Journal article
High-Resolution Ultrafast Chest CT in the Clinical Management of Febrile Bone Marrow Transplant Patients with Normal or Nonspecific Chest Roentgenograms
Chest, Vol.99(4), pp.928-933
04/1991
DOI: 10.1378/chest.99.4.928
PMID: 2009797
Abstract
Plain chest roentgenograms may be normal or show nonspecific abnormalities during the frequent febrile episodes that occur in patients after bone marrow transplantation. In this group, ultrafast 10-mm and 3-mm high-resolution CT scans were prospectively performed in 33 patients to determine if useful information was provided that either changed the patient's clinical management or added confidence to the clinical diagnosis. The 36 symptomatic episodes that occurred in 33 patients included fever in 20 episodes and fever combined with cough, dyspnea, chest pain, or rales in 16. Fourteen chest roentgenograms were interpreted as normal, and 22 were interpreted as demonstrating nonspecific changes; however, none of the roentgenograms was considered helpful in that they did not provide sufficient information for further management. In 2 of 14 episodes in patients with normal chest roentgenograms and in 9 of 22 episodes in patients with nonspecific chest roentgenograms, CT scanning resulted in a change in clinical management that included performing bronchoscopy, increasing or changing antibiotic coverage, starting white blood cell transfusions, requesting surgical biopsy, or a combination of these. In 1 of 14 episodes in patients with normal chest roentgenograms and in 8 of 22 episodes in patients with nonspecific roentgenograms, CT added confidence to the diagnosis. In the remaining 16 episodes, CT scans provided no additional information. We conclude that in many instances, noncontrast ultrafast chest CT scans can provide information that may either change a patient's clinical management or more clearly establish the extent of pulmonary disease.
Details
- Title: Subtitle
- High-Resolution Ultrafast Chest CT in the Clinical Management of Febrile Bone Marrow Transplant Patients with Normal or Nonspecific Chest Roentgenograms
- Creators
- Thomas J Barloon - From the Departments of Radiology, the University of Iowa College of Medicine, Iowa CityJeffrey R Galvin - From the Departments of Radiology, the University of Iowa College of Medicine, Iowa CityMasaki Mori - From the Departments of Radiology, the University of Iowa College of Medicine, Iowa CityWilliam Stanford - From the Departments of Radiology, the University of Iowa College of Medicine, Iowa CityRoger D Gingrich - From the Internal Medicine, the University of Iowa College of Medicine, Iowa City
- Resource Type
- Journal article
- Publication Details
- Chest, Vol.99(4), pp.928-933
- Publisher
- Elsevier Inc
- DOI
- 10.1378/chest.99.4.928
- PMID
- 2009797
- ISSN
- 0012-3692
- eISSN
- 1931-3543
- Language
- English
- Date published
- 04/1991
- Academic Unit
- Radiology; Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984051872402771
Metrics
22 Record Views