OBJECTIVE: To determine and compare the efficacy of image-guided percutaneous needle aspiration (PNA) versus percutaneous catheter drainage (PCD) in the treatment of intra-abdominal liquid collections. MATERIALS AND METHODS: A prospective study involving 52 patients referred to our service for percutaneous treatment of abdominal liquid collections was carried out. Sixteen of these patients had intra-abdominal liquid collections (six patients with simple localized collections and ten patients with complex, multiseptated or multiple, collections). The volume of the collections ranged from 40 to 1,200 ml (median, 200 ml). PCD was performed in ten (62.5%) collections and PNA in six (37.5%) collections. Successful treatment was defined as complete resolution of the collection with both clinical and laboratorial recovery. RESULTS: Success was achieved in 75% of cases. The success rate was 100% and 60% in the groups submitted to PNA and PCD, respectively. Successful treatment was observed in 50% of the patients submitted to PCD with collections £ 200 ml, and in 75% of the patients with larger collections. Complete resolution with PCD was obtained in 33.3% of complex, 42.9% of infected and 100% of simple or sterile collections. Only two minor complications (transient bacteremia and cutaneous infection) due to the procedures were observed. CONCLUSION: Our results showed that PCD and PNA are safe and effective in the treatment of intra-abdominal collections. In this study, needle aspiration was more effective than drainage, particularly for smaller collections.

Keywords: Intra-abdominal collections, Percutaneous needle aspiration, Percutaneous catheter drainage

Helical computed tomography has been widely used in the evaluation of the liver parenchyma for clinical and surgical management. The liver is probably the organ for which helical computed tomography examination is best indicated due to hepatic dual blood perfusion and the difference in blood supply between liver tumors and normal parenchyma. However, there are pitfalls in the interpretation of the images that may impair differentiation of true lesions from pseudolesions, particularly for the inexperienced radiologist. These pseudolesions present different shapes, location and characteristics that may mimic parenchymal lesions and their recognition and understanding are essential to avoid misdiagnoses. The aim of this study is to propose a systematic classification of the pseudolesions of the liver using illustrative cases and thus offer alternative means to differentiate these lesions from true parenchymal lesions.

Keywords: Liver, Helical computed tomography, Pitfalls

We report a case of a patient with primary cutaneous actinomycosis of the foot mimicking a soft tissue neoplasm. A literature review on the incidence, clinical features, pathology and imaging findings is also presented. The plain films and magnetic resonance imaging findings and the pathology results are presented. This paper reports a rare disease occurring in an atypical location, simulating a soft tissue neoplasm.

Keywords: Actinomycosis, Skin, Foot

Magnetic resonance imaging is currently an important method for the assessment of the liver. As with helical computed tomography, the use of fast magnetic resonance imaging sequences to obtain data from the different phases of vascularization allows the detection and identification of tumors. However, some lesions may mimic true parenchymatous lesions which are interpretation pitfalls. These lesions are called pseudolesions and may occur due to perfusion defects, focal fatty infiltration, and spared areas of fatty liver or artifacts, among other causes. The recognition of these lesions is essential to avoid false-positive results. The aim of this study was to classify, illustrate, and briefly describe these pseudolesions, and to provide alternatives to differentiate pseudolesions from true parenchymatous lesions.

Keywords: Liver, Magnetic resonance imaging, Pitfalls

OBJECTIVE: To determine and compare the efficacy of percutaneous needle aspiration and percutaneous catheter drainage, both guided by imaging methods, for the treatment of liver abscesses. MATERIALS AND METHODS: From 52 patients referred to our service for percutaneous treatment of abdominal abscesses, 17 presented liver abscesses, 13 of which were considered noncomplex and four were considered complex (multiloculated, multiple or associated to fistulas). Percutaneous needle aspiration was performed in 7/17 patients and 10/17 patients were submitted to percutaneous catheter drainage. The method used was considered successful when there was complete abscess resolution with both clinical and laboratorial improvement. RESULTS: The procedures were successful in 82.4% of all cases. In the group submitted to percutaneous needle aspiration the rate of success was 57.1% and in the group submitted to percutaneous catheter drainage the rate of success was 100%. Successful treatment was achieved in 75% of the patients submitted to percutaneous needle aspiration for abscesses smaller than 100 ml, but in only 33.3% of the patients with abscesses between 100 and 250 ml. There was complete resolution of the abscesses with percutaneous needle aspiration in 75% of the simple abscesses and in 25% of the complex abscesses. CONCLUSION: Percutaneous catheter drainage is more effective than percutaneous needle aspiration for the treatment of liver abscesses. Needle aspiration may probably be used as a valid alternative for smaller and noncomplex abscesses.

