Biomedical subjects

Michel W Brauner

Publications and source records attributed to Michel W Brauner.

5 recordsLinked to original sources

PubMed2005

[Imaging findings in interstitial lung disease].

Imaging is an essential step in the management of patients with interstitial lung disease, contributing to detection, diagnosis, evaluation of pulmonary damage and prognosis, surveillance, and screening for complications. The chest x-ray is the fundamental examination. High-resolution computed tomography is often useful, particularly for severe forms and for cases of difficult diagnosis. It should not however be used as a routine examination for the initial work-up nor repeated systematically. Computed tomography is more contributory to the diagnosis of subacute or chronic interstitial pneumonia than for acute forms. We present here the different imaging methods, the role of imaging in chronic and acute interstitial pneumonia, and discuss the main computed tomographic signs of chronic interstitial lung disease.

Humans↗

PubMed2004

CT findings in severe thoracic sarcoidosis.

Severe thoracic sarcoidosis includes manifestations with significant clinical and functional impairment and a risk of mortality. Severe thoracic sarcoidosis can take on various clinical presentations and is associated with increased morbidity. The purpose of this article was to describe the CT findings in severe thoracic sarcoidosis and to explain some of their mechanisms. Subacute respiratory insufficiency is a rare and early complication due to a high profusion of pulmonary lesions. Chronic respiratory insufficiency due to pulmonary fibrosis is a frequent and late complication. Three main CT patterns are identified: bronchial distortion, honeycombing and linear opacities. CT can be helpful in diagnosing some mechanisms of central airway obstruction such as bronchial distortion due to pulmonary fibrosis or an extrinsic bronchial compression by enlarged lymph nodes. An intrinsic narrowing of the bronchial wall by endobronchial granulomatous lesions may be suggested by CT when it shows evidence of bronchial mural thickening. Pulmonary hypertension usually occurs in patients with end-stage pulmonary disease and is related to fibrotic destruction of the distal capillary bed and to the resultant chronic hypoxemia. Several other mechanisms may contribute to the development of pulmonary hypertension including extrinsic compression of major pulmonary arteries by enlarged lymph nodes and secondary pulmonary veno-occlusive disease. Aspergilloma colonization of a cavity is the main cause of hemoptysis in sarcoidosis. Other rare causes are bronchiesctasis, necrotizing bronchial aspergillosis, semi-invasive pulmonary aspergillosis, erosion of a pulmonary artery due to a necrotic sarcoidosis lesion, necrosis of parenchymal sarcoidosis lesions and specific endobronchial macroscopic lesions.

Humans↗

PubMed2004

Pulmonary cryptococcosis.

Pulmonary cryptococcosis is the consequence of the inhalation of Cryptococcus neoformans, an encapsulated yeast, from various environmental sources. It is commonly accepted that the acquisition of the disease occurs early in life and that the disease is mostly related to a reactivation from a pulmonary site in immunocompromised hosts such as patients infected with human immunodeficiency virus. Clinical and radiological presentations of the disease are nonspecific and are more severe in immunocompromised hosts with acquired immunodeficiency syndrome (AIDS). However, fulminant forms have also been reported in apparently immunocompetent hosts. C. neoformans has rarely been responsible for colonization of the respiratory tract; this usually occurs in immunocompetent hosts with preexisting pulmonary disease. Diagnosis of pneumonia is obtained by either analysis of bronchoalveolar lavage in AIDS patients or by the histology/mycological analysis of a pulmonary nodule. In any case, a careful work-up for diagnosing dissemination should always be performed. Antifungal treatment has to be given in most of the immunocompetent hosts and always in those with any kind of immunodeficiency with isolated pulmonary cryptococcosis.

Journal Article↗

PubMed2002

New frontiers in CT imaging of airway disease.

Combining helical volumetric CT acquisition and thin-slice thickness during breath hold provides an accurate assessment of both focal and diffuse airway diseases. With multiple detector rows, compared with single-slice helical CT, multislice CT can cover a greater volume, during a simple breath hold, and with better longitudinal and in-plane spatial resolution and improved temporal resolution. The result in data set allows the generation of superior multiplanar and 3D images of the airways, including those obtained from techniques developed specifically for airway imaging, such as virtual bronchography and virtual bronchoscopy. Complementary CT evaluation at suspended or continuous full expiration is mandatory to detect air trapping that is a key finding for depicting an obstruction on the small airways. Indications for CT evaluation of the airways include: (a) detection of endobronchial lesions in patients with an unexplained hemoptysis; (b) evaluation of extent of tracheobronchial stenosis for planning treatment and follow-up; (c) detection of congenital airway anomalies revealed by hemoptysis or recurrent infection; (d) detection of postinfectious or postoperative airway fistula or dehiscence; and (e) diagnosis and assessment of extent of bronchiectasis and small airway disease. Improvement in image analysis technique and the use of spirometrically control of lung volume acquisition have made possible accurate and reproducible quantitative assessment of airway wall and lumen areas and lung density. This contributes to better insights in physiopathology of obstructive lung disease, particularly in chronic obstructive pulmonary disease and asthma.

Asthma↗

PubMed2001

Thin-section chest CT findings of primary Sjögren's syndrome: correlation with pulmonary function.

The purpose of this study was to describe thin-section CT findings of lung involvement in patients with primary Sjögren's syndrome (PSS), and to correlate them with pulmonary function tests (PFT). The chest thin-section CT examinations of 35 patients with proven diagnosis of PSS and respiratory symptoms were retrospectively assessed by two observers, in a first step independently with interobserver evaluation, and in a second step in consensus. The extent of the most frequent CT findings was scored. Correlation was made with PFT in 31 of these patients. Three main CT patterns were identified with good interobserver agreement (kappa coefficient 0.71): 19 of 35 (54%) large and/or small airways disease; 7 of 35 (20%) interstitial lung fibrosis (ILF); and 5 of 35 (14%) suggestive of lymphocytic interstitial pneumonia (LIP). The CT scans were normal in 2 patients (6%) and showed only dilatation of pulmonary vessels due to pulmonary arterial hypertension in two others (6%). Airway disease patients had predominantly obstructive profiles (mean FEV(1)/FVC ratio 69.7+/-12.7%, mean MEF(25) 50.1+/-22.9%), whereas patients with ILF and LIP had predominantly restrictive profiles and/or a decreased diffusing lung capacity (mean TLC 87.0+/-26.0 and 64.6+/-18.6%, mean DL(CO) 57.4+/-21.2 and 52.0+/-8.0%). Significant correlation ( p<0.01) was found between the scores of ground-glass attenuation and TLC ( r=-0.84) and DL(CO) ( r=-0.70) and between the score of air trapping and FEV1 ( r=-1.0). In patients with PSS and respiratory symptoms, thin-section CT may provide characterization of lung involvement which correlates with pulmonary function.

Adult↗