Skip to main content
SpringerLink
Log in

CT of Acute Pulmonary Disease: Infection, Infarction, and Trauma

  • Chapter
Pediatric Chest Imaging

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Abstract

Chest radiography is the primary means of imaging acute lung disease. Chest radiography is inexpensive, easy to obtain, rapidly processed, low in radiation dose, and available on a ubiquitous basis. However, there are a number of scenarios in which CT is playing an increasing role in evaluating acute lung disease. Because CT of the lung can be performed with tube currents as low as 40 mAs, high quality images can be obtained while minimizing radiation dose. Acute pulmonary processes can be related to infection, trauma, or infarction. Helical CT is playing an increasing role in the evaluation for pulmonary embolism and lung infarction in adults. This article will review the roles of and findings seen with CT imaging of pulmonary infection, suspected embolism, and trauma.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 299.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Alario AJ, McCarthy PL, Markowitz R, Kornguth P, Rosenfield N, Leventhal JM (1987) Usefulness of chest radiographs in children with acute lower respiratory tract disease. J Pediatr 111:187–193

    Article  CAS  PubMed  Google Scholar 

  • Baber CD, Hedlund LW, Oddson TA, Putman CE (1980) Differentiating empyemas and peripheral pulmonary abscess. The value of computed tomography. Radiology 135:755–758

    CAS  PubMed  Google Scholar 

  • Bettenay FAL, de Campo JF, McCrossin DB (1988) Differentiating bacterial from viral pneumonias in children. Pediatr Radiol 18:453–454

    Article  CAS  PubMed  Google Scholar 

  • Bouros D, Schiza S, Panagou P, Drositis J, Siafakas N (1994) Role of streptokinase in the treatment of acute loculated parapneumonic pleural effusions and empyema. Thorax 49:852–855

    Article  CAS  PubMed  Google Scholar 

  • Brown MJ, Miller RR, Muller NL (1994) Acute lung disease in the immunocompromised host: CT and pathologic examination findings. Radiology 190:247–254

    CAS  PubMed  Google Scholar 

  • Condon VR (1991) Pneumonia in children. J Thorac Imaging 6:31–44

    Article  CAS  PubMed  Google Scholar 

  • Conte P, Heitzman ER, Markarian B (1970) Viral pneumonia. Radiology 95:267–272

    CAS  PubMed  Google Scholar 

  • Danner PK, McFarland DR, Felson B (1968) Massive pulmonary gangrene. AJR Am J Roentgenol 103:548–554

    CAS  Google Scholar 

  • Donnelly LF (1999) Maximizing the usefulness of imaging in children with community-acquired pneumonia. AJR Am J Roentgenol 172:505–512

    CAS  PubMed  Google Scholar 

  • Donnelly LF, Klosterman LA (1997a) CT appearance of parapneumonic effusions in children: findings are not specific for empyema. AJR Am J Roentgenol;169:179–182

    CAS  PubMed  Google Scholar 

  • Donnelly LF, Klosterman LA (1997b) Pneumonia in children: decreased parenchymal contrast enhancement — CT sign of intense illness and impending cavitary necrosis. Radiology 205:817–820

    CAS  PubMed  Google Scholar 

  • Donnelly LF, Klosterman LA (1997c) Subpleural sparing: a CT finding of lung contusion in children. Radiololgy 204:385–387

    CAS  Google Scholar 

  • Donnelly LF, Klosterman LA (1998a) Cavitary necrosis complicating pneumonia in children: sequential findings on chest radiography. AJR Am J Roentgenol 171:253–256

    CAS  PubMed  Google Scholar 

  • Donnelly LF, Klosterman LA (1998b) The yield of CT of children who have complicated pneumonia and noncontributory chest radiography. AJR Am J Roentgenol 170:1627–1631

    CAS  PubMed  Google Scholar 

  • Donnelly LF, Kimball TR, Barr LL (1999) Purulent pericarditis presenting as acute abdomen in children: abdominal imaging findings. Clin Radiol 54:691–693

    Article  CAS  PubMed  Google Scholar 

  • Eichelberger MR, Randolph JG (1981) Thoracic trauma in children. Surg Clin North Am 61:1181

