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        “Crazy-Paving” Patterns on High-Resolution CT Scans in Patients with Pulmonary Complications after Hematopoietic Stem Cell Transplantation

        Edson Marchiori,Taisa Davaus Gasparetto,Daniela Peixoto Considera,Dante L. Escuissato,Tomas Franquet 대한영상의학회 2009 Korean Journal of Radiology Vol.10 No.1

        Objective: To describe the pulmonary complications following hematopoietic stem cell transplantation (HSCT) that can present with a “crazy-paving” pattern in high-resolution CT scans. Materials and Methods: Retrospective review of medical records from 2,537 patients who underwent HSCT. The “crazy-paving” pattern consists of interlobular and intralobular septal thickening superimposed on an area of ground-glass attenuation on high-resolution CT scans. The CT scans were retrospectively reviewed by two radiologists, who reached final decisions by consensus. Results: We identified 10 cases (2.02%), seven male and three female, with pulmonary complications following HSCT that presented with the “crazy-paving” pattern. Seven (70%) patients had infectious pneumonia (adenovirus, herpes simplex, influenza virus, cytomegalovirus, respiratory syncytial virus, and toxoplasmosis), and three patients presented with non-infectious complications (idiopathic pneumonia syndrome and acute pulmonary edema). The “crazy-paving” pattern was bilateral in all cases, with diffuse distribution in nine patients (90%), predominantly in the middle and inferior lung regions in seven patients (70%), and involving the anterior and posterior regions of the lungs in nine patients (90%). Conclusion: The “crazy-paving” pattern is rare in HSCT recipients with pulmonary complications and is associated with infectious complications more commonly than non-infectious conditions. Objective: To describe the pulmonary complications following hematopoietic stem cell transplantation (HSCT) that can present with a “crazy-paving” pattern in high-resolution CT scans. Materials and Methods: Retrospective review of medical records from 2,537 patients who underwent HSCT. The “crazy-paving” pattern consists of interlobular and intralobular septal thickening superimposed on an area of ground-glass attenuation on high-resolution CT scans. The CT scans were retrospectively reviewed by two radiologists, who reached final decisions by consensus. Results: We identified 10 cases (2.02%), seven male and three female, with pulmonary complications following HSCT that presented with the “crazy-paving” pattern. Seven (70%) patients had infectious pneumonia (adenovirus, herpes simplex, influenza virus, cytomegalovirus, respiratory syncytial virus, and toxoplasmosis), and three patients presented with non-infectious complications (idiopathic pneumonia syndrome and acute pulmonary edema). The “crazy-paving” pattern was bilateral in all cases, with diffuse distribution in nine patients (90%), predominantly in the middle and inferior lung regions in seven patients (70%), and involving the anterior and posterior regions of the lungs in nine patients (90%). Conclusion: The “crazy-paving” pattern is rare in HSCT recipients with pulmonary complications and is associated with infectious complications more commonly than non-infectious conditions.

      • KCI등재

        Reconstruction Algorithms Infl uence the Follow-Up Variability in the Longitudinal CT Emphysema Index Measurements

        Bruno Hochhegger,Klaus Loureiro Irion,Edson Marchiori,Jose Silva Moreira 대한영상의학회 2011 Korean Journal of Radiology Vol.12 No.2

        Objective: We wanted to compare the variability in the longitudinal emphysema index (EI) measurements that were computed with standard and high resolution (HR) reconstruction algorithms (RAs). Materials and Methods: We performed a retrospective review of 475 patients who underwent CT for surveillance of lung nodules. From this cohort, 50 patients (28 male) were included in the study. For these patients, the baseline and followup scans were acquired on the same multidetector CT scanner and using the same acquisition protocol. The CT scans were reconstructed with HR and standard RAs. We determined the difference in the EI between CT1 and CT2 for the HR and standard RAs, and we compared the variance of these differences. Results: The mean of the variation of the total lung volume was 0.14 L (standard deviation [SD] = 0.13 L) for the standard RA and 0.16 L (SD = 0.15 L) for the HR RA. These differences were not signifi cant. For the standard RA, the mean variation was 0.13% (SD = 0.44%) for EI -970 and 0.4% (SD = 0.88%) for EI -950; for the HR RA, the mean variation was 1.9% (SD = 2.2%) for EI -970 and 3.6% (SD = 3.7%) for EI -950. These differences were signifi cant. Conclusion: Using an HR RA appears to increase the variability of the CT measurements of the EI.

      • KCI등재

        Non-Infectious Granulomatous Lung Disease: Imaging Findings with Pathologic Correlation

        Tomás Franquet,Teri J. Franks,Jeffrey R. Galvin,Marchiori Edson,Giménez Ana,Mazzini Sandra,Johkoh Takeshi,Kyung Soo Lee 대한영상의학회 2021 Korean Journal of Radiology Vol.22 No.8

        Non-infectious granulomatous lung disease represents a diverse group of disorders characterized by pulmonary opacities associated with granulomatous inflammation, a relatively nonspecific finding commonly encountered by pathologists. Some lesions may present a diagnostic challenge because of nonspecific imaging features; however, recognition of the various imaging manifestations of these disorders in conjunction with patients’ clinical history, such as age, symptom onset and duration, immune status, and presence of asthma or cutaneous lesions, is imperative for narrowing the differential diagnosis and determining appropriate management of this rare group of disorders. In this pictorial review, we describe the pathologic findings of various non-infectious granulomatous lung diseases as well as the radiologic features and high-resolution computed tomography imaging features.

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