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2.  Pulmonary arterial hypertension: an imaging review comparing MR pulmonary angiography and perfusion with multidetector CT angiography 
The British Journal of Radiology  2012;85(1019):1446-1456.
Pulmonary hypertension (PH) is a progressive disease that leads to substantial morbidity and eventual death. Pulmonary multidetector CT angiography (MDCTA), pulmonary MR angiography (MRA) and MR-derived pulmonary perfusion (MRPP) imaging are non-invasive imaging techniques for the differential diagnosis of PH. MDCTA is considered the gold standard for the diagnosis of pulmonary embolism, one of the most common causes of PH. MRA and MRPP are promising techniques that do not require the use of ionising radiation or iodinated contrast material, and can be useful for patients for whom such material cannot be used. This review compares the imaging aspects of pulmonary MRA and 64-row MDCTA in patients with chronic thromboembolic or idiopathic PH.
PMCID: PMC3500786  PMID: 22932061
3.  The reversed halo sign: update and differential diagnosis 
The British Journal of Radiology  2012;85(1017):1226-1235.
The reversed halo sign is characterised by a central ground-glass opacity surrounded by denser air–space consolidation in the shape of a crescent or a ring. It was first described on high-resolution CT as being specific for cryptogenic organising pneumonia. Since then, the reversed halo sign has been reported in association with a wide range of pulmonary diseases, including invasive pulmonary fungal infections, paracoccidioidomycosis, pneumocystis pneumonia, tuberculosis, community-acquired pneumonia, lymphomatoid granulomatosis, Wegener granulomatosis, lipoid pneumonia and sarcoidosis. It is also seen in pulmonary neoplasms and infarction, and following radiation therapy and radiofrequency ablation of pulmonary malignancies. In this article, we present the spectrum of neoplastic and non-neoplastic diseases that may show the reversed halo sign and offer helpful clues for assisting in the differential diagnosis. By integrating the patient's clinical history with the presence of the reversed halo sign and other accompanying radiological findings, the radiologist should be able to narrow the differential diagnosis substantially, and may be able to provide a presumptive final diagnosis, which may obviate the need for biopsy in selected cases, especially in the immunosuppressed population.
PMCID: PMC3487053  PMID: 22553298
4.  MRI and CT findings of metastatic pulmonary calcification 
The British Journal of Radiology  2012;85(1011):e069-e072.
Metastatic pulmonary calcification is a consequence of calcium deposition in the normal pulmonary parenchyma, secondary to abnormal calcium metabolism. The most characteristic radiological manifestation is poorly defined nodular opacities that are mainly seen in the upper lung zone. The aim of this report is to describe the CT and MRI findings observed in two patients with metastatic pulmonary calcification. The disease may present in CT as consolidations with calcification, and with a high lesion/muscle signal intensity ratio on T1 weighted imaging without contrast in MRI. The high signal on T1 weighted imaging probably occurs because the low calcium concentration of the lesion changes the surface effects of diamagnetic calcium particles, causing T1 shortening of water protons. MRI is a good option for characterising calcium accumulation caused by a metabolic disorder.
PMCID: PMC3473981  PMID: 22391505
5.  Valsalva manoeuvre effect on distribution of lung damage in heroin inhalation 
The British Journal of Radiology  2011;84(1006):e200-e201.
This article reports the case of a patient demonstrating acute bilateral pneumonitis almost completely confined to the upper lobes as a result of inhaling heroin. We attribute this distribution to the patient performing the Valsalva manoeuvre immediately after inhaling heroin. This pattern has not been reported before and we believe it may be seen more frequently owing to a switch amongst drug users from intravenous to inhaled heroin.
PMCID: PMC3473762  PMID: 21933976
6.  MRI in lung cancer: a pictorial essay 
The British Journal of Radiology  2011;84(1003):661-668.