    CAS  PubMed  Google Scholar 

  • Eichelberger MR, Mangubat EA, Sacco WJ, Bowman LM, Lowenstein AD (1988) Outcome analysis of blunt injury in children. J Trauma 28:1109–1115

    Article  CAS  PubMed  Google Scholar 

  • Frush DP, Donnelly LF (1997) Pulmonary sequestration spectrum: a new spin with helical CT. AJR Am J Roentgenol 169:679–682

    CAS  PubMed  Google Scholar 

  • Garg K (2005) Acute pulmonary embolism (helical CT). In: eMedicine for WebMD. http://www.emedicine.com/radio/topic582/htm. Updated 6/9/05. Cited 1/3/07

    Google Scholar 

  • Grossman LK, Caplan SE (1988) Clinical, laboratory, and radiographic information in the diagnosis of pneumonia in children. Ann Emerg Med 17:43–46

    Article  CAS  PubMed  Google Scholar 

  • Gutman E, Pongdee O, Park YS (1973) Massive pulmonary gangrene. Radiology 107:293–294

    CAS  PubMed  Google Scholar 

  • Harvey-Smith W, Bush W, Northrop C (1980) Traumatic bronchial rupture. AJR Am J Roentgenol 134:1189–1193

    CAS  PubMed  Google Scholar 

  • Hedlund GL, Griscom NT, Cleveland RH, Kirks DR (1997) Respiratory system. In: Kirks DR (ed) Practical pediatric imaging, 3rd edn. Little, Brown, and Company, Boston, pp 619–821

    Google Scholar 

  • Himelman RB, Callen PW (1986) The prognostic valve of loculations in parapneumonic pleural effusion. Chest 90:852–856

    Article  CAS  PubMed  Google Scholar 

  • Isaacs RD (1986) Necrotizing pneumonia in bacteremic pneumococcal infection. Br J Dis Chest 80:295–296

    Article  CAS  PubMed  Google Scholar 

  • Kang EY, Patz EF, Muller NL (1996) Cytomegalovirus pneumonia in transplant patients: CT findings. J Comput Assist Tomogr 20:295–299

    Article  CAS  PubMed  Google Scholar 

  • Kerem E, Bar BZ, Rudenski A, Katz S, Kleid D, Branski D (1994) Bacteremia necrotizing pneumococcal pneumonia in children. Am J Respir Crit Care Med 149:242–244

    CAS  PubMed  Google Scholar 

  • Kern JA, Rogers BM (1993) Thoracoscopy in the management of empyema in children. J Pediatr Surg 23:1128–1132

    Article  Google Scholar 

  • Kirsh MM, Pellegrini RV, Sloan HE (1972) Treatment of blunt chest trauma. Surg Ann 4:51–90

    CAS  Google Scholar 

  • Knight L, Fraser RG, Robson HG (1975) Massive pulmonary gangrene: a severe complication of Klebsiella pneumonia. Can Med Assoc J 112:196–198

    CAS  PubMed  Google Scholar 

  • Leventhal JM (1982) Clinical predictors of pneumonia as a guide to ordering chest roentgenograms. Clin Pediatr 21:730–734

    Article  CAS  Google Scholar 

  • Light RW (1985) Parapneumonic effusions and empyema. Clin Chest Med 6:55–62

    CAS  PubMed  Google Scholar 

  • Light RW (1995) A new classification of parapneumoic effusions and empyema. Chest 108:229–301

    Article  Google Scholar 

  • Mahboubi S, O’Hara AE (1981) Bronchial rupture in children following blunt chest trauma. Report of five cases with emphasis on radiologic findings. Pediatr Radiol 10:133–138

    Article  CAS  PubMed  Google Scholar 

  • Manson D, Babyn PS, Palder S, Bergman K (1993) CT of blunt chest trauma in children. Pediat Radiol 23:1–5

    Article  CAS  PubMed  Google Scholar 

  • Marks MJ, Haney PJ, McDermott MP, White CS, Vennos AD (1996) Thoracic diseases in children with AIDS. Radio-Graphics 1349–1362

    Google Scholar 

  • McAdams HP, Rosado-de-Christenson ML, Templeton PA, Lesar M, Moran CA (1995) RadioGraphics 15:271–286

