic Hyperplasia. | 104 | ||
| Thymic Cysts. | 106 | ||
| Thymolipoma. | 107 | ||
| Thymic Epithelial Tumors. | 107 | ||
| Thymic Neuroendocrine Tumors. | 110 | ||
| Thyroid Lesions | 110 | ||
| Mediastinal Lymphoma | 111 | ||
| Mediastinal Germ Cell Tumors | 114 | ||
| Pericardiophrenic Masses | 114 | ||
| Pericardial Fat Pads. | 114 | ||
| Pericardial Cysts. | 115 | ||
| Pericardiophrenic Lymphadenopathy. | 115 | ||
| Visceral and Middle Mediastinal Masses and Common Vascular Lesions | 115 | ||
| Lymphadenopathy | 115 | ||
| Congenital-Developmental Cysts | 117 | ||
| Tracheal Lesions | 117 | ||
| Esophageal Lesions | 117 | ||
| Achalasia. | 117 | ||
| Esophagitis. | 117 | ||
| Esophageal Injury. | 118 | ||
| Esophageal Diverticula. | 120 | ||
| Esophageal Varices. | 121 | ||
| Hiatal Hernia. | 121 | ||
| Esophageal Neoplasms. | 122 | ||
| Selected Vascular Lesions | 124 | ||
| Aortic Aneurysm. | 124 | ||
| Traumatic Aortic Pseudoaneurysm. | 125 | ||
| Aortic Dissection. | 125 | ||
| Aberrant Subclavian Artery. | 126 | ||
| Azygous Continuation of the Inferior Vena Cava. | 126 | ||
| Paravertebral and Posterior Mediastinal Masses | 126 | ||
| Neurogenic Tumors | 126 | ||
| Peripheral Nerve Sheath Tumors. | 126 | ||
| Sympathetic Ganglion Tumors. | 128 | ||
| Paragangliomas. | 128 | ||
| Other Paravertebral and Vertebral Lesions | 128 | ||
| Neuroenteric Cysts. | 128 | ||
| Meningoceles. | 128 | ||
| Extramedullary Hematopoiesis. | 129 | ||
| Traumatic Lesions. | 129 | ||
| Diffuse Mediastinal Processes | 131 | ||
| Mediastinal Lipomatosis | 131 | ||
| Acute Mediastinitis | 131 | ||
| Fibrosing Mediastinitis | 132 | ||
| Pneumomediastinum | 136 | ||
| Suggested Readings | 136 | ||
| 6 The Airways | 137 | ||
| Keywords | 137.e1 | ||
| Normal Anatomy | 137 | ||
| Trachea | 137 | ||
| Bronchi | 137 | ||
| Imaging of the Airways | 137 | ||
| General | 137 | ||
| Radiography | 137 | ||
| Multidetector Computed Tomography | 138 | ||
| Magnetic Resonance Imaging | 138 | ||
| FDG PET/CT | 138 | ||
| Abnormalities of the Trachea | 138 | ||
| Tracheal Diverticula | 138 | ||
| Tracheal Stenosis | 138 | ||
| Idiopathic Laryngotracheal Stenosis | 139 | ||
| Postintubation Injury | 139 | ||
| Posttraumatic Tracheal and Bronchial Stenosis | 140 | ||
| Saber-Sheath Trachea | 140 | ||
| Tracheopathia Osteochondroplastica | 140 | ||
| Relapsing Polychondritis | 140 | ||
| Granulomatosis With Polyangiitis | 141 | ||
| Amyloidosis | 142 | ||
| Sarcoidosis | 143 | ||
| Infection | 143 | ||
| Rhinosclerosis. | 143 | ||
| Tuberculosis. | 143 | ||
| Tracheobronchomegaly (Mounier-Kuhn Syndrome) | 144 | ||
| Tracheal Neoplasms | 144 | ||
| Malignant Neoplasms | 144 | ||
| Squamous Cell Carcinoma. | 144 | ||
| Adenoid Cystic Carcinoma. | 144 | ||
| Benign Neoplasms | 145 | ||
| Squamous Cell Papilloma and Tracheobronchial Papillomatosis. | 145 | ||
| Tracheobronchomalacia | 146 | ||
| Abnormalities of the Bronchi | 147 | ||
