Pub Date : 2019-07-01DOI: 10.1093/med/9780199858064.003.0057
B. Little, T. Henry
In children, the term bronchiolitis refers to an acute respiratory illness caused by bronchiolar infection, typically by respiratory syncytial virus (RSV) or other viruses. In adults, the term refers to a primarily bronchiolar pattern of infection or inflammation caused by many pulmonary infections, systemic inflammatory conditions, inhaled irritants, certain systemic conditions, and accompanying several congenital diseases. Imaging may be helpful to assess the extent and severity of bronchiolitis and to establish a differential diagnosis based on the distribution of imaging findings, their respective morphologies, and any ancillary findings. Presence of cavities or architectural distortion with a bronchiolitis pattern, especially in the upper lungs, should prompt consideration of tuberculosis. Aspiration bronchiolitis is a common finding in patients with severe reflux or with impaired swallowing mechanisms. Early diagnosis of hypersensitivity pneumonitis can lead to prompt identification of the offending antigen. In cases with pure centrilobular nodules, smoking history is paramount – smokers get RB, non-smokers have a higher likelihood of hypersensitivity pneumonitis.
{"title":"Bronchiolitis","authors":"B. Little, T. Henry","doi":"10.1093/med/9780199858064.003.0057","DOIUrl":"https://doi.org/10.1093/med/9780199858064.003.0057","url":null,"abstract":"In children, the term bronchiolitis refers to an acute respiratory illness caused by bronchiolar infection, typically by respiratory syncytial virus (RSV) or other viruses. In adults, the term refers to a primarily bronchiolar pattern of infection or inflammation caused by many pulmonary infections, systemic inflammatory conditions, inhaled irritants, certain systemic conditions, and accompanying several congenital diseases. Imaging may be helpful to assess the extent and severity of bronchiolitis and to establish a differential diagnosis based on the distribution of imaging findings, their respective morphologies, and any ancillary findings. Presence of cavities or architectural distortion with a bronchiolitis pattern, especially in the upper lungs, should prompt consideration of tuberculosis. Aspiration bronchiolitis is a common finding in patients with severe reflux or with impaired swallowing mechanisms. Early diagnosis of hypersensitivity pneumonitis can lead to prompt identification of the offending antigen. In cases with pure centrilobular nodules, smoking history is paramount – smokers get RB, non-smokers have a higher likelihood of hypersensitivity pneumonitis.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121498018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0006
M. Rosado-de-Christenson
The introduction to portable chest radiography outlines a systematic approach to the performance and interpretation of bedside or portable chest radiography. These studies are frequently obtained in critically ill, debilitated and traumatized patients and are performed as anteroposterior (AP) chest radiographs. In each case, the radiologist should identify and assess all visible medical devices for appropriate positioning and exclusion of post procedural or post placement complications. In fact, it is important to explain the nature of all radiopaque structures visible on the radiograph. The radiologist then assesses the lung volume, presence or absence of airspace or interstitial disease, the pulmonary vasculature, and the pleural spaces and chest wall. Comparison to prior studies is important for the identification of subtle changes and abnormalities. Critical findings such as malpositioned medical devices, new consolidations, interval atelectasis, pneumothorax and/or pneumoperitoneum need to be promptly communicated to the clinical staff. In some cases, patients with new abnormalities may require further assessment with more advanced imaging such as chest CT.