    CAS  PubMed  Google Scholar 

  • Mori M, Galvin JR, Barloon TJ, Gingrich RD, Stanford W (1991) Fungal pulmonary infections after bone marrow transplantation: evaluation with radiography and CT. Radiology 178:721–726

    CAS  PubMed  Google Scholar 

  • Moulton JS, Benkert RE, Weisiger KH, Chambers JA (1995) Treatment of complicated pleural fluid collections with image-guided drainage and intracavitary urokinase. Chest 108:1252–1259

    Article  CAS  PubMed  Google Scholar 

  • Muller NL (1993) Imaging of the pleura. Radiology 186:297–309

    CAS  PubMed  Google Scholar 

  • Naidich DP, Zerhouni EA, Siegelman SS (1991) Computed tomography and magnetic resonance of the thorax, 2nd edn. Raven, New York, pp 423–426

    Google Scholar 

  • O’Reilly GV, Dee PM, Otteni GV (1978) Gangrene of the lung: successful medical management of three patients. Radiology 126:575–579

    PubMed  Google Scholar 

  • Osborne D (1978) Radiologic appearance of viral disease of the lower respiratory tract in infants and children. AJR Am J Roentgenol 130:29–33

    CAS  PubMed  Google Scholar 

  • Peter G (1988) The child with pneumonia: diagnostic and therapeutic considerations. Pediatr Infect Dis J 7:453–456

    CAS  PubMed  Google Scholar 

  • Pugatch RD, Sprin PW (1985) Radiology of the pleura. Clin Chest Med 6:17–32

    CAS  PubMed  Google Scholar 

  • Ramnath RR, Heller RM, Ben-Ami T, Miller MA et al. (1998) Implications of early sonographic evaluation of parapneumonic effusions in children with pneumonia. Pediatrics 101:68–71

    Article  CAS  PubMed  Google Scholar 

  • Rosen H, Nadkarni V, Theroux M, Padman R, Klein J (1993) Intrapleural streptokinase as adjunctive treatment for persistent empyema in pediatric patients. Chest 103:1190–1193

    Article  CAS  PubMed  Google Scholar 

  • Schoepf UJ, Costello P (2004) CT angiography for diagnosis of pulmonary embolism: state of the art. Radiology 230:329–337

    Article  PubMed  Google Scholar 

  • Shackford SR (1987) Blunt chest trauma: the intensivist’s perspective. J Intensive Care Med 1:125–136

    Article  Google Scholar 

  • Silen ML, Weber TR (1995) Thoraccoscopic debridement of loculated empyema thoracis in children. Ann Thorac Surg 59:1166–1168

    Article  CAS  PubMed  Google Scholar 

  • Sivit CJ, Taylor GA, Eichelberger MR (1989a) Chest injury in children with blunt abdominal trauma: evaluation with CT. Radiology 171:815–818

    CAS  PubMed  Google Scholar 

  • Sivit CJ, Taylor GA, Eichelberger MR (1989b) Visceral injury in battered children: a changing perspective. Radiology 173:659–661

    CAS  PubMed  Google Scholar 

  • Stark DD, Federle MP, Goodman PC, Podrasky AE, Webb WR (1983) Differentiating Lund abscess and empyema: radiography and computed tomography. AJR Am J Roentgenol 141:163–167

    CAS  PubMed  Google Scholar 

  • Stern EJ, Sun H, Haramati LB (1996) Peripheral bronchopleural fistulas: CT imaging features AJR Am J Roentgenol 167:117–120

    CAS  PubMed  Google Scholar 

  • Strovroff M, Teaque G, Heiss KF, Parker P, Ricketts RR (1995) Thoracoscopy in the management of pediatric empyema. J Pediatr Surg 30:1211–1215

    Article  Google Scholar 

  • Swischuk LE, Hayden CK Jr (1986) Viral vs. bacterial pulmonary infections in children (is roentgenographic differentiation possible?) Pediatr Radiol 16:278–284

    Article  CAS  PubMed  Google Scholar 

  • Tocino I, Miller MH (1987) Computed tomography in blunt chest trauma. J Thorac Imaging 2:45–59

