Imaging

Those who care for patients with pulmonary, critical care or sleep disorders rely heavily on chest radiology and pathology to determine diagnoses. The Southwest Journal of Pulmonary, Critical Care & Sleep publishes case-based articles with characteristic chest imaging and related pathology.

The editor of this section will oversee and coordinate the publication of a core of the most important chest imaging topics. In doing so, they encourage the submission of unsolicited manuscripts. It cannot be overemphasized that both radiologic and pathologic images must be of excellent quality. As a rule, 600 DPI is sufficient for radiographic and pathologic images. Taking pictures of plain chest radiographs and CT scans with a digital camera is strongly discouraged. The figures should be cited in the text and numbered consecutively. The stain used for pathology specimens and magnification should be mentioned in the figure legend. Those who care for patients with pulmonary, critical care or sleep disorders rely heavily on chest radiology and pathology to determine diagnoses. The Southwest Journal of Pulmonary, Critical Care & Sleep publishes case-based articles with characteristic chest imaging and related pathology. The editor of this section will oversee and coordinate the publication of a core of the most important chest imaging topics. In doing so, they encourage the submission of unsolicited manuscripts. It cannot be overemphasized that both radiologic and pathologic images must be of excellent quality. As a rule, 600 DPI is sufficient for radiographic and pathologic images. Taking pictures of plain chest radiographs and CT scans with a digital camera is strongly discouraged. The figures should be cited in the text and numbered consecutively. The stain used for pathology specimens and magnification should be mentioned in the figure legend.

Rick Robbins, M.D. Rick Robbins, M.D.

Medical Image of the Week: Fontan Procedure

Figure 1. Thoracic CT scan showing Fontan anatomy, with the superior vena cava (SVC) connected to the pulmonary arteries (yellow arrow) and a single atrium and ventricle (red arrow).

 

Figure 2. SVC venography shows SVC connected to the pulmonary artery.

A 25-year-old man with a history of transposition of the great vessels (L-TGA) was admitted for persistent hemoptysis. He had a history of a double inlet left ventricle, pulmonary hypertension and was postoperative for a Fontan procedure completed at age of 2. No anatomical source for the hemoptysis was found.  A thoracic CT showed the Fontan anatomy: SVC connected to the pulmonary artery as per the Glenn connection (IVC drained to right pulmonary artery through the Fontan pathway) and a single ventricle and atrium (Figure 1). SVC venography showed the SVC connected to the pulmonary artery (Figure 2). The hemoptysis resolved after started sidenafil and bosentan for pulmonary hypertension.

Mohammed Alzoubaidi MD, Carmen Luraschi Monjagatta MD, Maria Tumanik DO, Naomi Jean Young MD

University of Arizona

Department of Pulmonary and Critical Care Medicine

Internal Medicine, South Campus.

Family Medicine, South Campus

Tucson, AZ

Reference as: Alzoubaidi M, Monjagatta CL, Tumanik M, Young NJ. Medical image of the week: Fontan procedure. Southwest J Pulm Crit Care. 2013;7(2):112-3. doi: http://dx.doi.org/10.13175/swjpcc114-13 PDF

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