Critical care radiology

249 Pages·2011·13.43 MB·English

by  Schaefer-Prokop

Critical Care Radiology
Cornelia Schaefer-Prokop, MD
Associate Professor of Radiology
Medical School Hanover, Germany
Radiology Department
Meander Medical Center
Amersfoort
Academic Medical Center (AMC)
Amsterdam
The Netherlands
With contributions by
M. Cejna, E. Eisenhuber-Stadler, M. Fuchsjaeger, G. Heinz-Peer, M. Hoermann, L. Kramer,
S. Kreuzer, C. Loewe, S. Metz-Schimmerl, I. Noebauer-Huhmann, B. Partik, P. Pokieser, M. Prokop,
T. Sautner, C. Schaefer-Prokop, W. Schima, E. Schober, A. Smets, A. Stadler, M. Uffmann, M. Walz,
P. Wunderbaldinger
561 illustrations
Thieme
Stuttgart · New York
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Contents
This book is dedicated to my children
V
Foreword
Preface
Perhaps more than in any other setting, the interpreta- Consistentwithmyowninterests,thereaderwillno-
tionofradiologicalimagesinpostoperativeandintensive tice a particular emphasis on illustrative radiographic
care patients requires an interdisciplinary exchange of and CT images. I am indebtedtoall my friends and col-
information, and cooperation between the radiologist leagues who contributed to this book, whether in the
and the clinical team. The low specificity of many find- form of manuscripts or images. I thank the staff at
ings—especially in bedside chest radiographs and post- Thieme Medical Publishers—especially Dr. S. Steindl and
operativeabdominal studies—doesnotdiminishtheval- Dr.C.Urbanowicz—fortheirpatienceandhelpinbringing
ue of intensive care radiology. Regular and active inter- thisprojecttocompletion.IamgratefultoProf.U.Moed-
disciplinary information sharing will contribute greatly der for his personal support. I thank my husband, and
to accurate image interpretation and resulting manage- especially my children, for their support, their patience,
mentdecisions.Thisbookplacesspecialemphasis,there- and their understanding for the many hours of hard
fore,onthedifferentialdiagnosisofmorphologicfindings work.
and their interpretation within the clinical context, and I hope that this book will help radiologists, residents
onaccuratelydiscriminatingbetweennormalandabnor- in radiology, and even clinicians to interpret the often
malfindings. difficult and nonspecific findings in children and adults,
Thequalityofradiographicimageshasimproveddra- andthatitwillhelptoadvanceinterdisciplinarycoopera-
maticallyinrecentyearsasaresultofdigitaltechnology. tion in the diagnostic imagingof intensive care unit pa-
Computed tomography (CT) has assumed an expanding tients.
role owing to its rapid availability, short examination
times,newindications,anditsunrivaleddiagnosticaccu- CorneliaSchaefer-Prokop
racyand efficiency. This efficiency results notonly from
short scan times, but also from the ability to image the
bodyinarbitraryplanesofsection.
VI
Contributors
Contributors
Editor SoerenH.Kreuzer,MD
AssistantProfessorofRadiology
CorneliaSchaefer-Prokop,MD
DepartmentofDiagnosticRadiology
AssociateProfessorofRadiology
MedicalUniversityofVienna
MedicalSchoolHanover,Germany
Vienna,Austria
RadiologyDepartment
ChristianLoewe,MD
MeanderMedicalCenter
AssociateProfessorofRadiology
Amersfoort
DepartmentofDiagnosticRadiology
AcademicMedicalCenter(AMC)
DivisionofCardiovascularandInterventional
Amsterdam
Radiology
TheNetherlands
MedicalUniversityofVienna
Vienna,Austria
ContributingAuthors
SylviaMetz-Schimmerl,MD
ManfredCejna,MD AssistantProfessor
AssociatePofessorofRadiology DepartmentofDiagnosticRadiology
Chairman,DepartmentofRadiology MedicalUniversityofVienna
UniversityTeachingHospitalLKHFeldkirch Vienna,Austria
Feldkirch,Austria
Iris-M.Noebauer-Huhmann,MD
EdithEisenhuber-Stadler,MD AssistantProfessorofRadiology
DepartmentofRadiologyandDiagnosticImaging DepartmentofDiagnosticRadiology
GöttlicherHeilandHospitalandHerz-Jesu-Hospital DivisionofOsteologyandNeuroradiology
Vienna,Austria MedicalUniversityofVienna
Vienna,Austria
MichaelFuchsjaeger,MD