| Bronchial Neoplasms | 147 | ||
| Carcinoid Tumors | 147 | ||
| Mucoepidermoid Carcinoma | 147 | ||
| Hamartoma | 147 | ||
| Lipoma | 147 | ||
| Other Endobronchial Lesions | 148 | ||
| Broncholithiasis | 148 | ||
| Foreign Bodies | 149 | ||
| Airway Fistulas | 151 | ||
| Esophagorespiratory Fistulas | 151 | ||
| Other Fistulas | 151 | ||
| Bronchiectasis | 152 | ||
| Mucoid Impaction | 154 | ||
| Cystic Fibrosis | 154 | ||
| Allergic Bronchopulmonary Aspergillosis | 155 | ||
| Primary Ciliary Dyskinesia | 155 | ||
| Other Etiologies | 155 | ||
| Bronchiolitis | 155 | ||
| Overview of Imaging Findings | 156 | ||
| Infectious Bronchiolitis | 156 | ||
| Respiratory Bronchiolitis and Respiratory Bronchiolitis–Associated Interstitial Lung Disease | 156 | ||
| Follicular Bronchiolitis | 157 | ||
| Diffuse Panbronchiolitis | 157 | ||
| Constrictive Bronchiolitis | 157 | ||
| Conclusions | 157 | ||
| Suggested Reading | 157 | ||
| 7 The Pleura, Diaphragm, and Chest Wall | 159 | ||
| Pleura | 159 | ||
| Anatomy and Physiology | 159 | ||
| Pleural Effusions | 159 | ||
| Specific Types of Pleural Effusions and Their Imaging Features | 159 | ||
| Freely Layering Pleural Effusion | 159 | ||
| Subpulmonic Pleural Effusion | 160 | ||
| Loculated Pleural Effusion | 161 | ||
| Hydropneumothorax | 162 | ||
| Empyema | 162 | ||
| Hemothorax | 165 | ||
| Chylothorax | 165 | ||
| Pneumothorax | 165 | ||
| Tension Pneumothorax | 167 | ||
| Pneumothorax Ex Vacuo | 167 | ||
| Pneumonectomy Space | 167 | ||
| Asbestos-Related Pleural Disease (see Chapter 19) | 167 | ||
| Non–Asbestos-Related Pleural Thickening | 168 | ||
| Fibrothorax | 168 | ||
| Thoracolithiasis | 168 | ||
| Benign Pleural Tumors | 168 | ||
| Solitary Fibrous Tumor of the Pleura (Benign and Malignant) | 168 | ||
| Pleural Lipoma | 172 | ||
| Malignant Pleural Disease | 172 | ||
| Pleural Metastases | 172 | ||
| Mesothelioma | 173 | ||
| Pleural Lymphoma | 175 | ||
| Diaphragm | 176 | ||
| Anatomy and Function | 176 | ||
| Diaphragmatic Eventration | 176 | ||
| Diaphragmatic Weakness and Paralysis | 176 | ||
| Diaphragmatic Hernias | 179 | ||
| Hiatal Hernia | 179 | ||
| Bochdalek Hernia | 179 | ||
| Morgagni Hernia | 179 | ||
| Traumatic Diaphragmatic Injury | 179 | ||
| Chest Wall | 179 | ||
| Congenital and Developmental Anomalies | 179 | ||
| Pectus Excavatum | 179 | ||
| Pectus Carinatum | 180 | ||
| Poland Syndrome | 180 | ||
| Neurofibromatosis Type 1–Related Changes | 180 | ||
| Metabolic Conditions | 180 | ||
| Renal Osteodystrophy | 180 | ||
| Sickle Cell Disease | 181 | ||
| Paget Disease | 181 | ||
| Inflammatory Conditions | 181 | ||
| Ankylosing Spondylitis | 181 | ||
| SAPHO Syndrome | 182 | ||
| Infectious Diseases | 182 | ||
| Chest Wall Infections | 182 | ||
| Diskitis-Osteomyelitis | 183 | ||
| Benign Tumors and Tumor-like Conditions | 183 | ||
| Lipoma | 183 | ||
| Neurogenic Tumors | 187 | ||
| Hemangioma | 187 | ||
| Enchondroma | 188 | ||