Keywords: Liver abscesses, Percutaneous needle aspiration, Percutaneous catheter drainage

OBJECTIVE: To evaluate radiologist agreement on the quantification of bronchiectasis by high-resolution computed tomography (HRCT). MATERIALS AND METHODS: The HRCT scans of 43 patients with bronchiectasis were analyzed by two radiologists, who used a scoring system to grade the findings. Kappa (κ) values and overall agreement were calculated. RESULTS: For the measurement and appearance of bronchiectasis, the interobserver agreement was moderate (κ = 0.45 and κ = 0.43, respectively), as was the intraobserver agreement (κ = 0.54 and κ = 0.47, respectively). Agreement on the presence of mucous plugging was fair, for central distribution (overall interobserver agreement of 68.3% and κ = 0.39 for intraobserver agreement) and for peripheral distribution (κ = 0.34 and κ = 0.35 for interobserver and intraobserver agreement, respectively). The agreement was also fair for peribronchial thickening (κ = 0.21 and κ = 0.30 for interobserver and intraobserver agreement, respectively). There was fair interobserver and intraobserver agreement on the detection of opacities (κ = 0.39 and 71.9%, respectively), ground-glass attenuation (64.3% and κ = 0.24, respectively), and cysts/bullae (κ = 0.47 and κ = 0.44, respectively). Qualitative analysis of the HRCT findings of bronchiectasis and the resulting individual patient scores showed that there was an excellent correlation between the observers (intraclass correlation coefficient of 0.85 and 0.81 for interobserver and intraobserver agreement, respectively). CONCLUSION: In the interpretation of HRCT findings of bronchiectasis, radiologist agreement appears to be fair. In our final analysis of the findings using the proposed score, we observed excellent interobserver and intraobserver agreement.

Keywords: Bronchiectasis; Lung; Tomography, X-ray computed; Observer variation.

PET/CT is widely used for the evaluation of patients with thoracic malignancies. Although the levels of ¹⁸F-fluorodeoxyglucose (FDG) uptake are usually high in neoplastic diseases, they can also be physiological, due to artifacts. In addition, FDG uptake can occur in benign conditions such as infectious, inflammatory, and iatrogenic lesions. Furthermore, some malignant tumors, such as adenocarcinoma in situ (formerly known as bronchoalveolar carcinoma) and carcinoid tumors, may not show FDG uptake. Here, we illustrate the main pitfalls and artifacts in the interpretation of the results of oncologic PET/CT of the chest, outlining strategies for avoiding misinterpretation.

Keywords: Pitfalls; Chest; PET/CT; Oncology.

OBJECTIVE: The purpose of this study was to describe the high-resolution computed tomography (HRCT) findings in patients with hantavirus pulmonary syndrome (HPS). MATERIALS AND METHODS: We retrospectively reviewed HRCT findings from eight cases of HPS. All patients were men, aged 19-70 (mean, 41.7) years. Diagnoses were established by serological test (enzyme-linked immunosorbent assay) in all patients. Two chest radiologists analyzed the images and reached decisions by consensus. RESULTS: The predominant HRCT findings were ground-glass opacities (GGOs) and smooth inter- and intralobular septal thickening, found in all eight cases; however, the crazy-paving pattern was found in only three cases. Pleural effusion and peribronchovascular thickening were observed in five patients. The abnormalities were bilateral in all patients. CONCLUSION: The predominant HRCT findings in patients with HPS were GGOs and smooth inter- and intralobular septal thickening, which probably correlate with the histopathologic findings of pulmonary edema.

Keywords: Hantavirus; Computed tomography; Lung infections.

Coronavirus disease 2019 (COVID-19), which is caused by a new coronavirus—severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)—is a pandemic with major impacts on the health care sector, and a broad view of the disease is of fundamental importance for any radiologist. The purpose of this review is to address the main clinical and imaging aspects of COVID-19, as well as guidelines for requesting and using imaging methods; measures to protect patients and health care professionals; systems for quantifying pulmonary findings and preparing integrated reports; and the main innovations that have emerged during this pandemic.

Keywords: Coronavirus infection/diagnostic imaging; Coronavirus; Review.

OBJECTIVE: The aim of this study was to evaluate chest computed tomography (CT) findings in patients diagnosed with neurofibromatosis type 1 (NF1). MATERIALS AND METHODS This was a retrospective study in which we reviewed the chest CT scans of 14 patients diagnosed with NF1 and neurofibromatosis-associated diffuse lung disease (NF-DLD).The sample comprised eight women and six men.The median age was 55 years (range, 11–75 years).The diagnosis of NF1 was made on the basis of the diagnostic criteria established by the U.S.National Institutes of Health.The images were analyzed by two chest radiologists, who reached decisions by consensus. RESULTS: The predominant CT finding of NF-DLD was multiple cysts, which were observed in 13 patients (92.9%), followed by emphysema, in eight (57.1%) and subpleural bullae, in six (42.9%).Other findings included subcutaneous neurofibromas, in 12 patients (85.7%), ground-glass opacities, in one (7.1%), and tracheobronchial neurofibromas, in one (7.1%).The pulmonary abnormalities were bilateral in 12 cases (85.7%).The abnormalities were predominantly in the upper lung fields in eight cases (57.1%), and their distribution was random in 11 (78.6%). CONCLUSION: Pulmonary cysts, emphysema, and subpleural bullae appear to be the chest CT findings that are most characteristic of NF-DLD.

Keywords: Neurofibromatoses; Cysts; Lung diseases; Tomography, X-ray computed.