AssociateProfessorofRadiology BernhardPartik,MD
DepartmentofDiagnosticRadiology BrigittenauDiagnosticCenter
MedicalUniversityofVienna Vienna,Austria
Vienna,Austria
PeterPokieser,MD
GertraudHeinz-Peer,MD AssociateProfessorofRadiology
AssociateProfessorofRadiology Chairman,MedicalMediaServices
DepartmentofDiagnosticRadiology Vienna,Austria
MedicalUniversityofVienna
Vienna,Austria MathiasProkop,MD
ProfessorofRadiology
MarcusHoermann,MD Chairman,DepartmentofRadiology
AssociateProfessorofRadiology RadboudUniversityNijmegenMedicalCenter
DepartmentofDiagnosticRadiology Nijmegen,Netherlands
MedicalUniversityofVienna
Vienna,Austria ThomasSautner,MD
AssociateProfessorofSurgery
LudwigKramer,MD Chairman,DepartmentofSurgery
AssociateProfessorofInternalMedicine St.ElisabethHospital
MedicalClinicI Vienna,Austria
HietzingHospital
Vienna,Austria
VII
Contributors
WolfgangSchima,MD,MSc MartinUffmann,MD
AssociateProfessorofRadiology AssociateProfessorofRadiology
Chairman,DepartmentofRadiology Chairman,DepartmentofDiagnosticRadiology
GöttlicherHeilandHospitalandHerz-Jesu-Hospital LandesklinikumNeunkirchen
Vienna,Austria Neunkirchen,Austria
EwaldSchober,MD MichaelWalz,MD
DepartmentofDiagnosticRadiology HessenCenterforQualityAssuranceinRadiology
SocialMedicalCenterBaumgartnerHöhe LifeScienceGmbH
OttoWagnerHospital Eschborn,Germany
Vienna,Austria
PatrickWunderbaldinger,MD
AnneSmets,MD FavoritenDiagnosticCenter
PediatricRadiologist Vienna,Austria
DepartmentofRadiology
AcademicMedicalCenter(AMC)
Amsterdam,Netherlands
AlfredStadler,MD
DepartmentofRadiologyandNuclearMedicine
HospitalHietzig
Vienna,Austria
VIII
Abbreviations
Abbreviations
ALI acutelunginjury HPS hypertrophicpyloricstenosis
AP anteroposterior HRCT high-resolutioncomputedtomography
ARDS adult(acute)respiratorydistresssyndrome IAPB intra-aorticballoonpump
ATS AmericanThoracicSociety ICD implantablecardioverterdefibrillator
AV arteriovenous ICRP InternationalCommissiononRadiological
BAL bronchoalveolarlavage Protection
BPD bronchopulmonarydysplasia ICU intensivecareunit
BPF bronchopleuralfistula IPPB intermittentpositivepressurebreathing
CAP community-acquiredpneumonia IRDS infantilerespiratorydistresssyndrome
CAPD chronicabdominalperitonealdialysis IVP intravenouspyelogram
CCAM congenitalcysticadenomatoidmalformation LDH lactatedehydrogenase
CDH congenitaldiaphragmatichernia LIS LungInjuryScore
CK creatinekinase MAS meconiumaspirationsyndrome
CLL chroniclymphoblastoid(lymphocytic) MCL midclavicularline
leukemia MPR multiplanarreformation
CMV cytomegalovirus MRI magneticresonanceimaging
COP cryptogenicorganizingpneumonia MRSA methicillin-resistantStaphylococcusaureus
COPD chronicobstructivepulmonarydisease NEC necrotizingenterocolitis
CPAP continuouspositiveairwaypressure NOMI nonocclusivemesentericischemia
CPIS ClinicalPulmonaryInfectionScore NSIP nonspecificinterstitialpneumonia
CR computedradiography PA posteroanterior
CT computedtomography PBB protectedbrushbronchoscopy
CTDI computedtomographydoseindex PCN percutaneousnephrostomy
CVC centralvenouscatheter PCP pneumocystispneumonia
DAD diffusealveolarlavage PD pancreaticoduodenectomy
DAP dose–areaproduct PE pulmonaryembolism
DLP dose–lengthproduct PEEP positiveend-expiratorypressure
DR digitalradiography PEG percutaneousendoscopicgastronomy
DSA digitalsubtractionangiography PG prostaglandin
EBV Epstein–Barrvirus PIE pulmonaryinterstitialemphysema
ECG electrocardiography RAO rightanterioroblique
ECMO extracorporealmembraneoxygenation RSV repiratorysyncytialvirus
EPF esophagopleuralfistula SDD surfactantdeficiencydisease
ETT endotrachealtube SLE systemiclupuserythmatosus
FFD film–focusdistance TTN transienttachypneaofthenewborn
FRC functionalresidualcapacity TUR transurethralresection
GI gastrointestinal UAC umbilicalarterycatheter
GvHD graft-versus-hostdisease UVC umbilicalveincatheter
HFV high-frequencyventilation VAP ventilator-associatedpneumonia
HIV humanimmunodeficiencyvirus VILI ventilator-inducedlunginjury
HMD hyalinemembranedisease VZV varicella-zostervirus
IX