| Osteochondroma | 188 | ||
| Elastofibroma Dorsi | 189 | ||
| Fibrous Dysplasia | 189 | ||
| Malignant Tumors | 189 | ||
| Chest Wall Metastasis | 189 | ||
| Multiple Myeloma | 189 | ||
| Chondrosarcoma | 189 | ||
| Iatrogenic and Postsurgical Conditions | 189 | ||
| Suggested Readings | 192 | ||
| 8 Congenital Thoracic Malformations | 193 | ||
| Introduction | 193 | ||
| Trachea | 193 | ||
| Tracheomalacia | 193 | ||
| Congenital Tracheal Stenosis | 193 | ||
| Congenital Tracheobronchomegaly | 194 | ||
| Tracheoesophageal Fistula | 194 | ||
| Tracheal Bronchus | 194 | ||
| Bronchi | 196 | ||
| Accessory Cardiac Bronchus | 196 | ||
| Bronchial Isomerism | 196 | ||
| Bronchial Atresia | 196 | ||
| Congenital Bronchiectasis | 197 | ||
| Lungs | 197 | ||
| Pulmonary Underdevelopment | 197 | ||
| Congenital Lobar Overinflation | 197 | ||
| Congenital Pulmonary Airway Malformation | 199 | ||
| Pulmonary Sequestration | 199 | ||
| Intralobar Sequestration | 200 | ||
| Extralobar Sequestration | 200 | ||
| Mediastinum | 200 | ||
| Foregut Duplication Cysts | 200 | ||
| Bronchogenic Cysts | 200 | ||
| Esophageal Duplication Cysts | 201 | ||
| Neurenteric Cysts | 201 | ||
| Thymic Cysts | 202 | ||
| Pulmonary Vessels | 202 | ||
| Anomalies of the Pulmonary Arteries | 202 | ||
| Proximal Interruption | 202 | ||
| Anomalous Origin of the Left Pulmonary Artery From the Right | 204 | ||
| Pulmonary Artery Stenosis or Coarctation | 204 | ||
| Congenital Aneurysms of the Pulmonary Arteries | 204 | ||
| Anomalies of the Pulmonary Veins | 204 | ||
| Pulmonary Vein Stenosis and Unilateral Pulmonary Vein Atresia | 204 | ||
| Pulmonary Varix | 205 | ||
| Meandering Pulmonary Vein | 205 | ||
| Anomalous Pulmonary Venous Drainage | 205 | ||
| Anomalies Involving Arteries and Veins | 206 | ||
| Congenital Hypogenetic Lung Syndrome | 206 | ||
| Systemic Arterial Supply to Normal Lung | 206 | ||
| Pulmonary Arteriovenous Malformation | 207 | ||
| Congenital Anomalies of the Lymphatics | 208 | ||
| Lymphangiectasis | 208 | ||
| Lymphangioma | 208 | ||
| Lymphangiomatosis | 208 | ||
| Suggested Readings | 209 | ||
| 9 Thoracic Lines and Tubes | 210 | ||
| Introduction | 210 | ||
| Airway Tubes | 210 | ||
| Endotracheal Tube | 210 | ||
| Tracheostomy Tube | 212 | ||
| Vascular Lines | 212 | ||
| Central Venous Catheters | 212 | ||
| Pulmonary Artery Catheter | 215 | ||
| Pleural and Enteric Tubes | 216 | ||
| Chest Tubes | 216 | ||
| Nasogastric and Orogastric Tube and Feeding Tube | 217 | ||
| Respiratory and Hemodynamic Support Devices | 219 | ||
| Intraaortic Balloon Pump | 219 | ||
| Extracorporeal Membrane Oxygenation | 221 | ||
| Venovenous ECMO | 221 | ||
| Venoarterial Extracorporeal Membrane Oxygenation | 221 | ||
| Extracorporeal Membrane Oxygenation Complications | 222 | ||
| Ventricular Assist Devices | 222 | ||
| Cardiac Conduction Devices | 223 | ||
| Cardiac Pacemakers | 223 | ||
| Implantable Cardioverter Defibrillator | 225 | ||
