Paul Stark

Bullous Lung Disease: A Review

Bullous lung disease is encountered commonly and has characteristic imaging features. It can be complicated by rupture, infection, hemorrhage, and malignancy, all of which have recognizable radiological manifestations. The radiologist can play a crucial role by being aware of common and uncommon presentations, facilitating the diagnosis, and recognizing the complications of bullous lung disease.

Unilateral Pulmonary Edema: Clinical Scenarios and Differential Diagnosis

Pulmonary edema is one of the most commonly encountered pathologic processes in chest radiology. Although pulmonary edema has classically a bilateral and symmetric distribution, unilateral pulmonary edema is less common and may be confused easily with pneumonia. Familiarity with the causes of unilateral pulmonary edema is important for correct diagnosis and patient management.

Pulmonary Manifestations of Trauma

This article reviews the classification, mechanisms, and clinical and radiologic manifestations of trauma to the lung parenchyma. Injuries resulting from blunt trauma, penetrating trauma, and barotrauma will be discussed and illustrated. The effects of trauma can lead to rib fractures, lung contusion, lung hemorrhage, lung laceration, lung hematoma, atelectasis, lung hernia, lung torsion, pulmonary edema, diffuse alveolar damage, and pulmonary interstitial emphysema. Imaging findings can be subtle or obvious and characteristic; in general terms, the radiologic workup plays a fundamental and important role in the management of trauma victims.1–6

Imaging of Tetralogy of Fallot: A Continuum From Infancy To Adulthood

Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease. This disease accounts for approximately 10% of all congenital heart defects, affecting males and females equally.1 In addition, tetralogy of Fallot is the most common cyanotic heart disease that survives to adulthood. Although the cause for this disease is unknown, genetic mutations have been suggested to play a role: the occurrence rate from parent to child has been estimated to be as high as 8%. Mutations in a ligand expressed in the developing heart have been reported, as have transcription factor mutations and microdeletions on chromosome 22.1

Pericardial Defects: A Pictorial Essay

Pericardial defects are a rare entity with recognizable imaging features that lend themselves well to a radiologic diagnosis. Because the congenital pericardial defect is a rare and usually unsuspected cause of chest pain, the radiologist can make a valuable contribution by suggesting the diagnosis.

Radiographic Manifestations of Traumatic Diaphragmatic Rupture

Diaphragmatic rupture is an uncommon injury that can result from blunt, penetrating, or surgical trauma to the chest. Prompt diagnosis often is challenging due to concomitant distracting injuries, nonspecific clinical findings, and the latent period between rupture and eventual herniation of organs into the thorax. Delay in diagnosis can be costly—the case fatality rate approaches 30% when complications such as bowel strangulation and respiratory failure develop. This article considers the clinical features of traumatic diaphragmatic rupture and reviews its radiographic manifestations and pitfalls, with particular emphasis on conventional radiographic and CT findings.

The Challenge of Combined Lobar Atelectasis

In their classic form, lobar atelectases have characteristic radiographic manifestations. However, atypical features of atelectasis can lead to pitfalls in interpretation. One such difficulty is posed by combined lobar atelectasis, or atelectasis involving more than one lobe. The unexpected presentations of these forms of atelectasis can present a challenge and lead to misdiagnoses. This article presents an organized approach to the identification of combined lobar atelectasis and their variants. Radiographic appearance and evaluation of combined atelectasis of the right middle and lower lobes, right upper and middle lobes, right upper lobe and left lung, and simultaneous lower lobe atelectases are stressed. The etiology, radiographic signs, diagnosis, and differential diagnosis are discussed, and several examples are illustrated.