{"title":"Introduction to Portable Chest Radiography: Support Devices","authors":"M. Rosado-de-Christenson","doi":"10.1093/MED/9780199858064.003.0006","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0006","url":null,"abstract":"The introduction to portable chest radiography outlines a systematic approach to the performance and interpretation of bedside or portable chest radiography. These studies are frequently obtained in critically ill, debilitated and traumatized patients and are performed as anteroposterior (AP) chest radiographs. In each case, the radiologist should identify and assess all visible medical devices for appropriate positioning and exclusion of post procedural or post placement complications. In fact, it is important to explain the nature of all radiopaque structures visible on the radiograph. The radiologist then assesses the lung volume, presence or absence of airspace or interstitial disease, the pulmonary vasculature, and the pleural spaces and chest wall. Comparison to prior studies is important for the identification of subtle changes and abnormalities. Critical findings such as malpositioned medical devices, new consolidations, interval atelectasis, pneumothorax and/or pneumoperitoneum need to be promptly communicated to the clinical staff. In some cases, patients with new abnormalities may require further assessment with more advanced imaging such as chest CT.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121634508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0050
R. Benson
Bronchial carcinoid and bronchial gland carcinomas are rare airway-related thoracic malignancies. Carcinoid is a neuroendocrine neoplasm and comprises 1-2 % of primary lung cancers. Affected patients are younger than those with lung cancer, and may present with signs and symptoms of airway obstruction including cough, hemoptysis, wheezing, and recurrent pulmonary infection. Carcinoid typically manifests as a central nodule or mass and may cause post obstructive atelectasis or pneumonia. On imaging these lesions are usually well marginated pulmonary nodules or masses and may be completely endobronchial, partially endobronchial or may abut an airway. Typical carcinoid often exhibits an indolent behavior and carries a good prognosis with complete surgical excision. Atypical carcinoid is similar to typical carcinoid on imaging but has a more aggressive behavior and may be associated with metastatic intrathoracic lymphadenopathy. Bronchial gland carcinomas include adenoid cystic carcinoma (ACC) and mucoepidermoid carcinoma (MEC). ACC is the second most common primary tracheal malignancy and manifests as an endoluminal tracheal nodule or as circumferential tracheal narrowing. MEC typically affects segmental bronchi and may be indistinguishable from carcinoid on imaging. Although these lesions may exhibit an indolent course, they are locally invasive malignancies, and affected patients have a variable prognosis.
{"title":"Bronchial Carcinoids and Bronchial Gland Carcinomas","authors":"R. Benson","doi":"10.1093/MED/9780199858064.003.0050","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0050","url":null,"abstract":"Bronchial carcinoid and bronchial gland carcinomas are rare airway-related thoracic malignancies. Carcinoid is a neuroendocrine neoplasm and comprises 1-2 % of primary lung cancers. Affected patients are younger than those with lung cancer, and may present with signs and symptoms of airway obstruction including cough, hemoptysis, wheezing, and recurrent pulmonary infection. Carcinoid typically manifests as a central nodule or mass and may cause post obstructive atelectasis or pneumonia. On imaging these lesions are usually well marginated pulmonary nodules or masses and may be completely endobronchial, partially endobronchial or may abut an airway. Typical carcinoid often exhibits an indolent behavior and carries a good prognosis with complete surgical excision. Atypical carcinoid is similar to typical carcinoid on imaging but has a more aggressive behavior and may be associated with metastatic intrathoracic lymphadenopathy. Bronchial gland carcinomas include adenoid cystic carcinoma (ACC) and mucoepidermoid carcinoma (MEC). ACC is the second most common primary tracheal malignancy and manifests as an endoluminal tracheal nodule or as circumferential tracheal narrowing. MEC typically affects segmental bronchi and may be indistinguishable from carcinoid on imaging. Although these lesions may exhibit an indolent course, they are locally invasive malignancies, and affected patients have a variable prognosis.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130158192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0082
M. Rosado-de-Christenson
neoplasms and lymphoma characteristically affect the anterior mediastinum while neurogenic neoplasms typically occur in the paravertebral regions. Patients with mediastinal neoplasms may be asymptomatic or may present because of symptoms of compression or local invasion. Patients with thymoma may also present with paraneoplastic syndromes including myasthenia gravis. Thymoma is the most common primary anterior mediastinal neoplasm and usually manifests as a unilateral soft tissue mass with lobular contours that may exhibit local invasion or drop pleural metastases. Mature teratoma often demonstrates a spherical morphology and cystic change; intrinsic fat attenuation in such a lesion is virtually diagnostic. Malignant germ cell neoplasms almost exclusively affect men and manifest as anterior mediastinal soft tissue masses that may be homogeneous or exhibit areas of low attenuation from central necrosis and are indistinguishable from lymphoma with nodal coalescence on imaging. Neurogenic neoplasms are paravertebral lesions that may produce skeletal erosion and intraspinal extension and are optimally evaluated with MRI. Imaging diagnosis of primary mediastinal neoplasms requires identification of a mediastinal mass, placement of the mass in a specific mediastinal compartment and characterization of the lesion with cross-sectional imaging to formulate a focused differential diagnosis and appropriate management recommendations.