| Suggested Readings | 225 | ||
| 10 Acute Thoracic Conditions in the Intensive Care Unit | 226 | ||
| Introduction | 226 | ||
| Pulmonary Disease | 226 | ||
| Atelectasis | 226 | ||
| Aspiration | 226 | ||
| Pneumonia | 226 | ||
| Pulmonary Embolism | 227 | ||
| Pulmonary Edema | 229 | ||
| Acute Exacerbation of Interstitial Lung Disease | 233 | ||
| Pulmonary Hemorrhage | 233 | ||
| Abnormal Air Collections | 234 | ||
| Subcutaneous Air | 234 | ||
| Pneumothorax | 234 | ||
| Pulmonary Interstitial Emphysema | 234 | ||
| Pneumomediastinum | 235 | ||
| Pneumopericardium | 236 | ||
| Pneumoperitoneum | 236 | ||
| Fluid Collections | 237 | ||
| Pleural Effusions | 237 | ||
| Pericardial Effusion | 237 | ||
| Infusothorax | 237 | ||
| Hemothorax, Empyema, and Chylothorax | 237 | ||
| Suggested Readings | 237 | ||
| 11 Pulmonary Embolus and Pulmonary Vascular Diseases | 238 | ||
| Abstract | 238.e1 | ||
| Keywords | 238.e1 | ||
| Pulmonary Embolus | 238 | ||
| Imaging of Pulmonary Embolus | 238 | ||
| Chest Radiography | 238 | ||
| Ventilation/Perfusion Scintigraphy | 239 | ||
| Evaluation of the Leg Veins | 239 | ||
| Computed Tomography | 240 | ||
| Angiography | 245 | ||
| Magnetic Resonance Angiography | 247 | ||
| Nonthrombotic Pulmonary Embolus | 248 | ||
| Septic Embolus | 248 | ||
| Fat Embolus | 248 | ||
| Air Embolus | 248 | ||
| Amniotic Fluid Embolus | 248 | ||
| Tumor Embolus | 248 | ||
| Foreign Body Embolus | 248 | ||
| Pulmonary Hypertension | 248 | ||
| Imaging of Pulmonary Hypertension | 249 | ||
| Chest Radiography | 249 | ||
| Ventilation/Perfusion Scintigraphy | 249 | ||
| Computed Tomography | 249 | ||
| Magnetic Resonance Imaging | 251 | ||
| Pulmonary Vasculitis | 252 | ||
| Large-Vessel Vasculitis | 252 | ||
| Medium-Vessel Vasculitis | 253 | ||
| Small-Vessel Vasculitis | 253 | ||
| Antineutrophil Cytoplasm Antibody–Associated Vasculitis | 253 | ||
| Granulomatosis With Polyangiitis. | 253 | ||
| Eosinophilic Granulomatosis With Polyangiitis. | 254 | ||
| Microscopic Polyangiitis. | 255 | ||
| Immune Complex Small-Vessel Vasculitides | 255 | ||
| Antiglomerular Basement Membrane Disease. | 255 | ||
| Immunoglobulin A Vasculitis. | 255 | ||
| Hypocomplementemic Urticarial Vasculitis. | 255 | ||
| Cryoglobulinemic Vasculitis. | 255 | ||
| Variable Vessel Vasculitis | 255 | ||
| Other Causes of Vasculitis | 256 | ||
| Pulmonary Artery Pseudoaneurysm | 256 | ||
| Pulmonary Arteriovenous Malformation | 257 | ||
| Primary Pulmonary Artery Sarcoma | 257 | ||
| Suggested Readings | 258 | ||
| 12 The Postoperative Chest | 259 | ||
| Introduction | 259 | ||
| Lung Surgeries | 259 | ||
| Open and Minimally Invasive | 259 | ||
| Wedge Resection | 259 | ||
| Bullectomy and Blebectomy | 259 | ||
| Volume Reduction Surgery | 259 | ||
| Segmentectomy | 259 | ||
| Lobectomy | 260 | ||
| Pneumonectomy | 261 | ||
| Extrapleural Pneumonectomy | 262 | ||
| Complications | 263 | ||
