Massive hemoptysis is one of the most dreaded of all respiratory emergencies and can have a variety of underlying causes. In 90% of cases, the source of massive hemoptysis is the bronchial circulation. Diagnostic studies for massive hemoptysis include radiography, bronchoscopy, and computed tomography (CT) of the chest. Bronchoscopy and chest radiography have been considered the primary methods for the diagnosis and localization of hemoptysis. Many researchers currently suggest that CT should be performed prior to bronchoscopy in all cases of massive hemoptysis. Bronchial artery embolization (BAE) is a safe and effective nonsurgical treatment for patients with massive hemoptysis. However, nonbronchial systemic arteries can be a significant source of massive hemoptysis and a cause of recurrence after successful BAE. Knowledge of the bronchial artery anatomy, together with an understanding of the pathophysiologic features of massive hemoptysis, are essential for planning and performing BAE in affected patients. In addition, interventional radiologists should be familiar with the techniques, results, and possible complications of BAE and with the characteristics of the various embolic agents used in the procedure.

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Cervical carcinoma is one of the most frequent causes of death in women. Computed tomography (CT) and magnetic resonance (MR) imaging are the primary modalities for follow-up of treated cervical carcinoma. A normal vaginal cuff after hysterectomy appears as a smooth, low-signal-intensity muscular wall on T2-weighted MR images. Early (2-3 months after treatment) and significant decreases in the signal intensity and volume of the tumor at MR imaging indicate a good response to radiation therapy. Sites of recurrence are the pelvis, lymph nodes, and distant sites. Pelvic recurrence appears as a heterogeneously enhancing mass at contrast material-enhanced CT and often appears as a heterogeneous, high-signal-intensity mass at T2-weighted MR imaging. Lymph node recurrence ranges from scattered, minimally enlarged nodes to large, conglomerate nodal masses. Determination of neoplastic infiltration of lymph nodes is based on size; most researchers consider nodes greater than 1 cm in short-axis diameter to be metastatic. Distant metastases are usually due to recurrent disease and occur in the abdomen, thorax, and bone. Knowledge of the normal therapeutic changes and the spectrum of recurrent tumor in patients with cervical carcinoma is important for accurate interpretation of follow-up CT and MR images.

Positron emission tomography (PET) with fluorine 18 fluorodeoxyglucose (FDG) is used to diagnose, stage, and monitor breast cancer. FDG PET has the capability to depict abnormal metabolic activity before any anatomic change occurs; however, in the absence of identifiable anatomic structures on PET images, it may be impossible to identify the location of areas of increased radionuclide uptake. In such cases, the coregistration of PET images with images from computed tomography (CT) may help improve diagnostic accuracy and lead to better clinical management of patients with breast cancer. Although FDG PET/CT may have limited diagnostic value for detecting small primary breast tumors, well-differentiated breast cancer, or regional lymph node involvement, it is superior to conventional imaging modalities for detecting distant metastases and recurrences and for monitoring the response to therapy.

Multi-detector row computed tomography (CT) offers distinct advantages over traditional spiral CT. Multi-detector row CT scanners are faster and allow thinner collimation than single-detector row spiral CT scanners. The use of multi-detector row CT combined with postprocessing of the imaging data with a variety of three-dimensional reformatting techniques (eg, maximum intensity projection, shaded surface display, volume rendering) allows creation of vascular maps whose quality equals or exceeds that of maps created at classic angiography for many applications. Three-dimensional multi-detector row CT portal venography can help determine the extent and location of portosystemic collateral vessels (eg, left gastric vein, short gastric vein, esophageal and paraesophageal varices, splenorenal and gastrorenal shunts, paraumbilical and abdominal wall veins) in patients with liver cirrhosis and is probably the optimal imaging technique in this setting. © RSNA, 2002Abbreviations: MIP ϭ maximum intensity projection, SSD ϭ shaded surface display, 3D ϭ three-dimensional