{"title":"Primary Mediastinal Neoplasms","authors":"M. Rosado-de-Christenson","doi":"10.1093/MED/9780199858064.003.0082","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0082","url":null,"abstract":"neoplasms and lymphoma characteristically affect the anterior mediastinum while neurogenic neoplasms typically occur in the paravertebral regions. Patients with mediastinal neoplasms may be asymptomatic or may present because of symptoms of compression or local invasion. Patients with thymoma may also present with paraneoplastic syndromes including myasthenia gravis. Thymoma is the most common primary anterior mediastinal neoplasm and usually manifests as a unilateral soft tissue mass with lobular contours that may exhibit local invasion or drop pleural metastases. Mature teratoma often demonstrates a spherical morphology and cystic change; intrinsic fat attenuation in such a lesion is virtually diagnostic. Malignant germ cell neoplasms almost exclusively affect men and manifest as anterior mediastinal soft tissue masses that may be homogeneous or exhibit areas of low attenuation from central necrosis and are indistinguishable from lymphoma with nodal coalescence on imaging. Neurogenic neoplasms are paravertebral lesions that may produce skeletal erosion and intraspinal extension and are optimally evaluated with MRI. Imaging diagnosis of primary mediastinal neoplasms requires identification of a mediastinal mass, placement of the mass in a specific mediastinal compartment and characterization of the lesion with cross-sectional imaging to formulate a focused differential diagnosis and appropriate management recommendations.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131606984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0025
C. Raptis
“Sickle cell disease” describes the spectrum of pathology in patients with at least one HbS chain and one other abnormal β globin chain. Although patients with sickle cell disease often present with a simple community acquired pneumonia, acute chest syndrome must be considered in patients presenting with chest pain and fever, as it carries an increased risk of mortality, especially in adults. A few other entities, including rib infarction and subdiaphragmatic pathologies, can mimic the symptoms of acute chest syndrome. Finally, the findings of sickle cell disease on chest radiography will be discussed. Radiologists must be familiar with these findings in order to accurately interpret imaging studies, especially when the history of sickle cell is not provided.
{"title":"Pulmonary Complications of Sickle Cell Anemia","authors":"C. Raptis","doi":"10.1093/MED/9780199858064.003.0025","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0025","url":null,"abstract":"“Sickle cell disease” describes the spectrum of pathology in patients with at least one HbS chain and one other abnormal β globin chain. Although patients with sickle cell disease often present with a simple community acquired pneumonia, acute chest syndrome must be considered in patients presenting with chest pain and fever, as it carries an increased risk of mortality, especially in adults. A few other entities, including rib infarction and subdiaphragmatic pathologies, can mimic the symptoms of acute chest syndrome. Finally, the findings of sickle cell disease on chest radiography will be discussed. Radiologists must be familiar with these findings in order to accurately interpret imaging studies, especially when the history of sickle cell is not provided.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"128 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128161909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0044
M. Rosado-de-Christenson
The introduction to neoplasms of the lung and tracheobronchial tree addresses the different types of malignant and benign neoplasms of the lung. The most common primary lung neoplasm is lung cancer. It represents the most common cause of cancer mortality in American men and women. Lung cancer is comprised by four major cell types including adenocarcinoma, squamous cell carcinoma, small cell carcinoma and large cell carcinoma. Many patients with lung cancer are symptomatic at presentation and most present with advanced disease. Lung cancer has a variety of imaging manifestations including nodules, masses, post-obstructive atelectasis/pneumonia, intrathoracic lymphadenopathy, extrapulmonary involvement and/or metastatic disease. Carcinoid tumor is an uncommon primary lung malignancy that often affects the airways, but typically exhibits an indolent behavior. Benign pulmonary neoplasms are rare and include neoplasms of the lung and airways such as hamartoma and endobronchial mesenchymal neoplasms. Pulmonary metastases are probably the most common pulmonary neoplasms and usually manifest as multifocal pulmonary nodules and masses.