    Article  CAS  PubMed  Google Scholar 

  • Torres A, Agusti GA, Rodriques-Roisin R, Etopa R, Agusti-Vidal A (1984) Cavitation in bacteremic pneumococcal pneumonia. Am Rev Respir Dis 130:533–534

    CAS  PubMed  Google Scholar 

  • Turner RB, Lande AE, Chase P et al. (1987) Pneumonia in pediatric outpatients: cause and clinical manifestations. J Pediatr 111:194–200

    Article  CAS  PubMed  Google Scholar 

  • Wagner RB, Crawford WO Jr, Schimpf PP (1988) Classification of parenchymal injuries of the lung. Radiology 167:77–82

    CAS  PubMed  Google Scholar 

  • Waite RJ, Carbonneau RJ, Balikian JP, Umali CB, Pezzella AT, Nash J (1990) Parietal pleural changes in empyema: appearance at CT. Radiology 175:145–150

    CAS  PubMed  Google Scholar 

  • Wan YL, Tsai KT, Yeow KM, Tan CF, Wong HF (1997) CT findings of bronchial transection. Am J Emerg Med 15:176–177

    Article  CAS  PubMed  Google Scholar 

  • Weir IH, Muller NL, Connell DG (1988) CT diagnosis of bronchial rupture. J Comput Assist Tomogr 12:1035–1036

    Article  CAS  PubMed  Google Scholar 

  • Wildin SR, Chonmaitree T, Swischuk KE (1988) Roentgenographic features of common pediatric viral respiratory tract infections. Am J Dis Child 142:43–46

    CAS  PubMed  Google Scholar 

  • Williams JR, Stembridge VA (1964) Pulmonary contusion secondary to nonpenetrating chest trauma. AJR Am J Roentgenol 91:284–290

    Google Scholar 

  • Winer-Muram HT, Rubin SA, Fletcher BD, Kauffman WM, Jennings SG, Arheart KL, Bozeman PM (1994) Childhood leukemia: diagnostic accuracy of bedside chest radiography for severe pulmonary complications. Radiology 193:127–133

    CAS  PubMed  Google Scholar 

  • Worthy SA, Flint JD, Muller NL (1997) Pulmonary complications after bone marrow transplantation: high-resolution CT and pathologic findings. RadioGraphics 17:1359–1357

    CAS  PubMed  Google Scholar 

  • Yangco B, Derensinski S (1980) Necrotizing or cavitary pneumonia due to Streptococcus pneumonia: report of four cases and review of the literature. Medicine 59:449–457

    Article  CAS  PubMed  Google Scholar 

  • Yankelevitz DF, Gamsu G, Shah A et al. (2000) Optimization of combined CT pulmonary angiography with lower extremity CT venography. AJR Am J Roentgenol 174: 67–69

    CAS  PubMed  Google Scholar 

  • Zukin DD, Hoffman JR, Cleveland RH, Kushner DC, Herman TE (1986) Correlation of pulmonary signs and symptoms with chest radiographs in the pediatric age group. Ann Emerg Med 15:792–796

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Children’s Hospital Medical Center MLC 5031, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA

    Lane F. Donnelly MD (Professor, Radiologist-in-Chief)

Authors
  1. Lane F. Donnelly MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Pediatric Radiology and Institute of Diagnostic Imaging, Vall d’Hebron Hospitals, Ps. Vall d’Hebron 119-129, 08035, Barcelona, Spain

    Javier Lucaya MD (Emeritus and Director) (Emeritus and Director)

  2. Department of Radiology, Hospital Quirón, Plaña Alfonso Comin 5-7, 08023, Barcelona, Spain

    Javier Lucaya MD (Emeritus and Director) (Emeritus and Director)

  3. Department of Radiology Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA

    Janet L. Strife MD, FACR (Professor of Radiology and Pediatrics) (Professor of Radiology and Pediatrics)

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Donnelly, L.F. (2008). CT of Acute Pulmonary Disease: Infection, Infarction, and Trauma. In: Lucaya, J., Strife, J.L. (eds) Pediatric Chest Imaging. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-32676-2_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-32676-2_6

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-32675-5

  • Online ISBN: 978-3-540-32676-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation