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Pseudocalcification on chest CT scan.
- Source :
-
The British journal of radiology [Br J Radiol] 2007 Jul; Vol. 80 (955), pp. e125-7. - Publication Year :
- 2007
-
Abstract
- Liquid ventilation with perfluorocarbons is used in severe respiratory failure that cannot be managed by conventional methods. Very little is known about the use of liquid ventilation in paediatric patients with respiratory failure and there are no reports describing the distribution and excretion of perfluorocarbons in paediatric patients with severe respiratory failure. The aim of this report is to highlight the prolonged retention of perfluorocarbons in a paediatric patient, mimicking pulmonary calcification and misleading the interpretation of the chest CT scan. A 10-year-old girl was admitted to our intensive care unit with severe respiratory failure due to miliary tuberculosis. Extracorporeal membrane oxygenation (ECMO) was used to support gas exchange and partial liquid ventilation (PLV) with perfluorodecalin was used to aid in oxygenation, lavage the lungs and clear thick secretions. The patient developed a pneumothorax (fluorothorax) on the next day and PLV was discontinued. Multiple bronchoalveolar lavages were performed to clear thick secretions. With no improvement in lung function over the next month a CT scan of the chest was performed. This revealed extensive pulmonary fibrosis and multiple high attenuation lesions suggestive of pulmonary calcification. To exclude perfluorodecalin as the cause for high attenuation lesions, a sample of perfluorodecalin was scanned to estimate the Hounsfield unit density, which was similar to the density of high attenuation lesions on chest CT scan. High-density opacification should be interpreted with caution, especially following liquid ventilation.
- Subjects :
- Child
Diagnosis, Differential
Extracorporeal Membrane Oxygenation
Female
Fluorocarbons administration & dosage
Humans
Liquid Ventilation
Respiration, Artificial methods
Respiratory Insufficiency complications
Respiratory Insufficiency diagnostic imaging
Respiratory Insufficiency therapy
Tuberculosis, Miliary complications
Tuberculosis, Miliary diagnostic imaging
Tuberculosis, Miliary therapy
Calcinosis diagnostic imaging
Lung diagnostic imaging
Lung Diseases diagnostic imaging
Tomography, X-Ray Computed
Subjects
Details
- Language :
- English
- ISSN :
- 1748-880X
- Volume :
- 80
- Issue :
- 955
- Database :
- MEDLINE
- Journal :
- The British journal of radiology
- Publication Type :
- Academic Journal
- Accession number :
- 17704305
- Full Text :
- https://doi.org/10.1259/bjr/61486305