Clinically Oriented Pulmonary Imaging

309 Pages·2012·11.262 MB·English

by  Arlene Sirajuddin (auth.), Jeffrey P. Kanne (eds.)

Respiratory Medicine
Series Editor
Sharon I. S. Rounds
For furthervolumes:
http://www.springer.com/series/7665
Jeffrey P. Kanne
Editor
Clinically Oriented
Pulmonary Imaging
123
Jeffrey P.Kanne
Department of Radiology
Universityof Wisconsin
School ofMedicine and Public Health
600HighlandAve.
Madison, WI53792
USA
e-mail: [email protected]
ISBN 978-1-61779-541-1 e-ISBN978-1-61779-542-8
DOI 10.1007/978-1-61779-542-8
SpringerNewYorkDordrechtHeidelbergLondon
LibraryofCongressControlNumber:2011943358
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To Drs. J. David Godwin, Eric J. Stern, Julie E. Takasugi,
John R. Mayo, and Nestor L. Mu¨ller, all of whom mentored
meandtaughtmetorecognizethebeautyhidingbeneathallof
the ‘‘white stuff’’ in the lungs.
Preface
Imaging is central to the diagnosis and management of patients with
known or suspected pulmonary disease. Advances in imaging technol-
ogy, particularly computerized tomography (CT), have broadened our
understandingofpulmonarydiseaseandhavechangedhowwecarefor
our patients.
Chest radiography remains the most commonly performed medical
imaging examination because it is widely available, relatively inexpen-
sive,usesverylowdosesofionizingradiation,andoftencananswerthe
clinical question at hand. Radiography has been enhanced by the
transition from film-screen to digital imaging and the subsequent elec-
tronicdistributionofimagesandradiologicreports.Newertechnologies
such as dual-energy radiography and computer-aided detection (CAD)
can further enhance the utility of radiography.
The impact that CT has had on our understanding of pulmonary
diseasecannotbesummarizedinthisbriefintroduction.CThasbecome
a standard component of assessing respiratory tract disease. With cur-
rentscannertechnology,volumetrichigh-resolutionCT(HRCT)images
can readily be generated from routine chest CT scans at the time of
imagingwithlittleornochangeinacquisitionparameters.Infact,some
institutions,suchasmine,routinelygeneratethin-sectionimageswithall
chestCTscansperformed.CTpulmonaryangiographyhaschangedthe
paradigm for evaluating patients with suspected pulmonary thrombo-
embolic disease, providing more definitive diagnosis and frequently
identifying other causes of patients’ presenting signs and symptoms.
CT is also used to guide transthoracic needle biopsies.
The utility of magnetic resonance (MR) imaging for pulmonary
disease has been relatively limited not only because of technical limi-
tations but also because of overshadowing by the rapid growth in CT
technology and applications. However, MR imaging techniques cur-
rently under development show promise for evaluation of the lungs.
Furthermore, the ability to integrate cardiac and pulmonary imaging
withasingleMRimagingexaminationhasthepotentialtorevolutionize
how we think about the intimate relationship between the heart and
lungs.
While we can expect many exciting developments in pulmonary
imaginginthefuture,onestillneedstounderstandhowimagingavailable
vii
viii Preface
todayfitsintotheevaluationofourpatients.Thistextaimstoprovidea
clinically oriented approach to imaging the lungs and is by no means a
comprehensive thoracic imaging text. Rather, the authors focus on
specific clinical problems such as pulmonary thromboembolic disease,
hemoptysis, or lung cancer, and they discuss the utility of imaging in
addition to illustrating the imaging findings commonly encountered. It
ismyhopethatthenovicereaderwillfindthistextausefulintroduction
to how imaging fits into the evaluation of patients with known or sus-
pected pulmonary disease. Additionally, more experienced readers may
benefit from the focused approach to specific clinical problems or
patient care settings and better understand the imaging tools available
to improve care for their patients.
October 2011 Jeffrey P. Kanne
Acknowledgments
I would first like to acknowledge Linda Jacobs, my developmental
editor at Springer, who kept this project organized and on schedule.
Lindaensuredthateverypieceofthepuzzlewasinplacethroughoutthe
entireprocess.Second,thisbookwouldnotexistwithoutthehardwork
and dedication from the contributing authors. Finally, I would like to
thank my thoracic imaging colleagues at the University of Wisconsin
SchoolofMedicineandPublicHealthfortheirneverwaningsupportof
me during my work on this project.
ix
Contents
1 Normal Thoracic Anatomy and Common Variants . . . . . . 1
Arlene Sirajuddin
2 Management of Solitary Pulmonary Nodules. . . . . . . . . . . 19
Maria C. Shiau, Elie Portnoy and Stuart M. Garay
3 Lung Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Todd R. Hazelton and Frank W. Walsh
4 Pulmonary Infections in the Normal Host. . . . . . . . . . . . . 41
Loren Ketai and Helen Katrina Busby
5 PulmonaryInfectionsintheImmunocompromisedHost . . . 61
Jean W. Kuriakose and Barry H. Gross
6 Pleural Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
A. Keith Rastogi and Jeffrey P. Kanne
7 Pulmonary Thromboembolic Disease. . . . . . . . . . . . . . . . . 89
Amie J. Tucker, Gopal Allada and Steven L. Primack
8 Non-Thrombotic Vascular Diseases of the Chest . . . . . . . . 105
Elena Peña, Carole Dennie and George Chandy
9 Imaging of Pulmonary Hypertension. . . . . . . . . . . . . . . . . 139
Mark L. Schiebler, James Runo, Leif Jensen
and Christopher J. François
10 Obstructive Pulmonary Diseases. . . . . . . . . . . . . . . . . . . . 161
Megan Saettele, Timothy Saettele and Jonathan Chung
11 Imaging of Airway Disease. . . . . . . . . . . . . . . . . . . . . . . . 179
Shailaja J. Hayden and Sudhakar N. J. Pipavath
12 Idiopathic Interstitial Pneumonias. . . . . . . . . . . . . . . . . . . 195
Paul J. Lee and Jeffrey P. Kanne
xi
xii Contents
13 Occupational Lung Disease. . . . . . . . . . . . . . . . . . . . . . . . 209
Cris A. Meyer and James E. Lockey
14 Hemoptysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229
Kristie M. Guite, Trina J. Hollatz and Jeffrey P. Kanne
15 Non-AIDS Immunologic Diseases . . . . . . . . . . . . . . . . . . . 247
Stephen A. Quinet and Jeffrey P. Kanne
16 The Critically III Patient . . . . . . . . . . . . . . . . . . . . . . . . . 263
Jie C. Nguyen and Jeffrey P. Kanne
17 Image Guided Thoracic Interventions. . . . . . . . . . . . . . . . 281
Daniel Barnes, Kayvan Amjadi and Jean M. Seely
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 297