Helical CT is being increasingly utilized for the evaluation of suspected pulmonary embolism (PE). Proper scan interpretation depends on the awareness of several diagnostic pitfalls that may simulate PE, including normal bronchovascular structures such as pulmonary veins, bronchi, and lymph nodes, technical considerations such as improper bolus timing and streak artifacts, and patient-related factors such as motion artifacts, pulmonary arterial catheters, and vascular shunts. An understanding of these pitfalls facilitates accurate diagnosis.
18 Fluorine-2- Fluoro-2-Deoxy-D-Glucose positron emission tomography (18FDG PET) allows imaging of sites with increased metabolic activity. Increased metabolic activity in mediastinal nodes in sarcoidosis has been described. We report the prospective diagnosis of thoracic sarcoidosis on 18FDG PET based on extensive, peripheral, upper lobe parenchymal, and mediastinal nodal tracer uptake.
Clinical History: A 44 year-old man presented with refractory heart failure following the relatively asymptomatic detection of severe aortic regurgitation at auscultation 11 years earlier. When the valvular disease was discovered, the patient's left ventricular ejection fraction was 25%. He underwent open aortic valvular replacement and his systolic function stabilized on medication in the years that followed, but eventually his cardiac function deteriorated further and he was listed for cardiac transplant.As part of the pre -transplant evaluation frontal and lateral chest radiography ( Figure 1) was performed.
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