Imaging studies play a critical role in the diagnosis and staging of lung cancer. CT and 18-fluorodeoxyglucose positron emission tomography CT (PET/CT) are widely and routinely used for staging and assessment of treatment response. Many radiologists still use MRI only for the assessment of superior sulcus tumours, and in cases where invasion of the spinal cord canal is suspected. MRI can detect and stage lung cancer, and this method could be an excellent alternative to CT or PET/CT in the investigation of lung malignancies and other diseases. This pictorial essay discusses the use of MRI in the investigation of lung cancer.
PMCID: PMC3473490  PMID: 21697415
7.  Magnetic resonance imaging findings in acute pulmonary embolism 
The British Journal of Radiology  2011;84(999):282-287.
Pulmonary embolism (PE) is the third most common acute cardiovascular disease after myocardial infarction and stroke, and results in thousands of deaths each year. Improvements in MRI accuracy are ongoing with the use of parallel imaging for angiography techniques and pulmonary perfusion. This, associated with other potential advantages of MRI (e.g. a radiation free method and better safety profile of MR contrast media), reinforces its use. The aim of this paper is to perform a pictorial review of the principal findings of MRI in acute PE. Acute PE can manifest itself as complete arterial occlusion and the affected artery may be enlarged. We report the main vascular and parenchymal signs, and an overview of current literature regarding accuracy, limitations and technical aspects is provided.
PMCID: PMC3473863  PMID: 21224294
8.  Large pulmonary masses containing varicose veins: a rare presentation of benign metastasising leiomyomas 
The British Journal of Radiology  2010;83(995):e243-e246.
A 48-year-old woman presented with cough and chest pain. A chest radiograph and CT scans showed bilateral lung masses containing massive venous varices. A core biopsy specimen revealed benign metastasising leiomyoma with strong expression of progesterone receptors. A review of her medical history revealed a hysterectomy 11 years earlier. The lung masses showed significant reduction in size after induction of artificial menopause, although the pulmonary varices persisted.
PMCID: PMC3473723  PMID: 20965897
9.  Ketorolac tromethamine associated with diffuse pulmonary haemorrhage: high-resolution CT findings 
The British Journal of Radiology  2010;83(991):e158-e160.
Drug-induced lung diseases are a frequent cause of morbidity. Diffuse pulmonary haemorrhage is an uncommon complication of drug therapy, and is a potentially life-threatening situation. We report the high-resolution CT and clinical findings of a 32-year-old man with diffuse pulmonary haemorrhage induced by ketorolac tromethamine.
PMCID: PMC3473672  PMID: 20603403
10.  Pulmonary tuberculosis associated with the reversed halo sign on high-resolution CT 
The British Journal of Radiology  2010;83(987):e058-e060.
We describe the case of a 32-year-old woman with pulmonary tuberculosis in whom a high-resolution CT scan demonstrated the reversed halo sign. The diagnosis of tuberculosis was made by lung biopsy and the detection of acid-fast bacilli in the sputum smear and culture. Follow-up assessment revealed a significant improvement in the lesions.
PMCID: PMC3473561  PMID: 20197429
11.  Thoracic textilomas after myocardial revascularisation: typical CT findings 
The objective of this work was to report the tomographic findings in five cases of intrathoracic textilomas. The CT scans of five patients presenting with textilomas after being submitted to thoracotomy for myocardial revascularisation were reviewed retrospectively. Two chest radiologists studied the scans independently, and decisions concerning the CT findings were made by consensus. In each of the five cases, the imaging findings were similar and showed lesions resembling an extrapulmonary mass and well-defined contours situated at the marginal posterior pleural surface. In four of the five cases, a low-density centre and peripheral rim-like enhancement were observed after administration of contrast media. The suspicion of textiloma should be raised when a patient with a history of previous myocardial revascularisation surgery presents with an extrapulmonary mass in close contact with the posterior pleural surface.
PMCID: PMC3487248  PMID: 19433481

Results 1-11 (11)