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Spiral CT findings in septic pulmonary emboli
Y Iwasaki1, K Nagata, M Nakanishi
1Second Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602, Japan. yiwasaki@koto.kpu-m.ac.jp
Objectives:
The aim of the study was to determine the characteristics of septic pulmonary emboli and their prevalence on spiral computed tomographic (CT) scans.
Methods And Materials:
We evaluated 65 lesions on spiral CT scans in ten patients with septic pulmonary emboli. Spiral CT scans (10-mm collimation) were obtained at 10-mm intervals from the lung apex to the diaphragm and were compared with posteroanterior chest radiographs obtained within 24 h after CT scanning.
Results:
Only 21 (32%) of the 65 lesions detected on CT scans were also detected on chest radiographs. Peripheral nodules (39 lesions (60%)) were seen in all ten patients, wedge-shaped peripheral lesions (15 lesions (23%)) in nine patients, and infiltrates (11 lesions (17%)) in four patients. Subpleural lesions (45 lesions (69%)) and feeding vessels (35 (54%)) were found in all patients, and cavitary lesions (seven lesions (11%)) were seen in four patients. Subpleural peripheral nodules and wedge-shaped peripheral lesions were seen in nine patients. Thirty-two lesions (49%) ranged in diameter from 10 to 19 mm, and 59 lesions (91%) were less than 30 mm.
Conclusions:
Spiral CT is useful in detecting septic pulmonary emboli. On spiral CT subpleural peripheral nodules and wedge-shaped peripheral lesions less than 30 mm in diameter are often found in patients with septic pulmonary emboli.