{"title":"Introduction to Neoplasms of the Lung and Tracheobronchial Tree","authors":"M. Rosado-de-Christenson","doi":"10.1093/MED/9780199858064.003.0044","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0044","url":null,"abstract":"The introduction to neoplasms of the lung and tracheobronchial tree addresses the different types of malignant and benign neoplasms of the lung. The most common primary lung neoplasm is lung cancer. It represents the most common cause of cancer mortality in American men and women. Lung cancer is comprised by four major cell types including adenocarcinoma, squamous cell carcinoma, small cell carcinoma and large cell carcinoma. Many patients with lung cancer are symptomatic at presentation and most present with advanced disease. Lung cancer has a variety of imaging manifestations including nodules, masses, post-obstructive atelectasis/pneumonia, intrathoracic lymphadenopathy, extrapulmonary involvement and/or metastatic disease. Carcinoid tumor is an uncommon primary lung malignancy that often affects the airways, but typically exhibits an indolent behavior. Benign pulmonary neoplasms are rare and include neoplasms of the lung and airways such as hamartoma and endobronchial mesenchymal neoplasms. Pulmonary metastases are probably the most common pulmonary neoplasms and usually manifest as multifocal pulmonary nodules and masses.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125139628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0039
S. Martinez-Jiménez
Non-tuberculous mycobacteria (NTM), other than Mycobacterium tuberculosis (TB) may produce pulmonary infection. NTMI is typically an indolent infection except in immunocompromised and HIV infected patients. Imaging plays a crucial role in suggesting NTMI as a possible diagnosis in this patient population. Always consider classic or cavitary NTMI in patients with upper lobe cavitary disease similar to active cavitary TB. However, in such cases TB must always be excluded. In elderly white women, persistent right middle lobe/lingular atelectasis, bronchiectasis or consolidation should suggest the diagnosis of bronchiectactic NTMI. In patients with imaging findings of subacute hypersensitivity pneumonitis, the radiologist must review the history and consult with the clinician in order to identify the triggering allergen, including NTM which is associated with indoor hot tubs.
{"title":"Nontuberculous Mycobacterial Infection","authors":"S. Martinez-Jiménez","doi":"10.1093/MED/9780199858064.003.0039","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0039","url":null,"abstract":"Non-tuberculous mycobacteria (NTM), other than Mycobacterium tuberculosis (TB) may produce pulmonary infection. NTMI is typically an indolent infection except in immunocompromised and HIV infected patients. Imaging plays a crucial role in suggesting NTMI as a possible diagnosis in this patient population. Always consider classic or cavitary NTMI in patients with upper lobe cavitary disease similar to active cavitary TB. However, in such cases TB must always be excluded. In elderly white women, persistent right middle lobe/lingular atelectasis, bronchiectasis or consolidation should suggest the diagnosis of bronchiectactic NTMI. In patients with imaging findings of subacute hypersensitivity pneumonitis, the radiologist must review the history and consult with the clinician in order to identify the triggering allergen, including NTM which is associated with indoor hot tubs.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"444 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133532111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0009
T. Ternes
Cardiac conduction devices (CCDs) include pacemakers and implantable cardioverter defibrillators (ICDs) and are used for permanent management of cardiac conduction abnormalities. Most CCDs consist of a generator which houses the battery and computer. They gather electronic information and send electric pulses through their attached leads. Typically, the leads are placed via transvenous approach into the right atrial appendage, right ventricle, or coronary sinus, depending on the purpose. A single chamber pacer may be utilized to manage SA nodal disease, with a lead in the right ventricle. Dual-chamber pacers are often used for AV nodal disease, and have leads in the right atrium and right ventricle. Biventricular pacing may be used to improve synchronized right and left ventricular function, with the additional lead positioned in the coronary sinus to stimulate the left ventricle. The presence of a thick “shock coil” confirms the defibrillator capability of the device (ICD). Radiographic evaluation following CCD placement should ensure proper lead placement, and exclude pneumothorax, hemothorax, and/or hemopericardium. Subsequent imaging should exclude Twiddler’s syndrome (change in generator position) and lead fracture. Temporary pacing devices may also be used in emergent and postoperative settings, and typically consist of epicardial leads that can be easily removed.
