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Biomedical subjects

C Chiles

Publications and source records attributed to C Chiles.

61 records · Page 4Linked to original sources
PubMedDate not supplied

Pulmonary artery sarcomas: a review of clinical and radiologic features.

Primary pulmonary artery sarcomas are rare tumors that are frequently misdiagnosed as chronic pulmonary emboli. We present classic imaging findings and review data from 136 previously reported sarcomas. We believe that the imaging findings can be quite specific, especially when the disease is advanced. Despite a recent increase in antemortem diagnosis, the prognosis remains poor. Surgery prolongs survival time and is potentially curative. Experience with adjuvant chemotherapy and radiotherapy is limited.

Chemotherapy, Adjuvant↗
PubMedDate not supplied

Herpes simplex virus 1 pneumonia: patterns on CT scans and conventional chest radiographs.

PURPOSE: The goal of our study was to describe the herpes simplex virus type 1 (HSV 1) pneumonia patterns on CT scans and chest radiographs. METHOD: We retrospectively reviewed clinical records and chest radiographs of 24 patients with HSV 1 pneumonia and 10 with pneumonia from combined HSV and mixed flora infection. We also reviewed CT scans available for eight patients with HSV pneumonia and four with mixed pneumonia. RESULTS: CT scans of eight patients with HSV pneumonia demonstrated multifocal segmental and subsegmental ground-glass opacities (n = 8), additional focal areas of consolidation (n = 6), scattered distribution (n = 6), and pleural effusions (n = 7). Chest radiographs (23 patients) showed patchy segmental and subsegmental ground-glass opacities and consolidation (n = 23), scattered distribution (n = 20), and pleural effusions (n = 12). Radiographic patterns for isolated HSV pneumonia and mixed flora pneumonia were not significantly different. CONCLUSION: With a growing population of at-risk immunosuppressed patients, it is important to recognize CT and chest radiography patterns consistent with, although nonspecific for, HSV 1 pneumonia.

Adolescent↗
PubMedDate not supplied

Overview of traumatic injury of the thoracic aorta.

Traumatic injury of the thoracic aorta is a major clinical concern in patients who sustain deceleration or crush injuries. Several mechanical factors may explain the typical locations of thoracic aortic rupture (aortic isthmus, ascending aorta). Understanding these factors and the pathophysiology involved helps the radiologist to recognize aortic trauma at various imaging examinations. Chest radiography is the initial screening examination, and radiographs are evaluated specifically for signs of mediastinal hematoma, an indication of significant thoracic trauma. The most important of these signs include loss of aortic contour, tracheal deviation, ratio of mediastinal width to chest width, deviation of a nasogastric tube to the right of the T-4 spinous process, and depression of the left main-stem bronchus (> 40 degrees below the horizontal). Computed tomography (CT) is used increasingly when results of chest radiography are equivocal. CT can clearly demonstrate mediastinal hematoma, but this finding is also mimicked by several entities, including atelectatic lung, thymus, and pericardial recesses. Aortography is the standard for diagnosis. Traumatic aortic injury is treated urgently with surgical repair. The rare patient who survives aortic injury without surgery may develop a chronic pseudoaneurysm.

Algorithms↗
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Navigating the thoracic inlet.

The thoracic inlet is often seen on the "edge of the film" at computed tomography (CT); consequently, lesions affecting this structure are easily overlooked. A vascular abnormality that may be overlooked is venous thrombosis. The CT appearance of jugular vein thrombosis varies with the age of the lesion: In the acute phase, there is often loss of soft-tissue planes surrounding an enlarged, peripherally enhancing thrombus. In the chronic phase, the jugular vein appears as a tubular, nonenhancing "mass" without loss of surrounding fat planes. Intrathoracic goiters typically manifest as well-defined, markedly enhanced inhomogeneous lesions that are continuous with the cervical thyroid gland. Thyroid adenomas are typically round or oval low-attenuating lesions that enhance after contrast material administration. Thyroid carcinomas may manifest as single or multiple, irregularly shaped low-attenuating areas with or without calcification. Primary tracheal malignancies may appear as smooth or irregular, sessile or pedunculated intraluminal filling defects. Tracheomalacia manifests as destruction of the tracheal walls with soft-tissue narrowing of the tracheal lumen, whereas esophageal abnormalities manifest as thickening of the esophageal wall, dilatation of the esophageal lumen, or both. Schwannomas manifest as well-circumscribed lesions with soft-tissue attenuation that enhance after contrast material administration. Neurofibromas tend to have lower attenuation than schwannomas. Lymphangiomas typically have a cystic appearance with near water attenuation. Familiarity with the normal anatomy of the thoracic inlet as well as the CT features of related abnormalities is critical for correct diagnosis and prompt treatment.

Esophageal Diseases↗
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Metastatic involvement of the heart and pericardium: CT and MR imaging.

Metastases to the heart and pericardium are much more common than primary cardiac tumors and are generally associated with a poor prognosis. Tumors that are most likely to involve the heart and pericardium include cancers of the lung and breast, melanoma, and lymphoma. Tumor may involve the heart and pericardium by one of four pathways: retrograde lymphatic extension, hematogenous spread, direct contiguous extension, or transvenous extension. Metastatic involvement of the heart and pericardium may go unrecognized until autopsy. Impairment of cardiac function occurs in approximately 30% of patients and is usually attributable to pericardial effusion. The clinical presentation includes shortness of breath, which may be out of proportion to radiographic findings in patients with pericardial effusion or may be the result of associated pleural effusion. Patients may also present with cough, anterior thoracic pain, pleuritic chest pain, or peripheral edema. The differential diagnosis of pericardial effusion in a patient with known malignancy includes malignant pericardial effusion, radiation-induced pericarditis, drug-induced pericarditis, and idiopathic pericarditis. Any disease process that causes thickening or nodularity of the pericardium or myocardium or masses within the cardiac chambers can mimic metastatic disease.

Diagnosis, Differential↗
PubMedDate not supplied

Superior pericardial recess simulating aortic dissection on computed tomography.

Computed tomography is frequently used in the initial workup of patients with suspected aortic dissection to distinguish dissection involving the ascending aorta from dissection limited to the descending aorta. We reviewed CT of 19 patients who were proven by aortography to have normal ascending aortas. In eight patients the superior extension of the pericardium was visualized and thought to be a potential source of a false-positive diagnosis of type A aortic dissection.

Aortic Dissection↗