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Pleural Thickening and Pleural Calcification

Questions 1. What is the most likely diagnosis for the case illustrated in Fig. 5.1 ? a. Mesothelioma. b. Metastases. c. Empyema. d. Lung cancer. e. Lymphoma. 2. The large calcification in Fig. 5.2 is most probably caused by: a. Tuberculosis. b. Asbestosis. c. Mesothelioma. d. Empyema. e. Talcosis. 3. Which one of the following interstitial lung diseases is most likely to have associated plaques of…

Pleural Effusions

Questions 1. The most likely diagnosis in the case illustrated in Fig. 4.1 is: a. Necrotizing pneumonia with empyema. b. Tuberculosis. c. Lung cancer. d. Mesothelioma. e. Metastases. 2. The most likely diagnosis in the case illustrated in Fig. 4.2, A and B, is: a. Right lower-lobe pneumonia. b. Pulmonary embolism. c. Subphrenic abscess. d. Lymphoma. e. Diaphragmatic hernia. Discussion Pleural effusions may produce blunting of…

Pleural and Subpleural Opacities

Questions 1. Referring to Fig. 3.1, A-C , which of the following is the most likely diagnosis? a. Metastatic melanoma. b. Metastatic breast carcinoma. c. Invasive thymoma. d. Mesothelioma. e. Metastatic ovarian carcinoma. 2. Referring to Fig. 3.2, A and B , the most likely diagnosis for this case is: a. Rounded atelectasis. b. Localized fibrous tumor of the pleura. c. Multiple myeloma. d. Infarct. e.…

Chest Wall Lesions

Questions 1. The most likely diagnosis in the afebrile patient in Fig. 2.1 is: a. Neurofibroma. b. Lipoma. c. Multiple myeloma. d. Osteosarcoma. e. Chondrosarcoma. 2. The most likely diagnosis in Fig. 2.2 is: a. Ewing sarcoma. b. Osteosarcoma. c. Chondrosarcoma. d. Metastatic lung cancer. e. Plasmacytoma. Mark the following questions True or False: 3. _____ Chest wall lesions may sometimes be distinguished from pulmonary nodules…

Noncardiac Pathology

Eyes do not see what the mind does not know (Anonymous). Cardiovascular magnetic resonance (CMR) has been increasingly incorporated into clinical practice as a noninvasive method that offers superior structural and functional assessment of the heart, especially in patients presenting with complex cardiac pathology, congenital cardiac diseases and cardiomyopathies. Because CMR is a cross-sectional modality, it provides complementary information on noncardiac structures adjacent to the heart,…

Cardiac Positron Emission Tomography/Magnetic Resonance

For decades, cardiovascular magnetic resonance imaging (CMR) and positron emission tomography (PET) have been clinically established imaging modalities in cardiovascular medicine. For several years, a new multimodality imaging system, PET/magnetic resonance (MR), using sequential or even integrated scanner platforms has been available. This hybrid imaging technique is gradually being implemented into the clinical setting for cardiac imaging. Because of its unique capabilities, CMR has become a…

Cost-Effectiveness Analysis for Cardiovascular Magnetic Resonance Imaging

Explosive growth in medical imaging technology during the past few decades has provided physicians with an unparalleled ability to diagnose abnormalities of the cardiovascular system. However, in some cases, scientific enthusiasm and economic forces have helped diffuse new technologies widely without careful assessment of their costs and benefits to patient care. This growth in available imaging technologies has contributed to the continuous increase in health care…

Pediatric Interventional Cardiovascular Magnetic Resonance

The last two and a half decades have seen phenomenal advances made in the field of cardiovascular magnetic resonance (CMR), and these advances have supported research into interventional applications using CMR. Conventional x-ray fluoroscopically guided cardiac catheterization and interventions are associated with the risk of exposure to ionizing radiation for both patients and staff. This is particularly relevant in younger patients, who are often required to…

Interventional Cardiovascular Magnetic Resonance

An ideal imaging guidance system for cardiovascular, catheter-based interventional procedures would offer real-time, high-resolution, three-dimensional (3D) imaging of important anatomic tissues and chambers, irrespective of respiratory, cardiac, or patient motion alongside excellent visualization of catheters, guidewires, and other interventional devices. Such tools would quickly enable novel, minimally invasive alternatives to open surgical procedures. X-ray fluoroscopy guides most contemporary catheter-based procedures. However, fluoroscopy has important limitations (…

The Pericardium: Anatomy and Spectrum of Disease

The pericardium is an important structure in the evaluation of patients with cardiovascular disease. Understanding pericardial anatomy and the complex hemodynamics associated with pericardial pathology is critical in assessing the pericardium and its impact on cardiovascular function. Unfortunately, clinical evaluation through history and physical examination, clinical laboratory tests, and electrocardiograms (ECG) may be nonspecific and overlap with other clinical syndromes in patients with pericardial disease. Advanced…

Pulmonary Artery

Pathologies involving the pulmonary arterial system include pulmonary embolus (PE), pulmonary arterial hypertension (PAH), congenital anomalies, and pulmonary artery tumors. These diseases present a unique clinical diagnostic challenge often requiring multiple diagnostic examinations spanning the entire radiologic armamentarium. Initially, cardiovascular magnetic resonance (CMR) played only a minor role in evaluation of the pulmonary arterial system. However, with the advent of improved, high-performance gradients and bolus gadolinium,…

Cardiovascular Magnetic Resonance Angiography : Carotids, Aorta, and Peripheral Vessels

Magnetic resonance angiography (MRA) is an important imaging modality for the diagnosis, clinical workup, and treatment planning in patients suspected of a wide range of vascular pathology. The aim of MRA is to visualize the arterial and/or venous system by creating high contrast between the blood flow and its surrounding stationary tissue. To fulfill this aim, several techniques may be used in clinical practice. Depending on…

Thoracic Aortic Disease

The anatomic and functional characteristics of the aorta, which may at first glance appear relatively straightforward, are now recognized to be complex. Recent insights from both modern imaging technology and better understanding of the hydraulic principles associated with the variety of aortic diseases have helped the medical community to realize the multiple facets of in vivo aortic pathology, as well as its varied clinical presentation. Diagnostic…

Pulmonary Vein and Left Atrial Imaging

The development of radiofrequency ablation for the treatment of atrial fibrillation has led to an increased interest in the accurate determination of pulmonary vein anatomy and left atrial fibrosis assessment to help plan the procedure and to monitor for postablation pulmonary vein stenosis. Contrast-enhanced magnetic resonance angiography (CE-MRA) readily demonstrates the pulmonary veins and is the method of choice for these imaging studies. In this chapter,…

Simple and Complex Congenital Heart Disease: Adults

The number of adults with congenital heart disease living in the United States is estimated to be at least 1.4 million, and at least 300,000 of these people have complex forms of congenital heart disease. The majority of these patients have undergone surgical repairs in childhood, and lifelong follow-up is recommended. Many adults with congenital heart disease do not recognize subtle changes in exercise capacity and…

Simple and Complex Congenital Heart Disease: Infants and Children

The role of cardiovascular magnetic resonance (CMR) in the evaluation of infants and children with congenital heart disease is now widely accepted as a result of ongoing technologic advances and the growing realization of its clinical value. Improvements in CMR hardware and the development of new, highly efficient/faster imaging methods, have allowed for sufficient spatial and temporal resolution to comprehensively evaluate the complex cardiac anatomy and…