Mounier-Kuhn syndrome (Tracheobronchomegaly): Radiological diagnosis

Mounier Kuhn Syndrome or tracheobronchomegaly is a rare disease, characterized by dilatation of the trachea and the main bronchi. Our study concerns a case of 67-years old male patient, smoker, with a chronic cough. Chest scan was requested; it shows an enlargement of the tracheal clarity and the two main bronchi. Meanwhile, the Functional respiratory exploration was normal. The treatment includes mucolytics and pulmonary physiotherapy. Mounier-Kuhn syndrome is rare and the clinical signs are not specific, the positive diagnosis is purely radiological. The treatment is about to free the airways to prevent infection.     

Tracheobronchomegaly (Mounier-Kuhn Syndrome) with CT and bronchoscopic correlation: A case report

Tracheobronchomegaly, or Mounier-Kuhn syndrome, is a clinical and radiological entity characterized by marked dilatation of the trachea and bronchi as a result of severe atrophy of the elastic fibers, with thinning of the muscularis, and the formation of diverticula between the cartilaginous rings. The etiopathogenesis is uncertain and may be congenital or acquired. The clinical signs are not specific and are frequently revealed by recurrent respiratory infections and chronic cough. The diagnosis of Mounier-Kuhn syndrome is based on well-documented measurements of the trachea and main bronchi performed on a chest computed tomography scan. The management of patients is based on symptomatic treatment and may require, in severe cases, the use of endoscopic treatment by stent placement or surgical tracheobronchoplasty. We present a case of a 59yearold patient with recurrent respiratory infections that required several hospitalizations. Diagnosed with Mounier Kuhn syndrome, the thoracic computed tomography scan demonstrated a dilated trachea until the bifurcation and focal points of bronchial dilatation. Bronchoscopic examination showed a dilated and deformed trachea with the presence of diverticula on the tracheal anterior wall. The diameter of the trachea was reduced by more than 50% during expiration and coughing. For this reason, Mounier-Kuhn syndrome should be considered in cases of recurrent respiratory infection or persistent respiratory symptoms.     

CT在Mounier-Kuhn综合征诊断中的价值

目的探讨Mounier-Kuhn综合征的CT表现,以提高其诊断及鉴别诊断能力。资料与方法回顾性分析12例临床明确诊断为Mounier-Kuhn综合征患者的CT影像学资料,分别测量气管及两侧主支气管直径并与正常对照组比较,同时观察其他胸部异常表现。结果所有患者气管及两侧主支气管均有不规则或弥漫性的扩张,其测量值与对照组比较差异均有统计学意义(P=0.000),其他CT主要征象有:波浪征及憩室样改变(6/12),合并支气管扩张(7/12),合并肺炎(3/12)。结论 Mounier-Kuhn综合征的CT表现有一定特征。CT表现不仅能提示诊断,而且能够显示病变程度及继发改变,对治疗方案选择有指导意义。建议对可疑病例进行常规CT检查。     

CT诊断多脾综合征1例

<正>男,42岁,自述右下腹不适就诊,饮食、睡眠、大小便均正常,体格检查发现肝下缘可触及一不规则包块,握拳大,有轻度活动,边缘光滑,无明显压痛。超声提示肝肾间隙占位性病变,性质待定。血、尿常     

牵牛花综合征的CT诊断(附七例分析)

目的 研究牵牛花综合征（ｍｏｒｎｉｎｇ ｐｌｏｒｙ ｓｙｎｄｒｏｍｅ）的ＣＴ表现及其诊断价值。方法 回顾性分析了７例经临床证实的牵牛花综合征病人的ＣＴ资料。结果（１）眼球呈椭圆形,视盘呈“火山口”样凹陷３例;（２）视盘缺损,缺损边缘的巩膜变薄外翻,视神经头部呈漏斗状扩张,眼球呈梨状畸形２例;（３）视盘缺损,球后视神经囊状扩张,水样密度,与玻璃体腔相通,眼球呈“葫芦状”变形２例。结论 牵牛花综合征病     

脑颜面血管瘤综合征的CT诊断和临床分析(附8例报告)

目的:探讨脑颜面血管瘤综合征的CT表现特点及临床诊断价值。方法:回顾分析经临床和CT证实的8例脑颜面血管瘤综合征的CT和临床资料。结果:8例脑颜面血管瘤综合征均有脑皮层不同程度的脑回样或条带状钙化,4例伴病侧大脑萎缩,3例伴病侧颅板增厚,1例合并眼部脉络膜血管瘤和侧脑室脉络丛增大。8例均出现与CT表现相对应的临床症状和体征。结论:CT能准确诊断脑颜面血管瘤综合征,对临床有重要的指导意义。     

气管支气管巨大症1例

患者 男,61岁.因长期慢性咳嗽、咳痰,时有血痰20年,曾患肺结核.最近2年,黏液痰增多,虽经大剂量抗生素治疗好转,仍有咳嗽、咳痰或血痰.体检:营养较差,桶状胸,杵状指:听诊两肺呼吸音减弱,两下肺基底部闻及干啰音.     

