Wk 4, Case 32 - Review

EXAM: CT Chest w/ Contrast
CLINICAL INDICATION: PE Protocol;Acute shortness of breath, history of asthma.
TECHNIQUE: Written informed consent was obtained. Non-gated spiral axial images of the chest were obtained with nonionic intravenous contrast according to a pulmonary embolism protocol. There were no immediate complications reported.
FINDINGS:
PULMONARY ARTERIES:
Diagnostic to the level of the subsegmental pulmonary arteries. No pulmonary emboli are identified.
MEDIASTINUM/HEART/VESSELS:
Heart size normal, no pericardial effusion. No evidence of right heart dysfunction. No enlarged thoracic lymph nodes by CT size criteria. The aorta is normal in course and caliber, without thoracic aortic dissection.
AIRWAY/LUNGS/PLEURA:
Patchy ground glass opacities within all lobes the lungs, with a shifting distribution compared to prior examination, with some areas of new ground glass opacity, and improvement in other areas of ground glass opacity likely representing infection, such as a viral pneumonia. Diffuse bronchial wall thickening. No septal thickening or pleural effusions to suggest pulmonary edema.
VISIBLE ABDOMEN:
Images of the upper abdomen show no significant abnormality.
SOFT TISSUES/BONES:
Visualized bones are unremarkable.
IMPRESSION:
1. No pulmonary emboli.
2. Patchy ground glass opacities, most of which are bronchocentric, within all lobes of the lungs, with small amount of consolidation within the right middle lobe. These findings likely represent infection such as viral, atypical community acquired pneumonia such as mycoplasma, or other etiology of pneumonia.
3. Mild hilar lymph node enlargement, likely reactive in etiology.
4. Diffuse bronchial wall thickening, which can be seen in infectious bronchitis, and asthma.