Biomedical subjects

Joanne R Cleverley

Publications and source records attributed to Joanne R Cleverley.

3 recordsLinked to original sources

PubMed2002

Drug-induced lung disease: high-resolution CT and histological findings.

AIM: To compare the parenchymal high-resolution computed tomography (HRCT) appearances with histological findings in patients with drug-induced lung disease and to determine the prognostic value of HRCT. MATERIALS AND METHODS: Drug history, HRCT features, histological findings and outcome at 3 months in 20 patients with drug induced-lung disease were reviewed retrospectively. The HRCT images were assessed for the pattern and distribution of abnormalities and classified as most suggestive of interstitial pneumonitis/fibrosis, diffuse alveolar damage (DAD), organizing pneumonia (OP) reaction, or a hypersensitivity reaction. RESULTS: On histopathological examination there were eight cases of interstitial pneumonitis/fibrosis, five of DAD, five of OP reactions, one of hypersensitivity reaction and one of pulmonary eosinophilia. The most common abnormalities on HRCT were ground-glass opacities (n = 17), consolidation (n = 14), interlobular septal thickening (n = 15) and centrilobular nodules (n = 8). HRCT interpretation and histological diagnosis were concordant in only nine (45%) of 20 patients. The pattern, distribution, and extent of HRCT abnormalities were of limited prognostic value: all eight patients with histological findings of OP, hypersensitivity reaction, or eosinophilic infiltrate improved on follow-up compared to only five of 13 patients with interstitial pneumonitis/fibrosis or DAD. CONCLUSION: In many cases of drug-induced lung injury HRCT is of limited value in determining the histological pattern and prognosis.

Adult↗

PubMed2002

Direct findings of aortic injury on contrast-enhanced CT in surgically proven traumatic aortic injury: a multi-centre review.

OBJECTIVE: To review the contrast-enhanced CT findings in surgically proven traumatic aortic injury (TAI). MATERIALS AND METHODS: We searched the trauma registries of three academic medical centres from 1994 to 2000 and found 34 patients with surgically proven TAI that received pre-operative contrast-enhanced chest CT. Two chest radiologists recorded by consensus the size and location of direct (pseudoaneurysm, intimal flap) and indirect (mediastinal haematoma) findings of TAI. The imaging findings were correlated with surgical reports. RESULTS: Direct findings of aortic injury (pseudoaneurysm or intimal flap) were seen on contrast enhanced CT in all patients and confirmed at surgery. Specifically, a pseudoaneurysm was seen in 33 (97%), presenting either as a focal bulge in 22 (65%) or as more diffuse aneurysmal enlargement in 11 (32%). An intimal flap was identified in 31 cases (91%). A periaortic haematoma was seen in 31 cases (91%). In the three patients without periaortic haematoma, the only indications of aortic injury were a focal pseudoaneurysm in two (6%) and an intimal flap in one (3%). CONCLUSION: In this series of surgically proven TAI, direct findings of aortic injury were seen in all cases. Aortic tear occurred without mediastinal haematoma in 9% (3/34) of patients.

Accidents, Traffic↗

PubMed2002

Thin-section CT in obstructive pulmonary disease: discriminatory value.

PURPOSE: To use thin-section computed tomography (CT) to distinguish between causes of obstructive pulmonary disease, to determine which distinctions give rise to diagnostic imprecision, and to identify the most useful CT features. MATERIALS AND METHODS: Thin-section CT scans of 105 patients with obstructive pulmonary disease (asthma, n = 35; centrilobular emphysema, n = 30; panlobular emphysema, n = 21; and obliterative bronchiolitis, n = 19) and 33 healthy subjects were assessed independently by two observers. The most likely diagnosis and a confidence rating were assigned. Individual thin-section CT features were recorded. Accuracy, sensitivity, specificity, negative predictive value, and positive predictive value for first-choice diagnoses were calculated. The prevalence of CT features between pairs of conditions was compared with the chi(2) or Fisher exact test as appropriate. RESULTS: A correct first-choice diagnosis was made in 199 of 276 (72%) observations. A correct first-choice diagnosis was made in 35 of 38 (92%) observations in patients with obliterative bronchiolitis, in 53 of 60 (88%) observations in patients with centrilobular emphysema, in 53 of 66 (80%) observations in healthy subjects, in 37 of 70 (53%) observations in patients with asthma, and in 20 of 42 (48%) observations in patients with panlobular emphysema. The major sources of diagnostic inaccuracy were differentiation between panlobular and centrilobular emphysema, asthma and normality, and asthma and obliterative bronchiolitis. There were significant increases in prevalence of (a) bronchial wall thickening and vascular attenuation in patients with asthma when compared with healthy subjects and (b) vascular attenuation and decreased attenuation in patients with obliterative bronchiolitis when compared with patients with asthma (P <.001). CONCLUSION: CT helps to distinguish diseases that cause airflow obstruction. Thin-section CT is particularly accurate in the identification of obliterative bronchiolitis.

Adolescent↗