{"title":"Cardiac Conduction Devices","authors":"T. Ternes","doi":"10.1093/MED/9780199858064.003.0009","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0009","url":null,"abstract":"Cardiac conduction devices (CCDs) include pacemakers and implantable cardioverter defibrillators (ICDs) and are used for permanent management of cardiac conduction abnormalities. Most CCDs consist of a generator which houses the battery and computer. They gather electronic information and send electric pulses through their attached leads. Typically, the leads are placed via transvenous approach into the right atrial appendage, right ventricle, or coronary sinus, depending on the purpose. A single chamber pacer may be utilized to manage SA nodal disease, with a lead in the right ventricle. Dual-chamber pacers are often used for AV nodal disease, and have leads in the right atrium and right ventricle. Biventricular pacing may be used to improve synchronized right and left ventricular function, with the additional lead positioned in the coronary sinus to stimulate the left ventricle. The presence of a thick “shock coil” confirms the defibrillator capability of the device (ICD). Radiographic evaluation following CCD placement should ensure proper lead placement, and exclude pneumothorax, hemothorax, and/or hemopericardium. Subsequent imaging should exclude Twiddler’s syndrome (change in generator position) and lead fracture. Temporary pacing devices may also be used in emergent and postoperative settings, and typically consist of epicardial leads that can be easily removed.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"128 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129077265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0004
G. Abbott
The radiology report must communicate the results of imaging studies to the healthcare team in a clear, accurate, and timely manner - combining the radiologist’s medical knowledge, experience, and medical judgment to communicate their observations and form a summary impression of their findings. The key elements of a radiology report are 1) Administrative information, 2) Patient identification, 3) Clinical history and indications for the examination, 4) Imaging technique, 5) Comparison with prior studies, 6) Observations / Imaging findings, 7) Summary or Impression, and 8) Signature. These elements form the basis of “structured reporting”, a communication technique endorsed by the American College of Radiology (ACR).In structured reports of thoracic imaging studies, imaging findings are organized as separate paragraphs: 1) tubes and lines, 2) lungs and airways, 3) pleura, 4) heart and mediastinum, 5) bones, and 6) soft tissues. This format is preferred by clinicians, as information pertaining to specific organ systems can be retrieved and compared to previous reports more easily.
{"title":"The Radiology Report","authors":"G. Abbott","doi":"10.1093/MED/9780199858064.003.0004","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0004","url":null,"abstract":"The radiology report must communicate the results of imaging studies to the healthcare team in a clear, accurate, and timely manner - combining the radiologist’s medical knowledge, experience, and medical judgment to communicate their observations and form a summary impression of their findings. The key elements of a radiology report are 1) Administrative information, 2) Patient identification, 3) Clinical history and indications for the examination, 4) Imaging technique, 5) Comparison with prior studies, 6) Observations / Imaging findings, 7) Summary or Impression, and 8) Signature. These elements form the basis of “structured reporting”, a communication technique endorsed by the American College of Radiology (ACR).In structured reports of thoracic imaging studies, imaging findings are organized as separate paragraphs: 1) tubes and lines, 2) lungs and airways, 3) pleura, 4) heart and mediastinum, 5) bones, and 6) soft tissues. This format is preferred by clinicians, as information pertaining to specific organ systems can be retrieved and compared to previous reports more easily.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"161 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134387064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0049
R. Benson
Lung cancer staging is a process used to assess the extent of spread of lung cancer, determine the most appropriate treatment and predict the patient’s prognosis. Clinical staging is performed prior to surgical resection, while surgical-pathologic staging is based on histologic analysis of the resected tumor and lymph nodes. Restaging is performed following treatment. Staging is based on the TNM classification system. T refers to the primary tumor, N to thoracic lymph node involvement and M to metastatic disease. Recent changes to T and M descriptors were made to better reflect actual survival. For the majority of non-small cell lung cancers, the presence or absence of mediastinal lymph node spread is the most important outcome predictor. Although no changes were made to the N descriptor, the actual intrathoracic lymph node stations were recently clarified. Although the majority of small cell lung cancers are metastatic at the time of presentation, the presence of limited versus extensive spread of disease determines treatment options. However, the overall prognosis and survival for affected patients is poor. TNM staging is now recommended for carcinoid tumors as well as small cell lung cancer.
{"title":"Lung Cancer: Staging","authors":"R. Benson","doi":"10.1093/MED/9780199858064.003.0049","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0049","url":null,"abstract":"Lung cancer staging is a process used to assess the extent of spread of lung cancer, determine the most appropriate treatment and predict the patient’s prognosis. Clinical staging is performed prior to surgical resection, while surgical-pathologic staging is based on histologic analysis of the resected tumor and lymph nodes. Restaging is performed following treatment. Staging is based on the TNM classification system. T refers to the primary tumor, N to thoracic lymph node involvement and M to metastatic disease. Recent changes to T and M descriptors were made to better reflect actual survival. For the majority of non-small cell lung cancers, the presence or absence of mediastinal lymph node spread is the most important outcome predictor. Although no changes were made to the N descriptor, the actual intrathoracic lymph node stations were recently clarified. Although the majority of small cell lung cancers are metastatic at the time of presentation, the presence of limited versus extensive spread of disease determines treatment options. However, the overall prognosis and survival for affected patients is poor. TNM staging is now recommended for carcinoid tumors as well as small cell lung cancer.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"167 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132325941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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