RSNA | Journals

Journal Highlights

The following are highlights from the current issues of RSNA's two peer-reviewed journals.

Tracheobronchomalacia in Infants and Children: Multidetector CT Evaluation

Axial CT image obtained at end inspiration in a five-year-old girl shows normal-appearing oval-shaped trachea (T).

Although tracheobronchomalacia
(TBM) frequently goes unrecognized or is misdiagnosed as other respiratory conditions, multidetector CT enables a comprehensive evaluation of pediatric patients suspected of having TBM by facilitating accurate diagnosis, determining the extent and degree of disease, identifying predisposing conditions and providing objective pre- and postoperative assessments.

In a review article in the July issue of Radiology (RSNA.org/Radiology), Edward Y. Lee, M.D., of Children's Hospital Boston and Harvard Medical School, and Phillip M. Boiselle, M.D., of Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, provide a step-by-step primer on multidetector CT for evaluating infants and children with suspected TBM. Along with reviewing the epidemiology and pathophysiology of TBM, reviewers discuss:

• Clinical indications

• Patient preparation

• Multidetector CT techniques and protocols

• Postprocessing techniques

• Image interpretation

• Treatment of TBM

• Future directions

"Familiarity with multidetector CT protocols, postprocessing CT imaging methods, and visual and quantitative analysis of the central airways for TBM will enable radiologists to accurately diagnose TBM in infants and children, determine its degree and extent, assess for predisposing conditions, aid in preoperative or preprocedure planning and quantify response of treatment to intervention," the authors conclude.

To access this Radiology article now, click here.

Imaging of Posttransplantation Lymphoproliferative Disorder after Solid Organ Transplantation

This article meets the criteria for 1.0 AMA PRA Category 1 Credit™.

Although early diagnosis is critical in treating posttransplantation lymphoproliferative disorder (PTLD), imaging and clinical manifestations vary and are not predictive of histologic findings. Familiarity with risk factors, the imaging appearance of lesions and pattern of disease based on allograft type can allow a more accurate diagnosis of PTLD which can occur any time after solid organ transplantation and involve any organ.

Monomorphic PTLD in a 60-year-old man who had undergone renal transplantation 21 years earlier.

Axial fused PET/CT image shows extensive retroperitoneal lymph node enlargement with increased FDG uptake. The results of biopsy were consistent with monomorphic PTLD.

In an article in the July-August issue of RadioGraphics (RSNA.org/RadioGraphics), Amir A. Borhani, M.D., and colleagues from the University of Pittsburgh Medical Center, illustrate and discuss PTLD in terms of:

• Pathogenesis and classification

• Lesion distribution based on transplant type

• Lesion identification in different organs based on imaging appearance

The majority of PTLD cases are characterized by B-cell proliferation and are related to infection from Epstein-Barr virus. PTLD occurs most frequently in multi-organ transplant recipients, followed by bowel, heart-lung and lung recipients. Authors discuss the imaging features of PTLD in different organ systems, including intra-abdominal, thoracic, head and neck and musculoskeletal, based on the type of transplant.

"Knowledge of the distribution and radiologic features of PTLD allows the radiologist to play a pivotal role in making an early diagnosis and in guiding biopsy," researchers conclude.

To access this RadioGraphics article now, click here.

"See How It's Done" with Radiology Online Videos

Beginning this month, videos will accompany some articles in the "How I Do It" section on the Radiology Web site at RSNA.org/radiology. The first article to include a video is, "Tracheobronchomalacia in Infants and Children: Multidetector CT Evaluation," by Edward Y. Lee, M.D., Children's Hospital Boston and Harvard Medical School, and Phillip M. Boiselle, M.D., Beth Israel Deaconess Medical Center, Harvard Medical School, discussed above. The "See How It's Done," videos will be archived and available for downloading on the journal's home page.