| Air Leak | 263 | ||
| Bronchopleural Fistula | 263 | ||
| Lobar Torsion | 263 | ||
| Venous Infarct | 264 | ||
| Cardiac Herniation or Torsion | 265 | ||
| Diaphragmatic Dehiscence | 266 | ||
| Other Early Complications | 266 | ||
| Tumor Recurrence | 266 | ||
| Postpneumonectomy Syndrome | 267 | ||
| Lung Transplantation | 267 | ||
| Technique | 267 | ||
| Complications | 268 | ||
| Reperfusion Edema | 268 | ||
| Anastomotic Dehiscence | 268 | ||
| Anastomotic Stricture | 269 | ||
| Rejection | 269 | ||
| Posttransplantation Lymphoproliferative Disorder | 270 | ||
| Other Complications | 270 | ||
| Pleural Procedures | 270 | ||
| Pleurodesis | 270 | ||
| Decortication and Pleurectomy | 271 | ||
| Open Pleural Drainage | 271 | ||
| Mediastinal Surgeries | 271 | ||
| Esophagectomy | 271 | ||
| Mediastinal Tumor Resection | 272 | ||
| Complications | 273 | ||
| Anastomotic Leak | 273 | ||
| Esophagopleural Fistula | 273 | ||
| Anastomotic Stricture | 274 | ||
| Chylothorax | 274 | ||
| Nerve Injury | 274 | ||
| Mediastinal Hematoma | 274 | ||
| Sternal Dehiscence and Osteomyelitis | 275 | ||
| Chest Wall Surgeries | 275 | ||
| Types and Techniques | 275 | ||
| Retained Surgical Foreign Bodies | 275 | ||
| Suggested Readings | 278 | ||
| 13 Thoracic Trauma | 279 | ||
| Introduction | 279 | ||
| Pulmonary, Pleural, and Diaphragmatic Injuries | 279 | ||
| Lung Contusions and Lacerations | 279 | ||
| Tracheobronchial Injuries | 280 | ||
| Injuries of the Pleural Space | 280 | ||
| Pneumothorax | 280 | ||
| Hemothorax | 281 | ||
| Diaphragmatic Injuries | 282 | ||
| Mediastinal Injuries | 283 | ||
| Traumatic Aortic and Great Vessel Injuries | 283 | ||
| Esophageal Injuries | 285 | ||
| Cardiac and Pericardial Injuries | 285 | ||
| Thoracic Skeletal Injuries | 285 | ||
| Rib Fractures | 285 | ||
| Sternal and Clavicular Injuries | 286 | ||
| Thoracic Spine Injuries | 286 | ||
| Suggested Readings | 288 | ||
| 14 Community-Acquired Pneumonia | 289 | ||
| Introduction | 289 | ||
| Mechanisms and Patterns of Infection | 289 | ||
| Inhalational Pneumonia | 289 | ||
| Lobar Pneumonia | 289 | ||
| Bronchopneumonia | 290 | ||
| Interstitial Pneumonia | 291 | ||
| Aspiration Pneumonia | 293 | ||
| Hematogenous and Direct Spread of Infection | 293 | ||
| Patterns of Host Response to Infection | 294 | ||
| Complications | 296 | ||
| Cavitation and Abscess | 296 | ||
| Pneumatocele Formation | 296 | ||
| Lymphadenopathy | 297 | ||
| Pleural Complications | 297 | ||
| Other Complications | 298 | ||
| Clinical Approach to Pneumonia | 298 | ||
| Bacterial Pneumonia | 298 | ||
| Viral Pneumonia | 299 | ||
| Fungal Pneumonia | 300 | ||
| Parasitic Infection | 305 | ||
| Conclusion | 305 | ||
| Suggested Readings | 309 | ||
| 15 Pulmonary Disease in the Immunocompromised Patient | 310 | ||
| Introduction | 310 | ||
| Pulmonary Diseases | 310 | ||
| Pulmonary Infections | 310 | ||
| Bacterial Infection | 310 | ||
