Clinical imaging
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Comparative Study
Diagnostic imaging of idiopathic adult respiratory distress syndrome (ARDS)/diffuse alveolar damage (DAD) histopathological correlation with radiological imaging.
In ten patients with idiopathic adult respiratory distress syndrome (ARDS) who had histopathologically diffuse alveolar damage (DAD), and who did not have specific underlying diseases, we compared the histopathological findings with their radiographic images in order to study the detail analysis of radiographic images and the clinical courses. These patients were roughly classified as having the interstitial pneumonia dominant type (type IP) of idiopathic ARDS, in which alveolar septal thickening, alveolitis, or both were the predominant histological findings and images showed increasing attenuation of lung fields with small honeycomb lung, or the organizing pneumonia dominant type (type OP), in which organizing exudate predominantly filled the alveoli histologically and images showed consolidation shadows with some air. Hyaline membrane was seen very frequently in patients with a short clinical course, and in accordance with a longer clinical course, widespread fibrosis and honeycomb lung covered by organizing hyaline membrane was seen with both types. Patients with type OP in whom collapse of the normal pulmonary structure was less and for whom changes on radiographic images were larger seemed to respond relatively favorably to steroid treatment, as judged from pulmonary function and radiographic images.
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The purpose of this study was to review the computed tomography (CT) appearance of mycotic aneurysm of the aorta caused by Salmonella infection. Eight patients were suggested to have mycotic aneurysm of the aorta by clinical presentation of fever, abdominal or back pain, leukocytosis, and pulsatile abdominal mass in addition to positive blood or tissue culture of salmonella. ⋯ CT features of mycotic aneurysm of aorta included (a) hazy aortic wall with rupture; (b) gas-forming inflammation around the aneurysm; (c) retroperitoneal paraaortic fluid collection and vertebral erosion; and (d) thrombus formation within a false lumen after aneurysmal rupture. Because of its availability and noninvasiveness, CT is the major diagnostic modality to use for Salmonella-related mycotic aneurysm.