A pictorial review of “signs in thoracic imaging 01”
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Transcript of A pictorial review of “signs in thoracic imaging 01”
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A Pictorial Review of “Signs in Thoracic Imaging”Part 01
Dr Mazen QusaibatyMD, DIS
Head Pulmonary and Internist Department Ibnalnafisse Hospital
Ministry of Syrian healthEmail:
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Topic Outline
1. Air bronchogram sign2. Air crescent sign
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Air bronchogram signالهوائي القصبي االرتسام عالمة
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Air bronchogram signالهوائي القصبي االرتسام عالمة
على • القدرة هيالحدود مشاهدة
ضمن القصبيةالرئوي المتن
بحديثة المصابتقيحية مرضية ) وذمية) أو قيح
) ماء) •. الرئة ذات
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Air bronchogram sign
RUL Consolidation Sterp Pneumonia
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Air bronchogram sign Pneumococcal pneumonia
• Consolidation with multiple air bronchograms ( black
branching structures) in the:A. RULB. RMLC. RLL
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Air bronchogram sign Pneumococcal pneumonia
• Consolidation with multiple air bronchograms in the:A. Segment anterior
of RULB. RMLC. RLL
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Air bronchogram sign
Diffuse Alveolar Hemorrhage
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Air bronchogram sign
Acute eosinophilic pneumonia
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Air Bronchogram Sign
DD:PneumoniaLymphoma Bronchoalveolar cell carcinoma.
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Conclusion: Air bronchogram
Indicates a parenchymal process
Including non-obstructive atelectasis
Distinguished from pleural or mediastinal processes
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Air crescent signالغازي الهالل عالمة
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Crescent-shaped area of air within:
Nodule
Mass
Consolidation
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Air crescent sign results most commonly from mycetoma (fungus ball) within:
• Pulmonary cavity• Ectatic bronchus
• Angioinvasive aspergillosis in patients with severe neutropenia
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Air crescent signالغازي الهالل عالمة
The air surrounding a radio opaque material
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Air crescent signالغازي الهالل عالمة
In a crescentric manner along both its inner and outer margins indicating cavitary disease
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Air crescent signالغازي الهالل عالمة
Aspergilloma in an old TB cavity
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o The arrows denote an ill-defined nodular opacity in medial aspect of right upper lobe with ill-defined rim of lucency surrounding it.
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Invasive aspergillosis in a 6-year-old girl with neutropenia and acute
lymphocytic leukemia19
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Frontal chest radiograph shows two air crescent signs (arrowheads)
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Chest roentgenogram PA view
Rightpneumothorax
Mycetoma with air-crescent sign
The tip ofintercostal drain is also visible near the base.
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Computed tomogram of the thorax
Various viewsof the mycetoma
Rupture into the pleural cavity leading to pneumothorax22
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Coronal reformation imageIntracavitary aspergilloma (*) in the left upper lobe
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Air crescent –shaped surrounding oval opacity within cavity
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• Subpleural honeycombing in the lower lobes consistent with idiopathic pulmonary fibrosis.
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What is your diagnosis?
The patient was a 58-year-old man with previous tuberculosis and intracavitary aspergilloma
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Sagittal reformat from a CT scan of the chest
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• A 14 year-old female with acute myeloblastic leukaemia
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Where is located this lesion?
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A. Left LungB. Right Lung
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Where is located this lesion?
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A. Left LungB. Apical segment of
Right Upper Lobe in lateral position
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Correct description
A Mycetoma with air-crescent sign located in apical segment of right upper lobe in lateral position
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Air crescent sign in anterior segment of right upper lobeAspergilloma
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PA Projection radiograph
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• Patchy airspace disease with areas of lucency suggestive of cavitation in the right upper lobe.
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PA Projection radiograph
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• Emphysematous changes are seen bilaterally.
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Chest CT scan
Air crescent sign within the consolidated right upper lobe.
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Chest CT scan
Paraseptal emphysema
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Chest CT scanA cavity with an intracavitary mass within the consolidated right upper lobe
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Conclusion: Air crescent sign
• indicates a lung cavity, often due to fungal infection