Related Articles

Lung Ultrasound in Community-Acquired Pneumonia and in Interstitial Lung Diseases.

Respiration. 2014 Jan 28;

Authors: Reissig A, Copetti R

Abstract
Lung ultrasound (LUS) is an accurate tool for the diagnosis and follow-up of pneumonia in adults as well as in children. LUS is at least as accurate as chest radiography in diagnosing pneumonia. The most important parenchymal criterion is the positive air bronchogram within an echopoor area. Among pleural criteria, basal effusion was most often detected. The presence of multiple diffuse bilateral B-lines on lung examination indicates the interstitial syndrome (IS). For further differential diagnosis, an integrated consideration of history, clinical examination, LUS and echocardiography should be performed. LUS is an excellent tool for IS screening. Repeated LUS control examinations may reflect the dynamics of IS under therapy and so LUS may serve as a therapy guide. © 2014 S. Karger AG, Basel.

PMID: 24481027 [PubMed - as supplied by publisher]

Related Articles

New applications of magnetic resonance imaging for thoracic oncology.

Semin Respir Crit Care Med. 2014 Feb;35(1):27-40

Authors: Ohno Y

Abstract
Since the clinical introduction of magnetic resonance imaging (MRI), the chest has been one of its most challenging applications, and since the 1980s many physicists and radiologists have been trying to evaluate images for various lung diseases as well as mediastinal and pleural diseases. However, thoracic MRI could not yield image quality sufficient for a convincing diagnosis within an acceptable examination time, so MRI did not find acceptance as a substitute for computed tomography (CT) and other modalities. Until the 2000, thoracic MRI was generally used only for select, minor clinical indications. Within the past decade, however, technical advances in sequencing, scanners and coils, adaptation of parallel imaging techniques, utilization of contrast media, and development of postprocessing tools have been developed. In addition, pulmonary functional MRI has been extensively researched, and MR is being assessed as a new research and diagnostic tool for pulmonary diseases. State-of-the art thoracic MRI now has the potential as a substitute for traditional imaging techniques and/or to play a complimentary role in patient management. In this review, we focus on these advances in MRI for thoracic oncologic imaging, especially for pulmonary nodule assessment, lung cancer staging, mediastinal tumor diagnosis and malignant mesothelioma evaluation, prediction of postoperative lung function, and prediction or evaluation of therapeutic effectiveness. We also discuss the potential and limitations of these advances for routine clinical practice in comparison with other modalities such as CT, positron emission tomography (PET), PET/CT, or nuclear medicine studies.

PMID: 24481757 [PubMed - in process]

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High-Resolution CT of Interstitial Lung Disease: A Continuous Evolution.

Semin Respir Crit Care Med. 2014 Feb;35(1):129-44

Authors: Walsh SL, Hansell DM

Abstract
Before the advent of high-resolution computed tomography (HRCT), the role of imaging, chest radiography in particular, in the management of patients with interstitial lung disease was limited. In the past 25 years, this has radically changed. HRCT has transformed the diagnostic landscape by providing detailed cross-sectional imaging of the lungs, which permit ready identification of a variety of different interstitial lung diseases. Although the position of HRCT as the dominant imaging technique for interstitial lung disease has remained unchallenged since its introduction in the late 1980s, the roles assumed by HRCT have undergone a steady evolution. This evolution has occurred in stages. The first investigations of HRCT in interstitial lung disease during the late 1980s and early 1990s marked a golden era of HRCT-pathologic correlative studies, typified by the work of Müller and Miller. It was this groundbreaking work that defined basic HRCT patterns, correlated to histopathologic appearances, which underpin the pattern recognition approach used to interpret HRCT images to this day. Subsequently, attention turned to issues of disease reversibility and responsiveness and how this could be predicted by HRCT. At the turn of the millennium, the previously long accepted belief in histopathological diagnosis as the reference standard in interstitial lung disease gave way to a growing perception that histopathology was not infallible. This change in diagnostic thinking arguably has had the biggest impact on how HRCT's role subsequently evolved. Recently, HRCT data have been integrated with pulmonary function in staging models to predict prognosis particularly in idiopathic fibrosing lung disease. This article reviews these stages of evolution. The emergence of the multidisciplinary approach to diagnosis will also be considered.

PMID: 24481766 [PubMed - in process]

Pulmonary Langerhans cell histiocytosis (PLCH): a new UK register.

Thorax. 2014 Jan 30;

Authors: Mason RH, Foley NM, Branley HM, Adamali HI, Hetzel M, Maher TM, Suntharalingam J

Abstract
Pulmonary Langerhans cell histiocytosis (PLCH) is a rare interstitial lung disease of unknown aetiology. We aimed to characterise a UK-wide cohort of patients with PLCH and compare diagnostic and management methods in specialist and non-specialist centres. 106 cases (53 hospitals) identified. Complete data received in 67 cases (53.7% female, age 37.1±14.4 years). 96% current or ex-smokers. Treatment; smoking cessation (79%), corticosteroids (30.6%), cytotoxic therapy (26.9%) and lung transplant (6%). Patients at specialist centres received cytotoxic drugs more often (p=0.0001) and survival appeared higher. This dataset indicates a more even gender distribution than previously documented. It suggests variation in clinical management and outcomes achieved dependent on clinical experience.

PMID: 24482091 [PubMed - as supplied by publisher]