| Fungal Infection | 313 | ||
| Viral Infection | 314 | ||
| Malignant Neoplasms | 314 | ||
| Kaposi Sarcoma | 314 | ||
| Lymphoma | 314 | ||
| Lung Cancer | 316 | ||
| Lymphoproliferative Disorders | 316 | ||
| Other Pulmonary Disorders | 317 | ||
| Other Forms of Immunocompromise | 317 | ||
| Radiologic Patterns of Pulmonary Infections | 317 | ||
| Lobar or Segmental Consolidation | 317 | ||
| Nodules and Masses With Rapid Growth or Cavitation | 318 | ||
| Diffuse Lung Disease | 319 | ||
| Diagnostic and Therapeutic Approach | 321 | ||
| Suggested Readings | 322 | ||
| 16 Mycobacterial Infection | 323 | ||
| Introduction | 323 | ||
| Tuberculous Mycobacterial Infection | 323 | ||
| Primary Tuberculosis | 323 | ||
| Consolidation | 324 | ||
| Lymphadenopathy | 324 | ||
| Pleural Infection | 324 | ||
| Pericardial Effusion | 324 | ||
| Healed Tuberculosis | 324 | ||
| Extrapulmonic Thoracic Tuberculosis | 324 | ||
| Postprimary Tuberculosis | 328 | ||
| Miliary Tuberculosis | 329 | ||
| Nontuberculous Mycobacterial Infection | 333 | ||
| Cavitary Form (Classic) | 333 | ||
| Bronchiectatic Form (Nonclassic) | 333 | ||
| Conclusion | 333 | ||
| Suggested Readings | 334 | ||
| 17 Approach to Diffuse Lung Disease | 335 | ||
| Introduction | 335 | ||
| High-Resolution Computed Tomography Protocol | 335 | ||
| High-Resolution Computed Tomography Evaluation | 335 | ||
| Anatomy of the Secondary Pulmonary Lobule | 336 | ||
| Lung Interstitium | 339 | ||
| High-Resolution Computed Tomography Patterns | 339 | ||
| Nodular Pattern (Table 17.2) | 340 | ||
| Perilymphatic Nodules | 340 | ||
| Random Nodules | 340 | ||
| Centrilobular Nodules | 340 | ||
| Reticular Opacities (Table 17.3) | 341 | ||
| Interlobular Septal Thickening | 344 | ||
| Intralobular Lines | 344 | ||
| Honeycombing | 346 | ||
| Increased Attenuation (Table 17.4) | 346 | ||
| Ground-Glass Opacity | 346 | ||
| Consolidation | 348 | ||
| Decreased Attenuation (Table 17.5) | 348 | ||
| Emphysema | 348 | ||
| Cystic Disease | 351 | ||
| Mosaic Attenuation | 354 | ||
| Conclusion | 354 | ||
| Suggested Readings | 354 | ||
| 18 Diffuse Lung Diseases | 355 | ||
| Introduction | 355 | ||
| Idiopathic Interstitial Pneumonias | 355 | ||
| Chronic Fibrosing Interstitial Pneumonias | 355 | ||
| Idiopathic Pulmonary Fibrosis | 355 | ||
| Nonspecific Interstitial Pneumonia | 357 | ||
| Acute and Subacute Fibrosing Interstitial Pneumonia | 357 | ||
| Organizing Pneumonia | 357 | ||
| Acute Interstitial Pneumonia | 358 | ||
| Smoking-Related Interstitial Pneumonias | 359 | ||
| Respiratory Bronchiolitis–Interstitial Lung Disease | 359 | ||
| Desquamative Interstitial Pneumonia | 359 | ||
| Rare Entities | 360 | ||
| Lymphocytic Interstitial Pneumonitis | 360 | ||
| Idiopathic Pleuroparenchymal Fibroelastosis | 360 | ||
| Connective Tissue Diseases | 361 | ||
| Rheumatoid Arthritis | 361 | ||
| Systemic Lupus Erythematosus | 361 | ||
| Mixed Connective Tissue Disease | 361 | ||
