High resolution computed tomographic findings in pulmonary tuberculosis

Background - Although chest radiographs usually provide adequate information for the diagnosis of active pulmonary tuberculosis, minimal exudative tuberculosis can be overlooked on standard chest radiographs. The aim of the present study was to assess the findings of active pulmonary tuberculosis on high resolution computed tomographic (HRCT) scans and to evaluate their possible use in determining disease activity

Respiratory failure due to tracheobronchomalacia.

A case is described of tracheobronchomegaly progressing to extensive tracheomalacia, complicated by episodic choking, recurrent pulmonary infections, and irreversible hypercapnic respiratory failure. A Y-shaped tracheobronchial stent was placed endoscopically to splint the trachea open, with excellent clinical and physiological improvement. New stent designs may provide long term palliation in selected cases of diffuse tracheal collapse or stenosis, and offer an alternative to surgical repair

Effects of dual-energy subtraction chest radiography on detection of small pulmonary nodules with varying attenuation: receiver operating characteristic analysis using a phantom study

Purpose: To investigate the detectability of simulated pulmonary nodules with different X-ray attenuation by flat-panel detector (FPD) chest radiography using a dual-exposure dual-energy subtraction (DES) technique.Materials and Methods: Using a FPD radiography system we obtained 108 sets of chest radiographs of a chest phantom. They consisted of 54 sets each of chest radiographs with- and without simulated nodules. Each data set contained a standard- and a corresponding dual-energy subtracted chest radiograph (DES image). The diameter of the simulated nodules was 8-, 10-, and 12 mm; nodules of each size manifested attenuation of -450, -200, and 30 Hounsfield units (HU). We performed receiver operating characteristic (ROC) analysis to compare the observers’ performance in detecting nodules.Results: For -450 HU nodules the mean area under the ROC curve (AUC) without and with DES images was 0.66 and 0.77, respectively; the difference was significant (paired t-test, p < 0.01). For nodules with -200- and 30 HU, there was no significant difference in the AUC value (0.79 vs. 0.77, p=0.13; 0.92 vs. 0.94, p=0.17, respectively).Conclusion: The addition of DES images to standard chest radiographs improved the performance of radiologists charged with detecting simulated nodules with an attenuation of -450 HU