Celiac artery compression syndrome: diagnosis with multislice CT

Celiac artery compression syndrome is a rare disorder characterized by postprandial intestinal angina caused by insufficient blood supply to the gastrointestinal organs. In this syndrome, the root of the celiac artery is compressed and narrowed by the median arcuate ligament of the diaphragm during expiration. We report here 3 such cases that were diagnosed by the use of multislice computed tomography.     

部分型Poland综合征的CT诊断

【摘要】目的：探讨部分型Poland综合征的CT表现特征,提高对本病的认识。方法：回顾性分析9例Poland综合征患儿的CT原始图像及VR重组图像,分别观察胸肌、肋骨、肋软骨、乳房、肺部、心脏等情况。结果：9例患儿中,累及右侧5例（55.56%）,左侧4例（44.44%）。所有病例胸大肌胸肋部缺如,其中1例累及全部胸大肌。全部患儿胸小肌缺如,7例肋间肌缺如（77.78%）,2例肋间肌菲薄（22.22%）,4例前锯肌变薄（44.44%）,2例背阔肌变薄（22.22%）,2例斜方肌变薄（22.22%）。全部患儿患侧胸廓均小于对侧,胸骨向患侧倾斜。3例患儿患侧乳芽缺如（33.33%）,6例发育不良并低位（66.67%）。肋骨缺如或发育不良6例（66.67%）,肋软骨缺如或发育不良8例（88.89%）,高位肩胛2例（22.22%）。4例可见心脏向健侧移位或旋转（44.44%）,全部患儿未见肺疝。结论：Poland综合征是一类少见的先天畸形,特征为单侧胸壁发育不良、同侧手部畸形并伴随多种其他畸形。部分型Poland综合征由于不合并手部畸形的表现,临床易漏诊。MSCT可对患儿胸壁肌肉、乳房、骨骼、肺部、心脏及合并畸形进行一站式检查,早期诊断及评价对手术治疗具有重要帮助。     

CT diagnosis of afferent loop syndrome

OBJECTIVE: To report the computed tomography (CT) features of afferent loop syndrome which is often clinically unsuspected. MATERIALS AND METHODS: The CT studies of five patients with afferent loop syndrome were reviewed. These patients had undergone gastroenterostomy and other surgical procedures, for malignant neoplasms in four and for peptic ulcer in one. Patients presented between 4 months and 15 years (average 5.5 years) after surgery. Symptoms were acute in all patients, the most common symptom being abdominal pain. In addition three of the patients had chronic symptoms including recurrent episodes of abdominal pain, recurrent ascending cholangitis, jaundice and bilious vomiting. RESULTS: The obstructed afferent loop appeared on CT as a fluid-filled tubular mass with an average diameter of 5.3cm. Valvulae conniventes were identified in all, and small intraluminal air bubbles in four. The dilated afferent loop was opacified with oral contrast material in only one patient. The loop was located in the subhepatic area in three patients and crossed the midline between the aorta and the superior mesenteric vessels in the other two. Additional findings included biliary dilatation in all five patients and signs of pancreatitis in one. Treatment was surgical in four patients (delayed for four months in one) and conservative in one. CONCLUSION: A fluid-filled tubular structure containing small air bubbles in the right upper quadrant or crossing the midline on CT in symptomatic patients after gastroenterostomy is characteristic of a dilated, possibly obstructed, afferent loop. The diagnosis is often not suspected clinically since patients may present many years after the initial surgery. Recognition of the characteristic CT findings will avoid both inappropriate procedures such as aspiration or drainage of an obstructed afferent loop and delay in treatment.     

布-加综合征的CT诊断

目的探讨布-加综合征的CT影像特征及CT诊断价值。方法对11例经DSA证实的布-加综合征及2例误诊为布-加综合征的病例的CT图像进行回顾性分析。结果肝脏体积增大伴尾叶增大9例,下腔静脉病变11例,肝静脉病变3例。结论CT对下腔静脉病变导致的布-加综合征有较高的诊断价值,但对肝静脉病变的诊断价值有限。     

肝内胆管炎CT诊断1例

胆系炎症包括胆囊炎、胆管炎,又以胆总管感染较多,而局限性肝内胆管感染报道较少,现将我院遇到1例局限性肝内胆管感染报道如下。患者男性,50岁。右上腹疼痛反复发作10年,加剧1天入院。查体:T38℃,皮肤巩膜黄染、右上腹压痛,WBC 18.6×109/L,中性96%,谷丙转氨酶627IU/L,总胆红素120μmol/L,HbsAg(-),经抗菌消炎解痉治疗后,体温正常,WBC 4.5×109/L,中性58%,谷丙转氨酶217IU/L,总胆红素21μmol/L。平扫发现肝右叶后段CT平扫略低密度影,大小约7.2×3.7cm,占位效应不明显,边缘不清,CT值49HU(正常肝CT值53HU),胆囊缩小,胆壁略增厚,腔…