| Scleroderma | 361 | ||
| Myositis | 362 | ||
| Sjögren Syndrome | 363 | ||
| Hypersensitivity Pneumonitis | 363 | ||
| Hypersensitivity Pneumonitis–Specific Diseases | 364 | ||
| Farmer’s Lung | 364 | ||
| Humidifier Lung | 364 | ||
| Pigeon Breeder’s Lung | 364 | ||
| Hot Tub Lung | 364 | ||
| Sarcoidosis | 365 | ||
| Cystic Lung Diseases | 366 | ||
| Lymphangioleiomyomatosis | 366 | ||
| Pulmonary Langerhans Cell Histiocytosis | 368 | ||
| Other Diffuse Cystic Lung Diseases | 369 | ||
| Eosinophilic Lung Disease | 370 | ||
| Characteristics | 370 | ||
| Loeffler Syndrome | 370 | ||
| Chronic Eosinophilic Pneumonia | 371 | ||
| Acute Eosinophilic Pneumonia | 371 | ||
| Idiopathic Hypereosinophilic Syndrome | 372 | ||
| Parasitic Infections | 372 | ||
| Drug-Induced Lung Disease | 372 | ||
| Patterns of Injury | 373 | ||
| Noncardiogenic Pulmonary Edema | 373 | ||
| Pulmonary Hemorrhage | 373 | ||
| Pulmonary Fibrosis | 373 | ||
| Eosinophilic Pneumonia | 373 | ||
| Exogenous Lipoid Pneumonia | 373 | ||
| Drug-Induced Lupus Syndrome | 373 | ||
| Obliterative Bronchiolitis | 373 | ||
| Illicit Drug Use | 373 | ||
| Specific Drugs | 374 | ||
| Amiodarone | 374 | ||
| Nitrofurantoin | 374 | ||
| Methotrexate | 374 | ||
| Bleomycin | 375 | ||
| Interferon | 375 | ||
| Checkpoint Inhibitor Immunotherapy | 375 | ||
| Suggested Readings | 376 | ||
| 19 Pneumoconioses | 377 | ||
| Introduction | 377 | ||
| Pathophysiology | 377 | ||
| International Labour Organization Classification of Pneumoconiosis | 378 | ||
| Mineral Dust Pneumoconiosis | 379 | ||
| Silicosis | 379 | ||
| Acute Silicosis | 379 | ||
| 20 Obstructive Lung Diseases | 391 | ||
| Introduction | 391 | ||
| Chronic Obstructive Pulmonary Disease | 392 | ||
| Emphysema | 392 | ||
| Clinical Features | 392 | ||
| Pathologic Features | 393 | ||
| Imaging Features | 395 | ||
| Radiography | 395 | ||
| Computed Tomography | 396 | ||
| Clinical Indications, Applications, and Implications. | 398 | ||
| Differential Diagnosis. | 399 | ||
| Chronic Bronchitis | 399 | ||
| Clinical Features | 399 | ||
| 21 Pulmonary Tumors and Lymphoproliferative Disorders | 405 | ||
| Lung Cancer | 405 | ||
| Risk Factors | 405 | ||
| Clinical Presentation | 406 | ||
| Classifications | 406 | ||
| Adenocarcinoma | 406 | ||
| Clinical Features. | 406 | ||
| Pathologic Features. | 407 | ||
| Imaging Features. | 407 | ||
| Squamous Cell Carcinoma | 408 | ||
| Clinical Features. | 408 | ||
| Pathologic Features. | 408 | ||
| Imaging Features. | 408 | ||
| Superior Sulcus Tumor | 410 | ||
| Clinical Features. | 410 | ||
| Imaging Features. | 411 | ||
| Neuroendocrine Tumors | 411 | ||
| Small Cell Lung Carcinoma | 411 | ||
| Clinical Features. | 411 | ||
| 22 Incidental Pulmonary Nodule | 428 | ||
| Introduction | 428 | ||
| Approach to Assessment of Lung Nodules | 428 | ||
| Attenuation | 428 | ||
| Shape and Contour | 430 | ||
| Enhancement | 430 | ||
| Location | 432 | ||
| Size and Evolution | 432 | ||
| Management of Solid Nodules | 433 | ||
| Radiograph | 433 | ||
| Computed Tomography | 435 | ||
| Guidelines | 435 | ||
| Nodule Mimics | 436 | ||
| Management of Subsolid Nodules | 437 | ||
| Radiography | 437 | ||
| Computed Tomography | 437 | ||
| Transient Versus Persistent | 437 | ||
| Guidelines | 437 | ||
| Nodule Mimics | 440 | ||
| Suggested Readings | 440 | ||
| 23 Lung Cancer Screening | 441 | ||
| Why Screen? | 441 | ||
| Who to Screen? | 441 | ||
| How to Screen? | 442 | ||
| Lung Nodule Assessment | 442 | ||
| Morphology | 442 | ||
| Size | 446 | ||
| Growth | 446 | ||
| Presence of Calcification or Fat | 446 | ||
| Pitfalls in Lung Cancer Screening | 446 | ||
| Lung Nodule Management Algorithms | 446 | ||
| Incidental Findings | 447 | ||
| Structured Reporting | 448 | ||
| Potential Harms of Low-Dose Computed Tomography Screening for Lung Cancer | 448 | ||
| False-Positive Results in the NLST Trial | 448 | ||
| Overdiagnosis | 448 | ||
| Radiation | 448 | ||
| The Future of Lung Cancer Screening | 449 | ||
| Conclusion | 449 | ||
| Suggested Reading | 449 | ||
| 24 Lung Cancer Staging | 450 | ||
| Introduction | 450 | ||
| Imaging and Surgical Staging Procedures (Table 24.2) | 451 | ||
| Imaging Modalities | 451 | ||
| Surgical (Interventional) Procedures | 451 | ||
| Tumor, Node, Metastasis Classification | 453 | ||
| Primary Tumor | 453 | ||
| Nodal Involvement | 456 | ||
| Metastasis | 457 | ||
| Changes From the Last TNM Staging Edition | 458 | ||
| Group Stages and Treatment | 458 | ||
| Multiple Cancers | 458 | ||
| Suggested Readings | 459 | ||
| 25 Interventional Techniques | 460 | ||
| Introduction | 460 | ||
| Biopsy of Lung and Mediastinum | 460 | ||
| Indications and Contraindications | 460 | ||
| Sedation Plan | 460 | ||
| Tools and Technical Principles | 460 | ||
| Procedure | 461 | ||
| Postprocedure Care | 463 | ||
| Complications | 464 | ||
| Percutaneous Localization Techniques | 465 | ||
| Thermal Ablation | 466 | ||
| Indications and Contraindications | 466 | ||
| Tools and Technical Principles | 466 | ||
| Sedation Plan | 466 | ||
| Procedure | 466 | ||
| Postprocedure Care | 468 | ||
| Complications | 468 | ||
| Thoracentesis and Pleural Drainage | 469 | ||
| Indications and Contraindications | 469 | ||
| Tools and Technical Principles | 470 | ||
| Sedation Plan | 470 | ||
| Procedure | 470 | ||
| Postprocedure Care | 471 | ||
| Complications | 472 | ||
| Suggested Readings | 472 | ||
| Index | 473 | ||
| A | 473 | ||
| B | 473 | ||
| C | 474 | ||
| D | 475 | ||
| E | 475 | ||
| F | 476 | ||
| G | 476 | ||
| H | 476 | ||
| I | 477 | ||
| J | 477 | ||
| K | 477 | ||
| L | 477 | ||
| M | 478 | ||
| N | 479 | ||
| O | 480 | ||
| P | 480 | ||
| Q | 482 | ||
| R | 482 | ||
| S | 482 | ||
| T | 483 | ||
| U | 484 | ||
| V | 484 | ||
| W | 484 | ||
| X | 484 | ||
| Y | 484 | ||
| Z | 484 | ||
| Inside Back Cover | ibc1 |