MDCT and US of intrathoracic extrapleural space soft tissue-containing lesions: US extrapleural fat sign and MDCT fat ghost ribs sign

Valente, Tullio; Tortora, Giovanni; Bocchini, Giorgio; Rea, Gaetano; Marino, Maurizio; Muto, Maurizio

doi:10.1007/s11547-017-0744-8

Cited by 8 publications

(11 citation statements)

References 22 publications

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“…It contains extrapleural fat, endothoracic fascia, and the innermost intercostal muscle (Fig. 1) [13,36]). The normal extrapleural space is not distinguishable as separate structures on CT images [13,36], and it can extend into the mediastinum [13].…”

Section: Air Collection In the Intrathoracic Extrapleural Space (Ii-2)mentioning

confidence: 99%

“…1) [13,36]). The normal extrapleural space is not distinguishable as separate structures on CT images [13,36], and it can extend into the mediastinum [13]. Air collection in the extrapleural space is caused by barotrauma, disruption of the tracheobronchial and esophagus, and the extension of air from other space, such as the neck and retroperitoneum [13].…”

Section: Air Collection In the Intrathoracic Extrapleural Space (Ii-2)mentioning

confidence: 99%

“…21) [16,49,51]. Rapid changes in the distribution and extent of air are characteristic of PIE [36], and it may disappear within 1 to 2 days [49].…”

Section: Pie (V-1)mentioning

confidence: 99%

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Thoracic abnormal air collections in patients in the intensive care unit: radiograph findings correlated with CT

et al. 2020

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An abnormal collection of air in the thorax is one of the most common life-threatening events that occurs in the intensive care unit. Patient management differs depending on the location of the air collection; therefore, detecting abnormal air collection and identifying its exact location on supine chest radiographs is essential for early treatment and positive patient outcomes. Thoracic abnormal air collects in multiple thoracic spaces, including the pleural cavity, chest wall, mediastinum, pericardium, and lung. Pneumothorax in the supine position shows different radiographic findings depending on the location. Many conditions, such as skin folds, interlobar fissure, bullae in the apices, and air collection in the intrathoracic extrapleural space, mimic pneumothorax on radiographs. Additionally, pneumopericardium may resemble pneumomediastinum and needs to be differentiated. Further, some conditions such as inferior pulmonary ligament air collection versus a pneumatocele or pneumothorax in the posteromedial space require a differential diagnosis based on radiographs. Computed tomography (CT) is required to localize the air and delineate potential etiologies when a diagnosis by radiography is difficult. The purposes of this article are to review the anatomy of the potential spaces in the chest where abnormal air can collect, explain characteristic radiographic findings of the abnormal air collection in supine patients with illustrations and correlated CT images, and describe the distinguishing features of conditions that require a differential diagnosis. Since management differs based on the location of the air collection, radiologists should try to accurately detect and identify the location of air collection on supine radiographs.

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Section: Air Collection In the Intrathoracic Extrapleural Space (Ii-2)mentioning

confidence: 99%

Section: Air Collection In the Intrathoracic Extrapleural Space (Ii-2)mentioning

confidence: 99%

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Thoracic abnormal air collections in patients in the intensive care unit: radiograph findings correlated with CT

et al. 2020

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“…In the upper mediastinum there was an anomalous course of the left brachiocephalic vein passing posteriorly to the ascending aorta (AAo) and forming the superior vena cava with the right brachiocephalic vein (Figure 3). This complex anatomy was associated to a hematoma around the descending aorta (DAo) separating the parietal pleura from the endothoracic fascia, mostly extending to the left-side extrapleural space, forming a large (10 x 13 x 32 cm) EPH with typical "extrapleural fat" and "fat ghost ribs" signs, related to the inward displacement of the extrapleural fat stripe medially to the ribs by the EPH (Figure 4) [6,7]. Through the right femoral artery two endoprosthesis were deployed in a tel-This article is distributed under the terms of the Creative Commons Attribution Noncommercial License (by-nc 4.0) which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.…”

Section: Case Reportmentioning

confidence: 99%

First MDCT evidence of ruptured aberrant left subclavian artery aneurysm in right aortic arch, Kommerell’s diverticulum and extrapleural hematoma treated by emergency thoracic endovascular aortic repair

Sica

Dialetto

Bocchini

et al. 2020

Monaldi Arch Chest Dis

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Spontaneous ruptured aneurysm involving an aberrant subclavian artery with a right-sided aortic arch and Kommerell’s diverticulumis a rare life-threatening condition that can be treated successfully if promptly identified. Multidetector Computed Tomography angiography is the first line imaging modality of thoracic vascular anomalies diagnosis. We report the case of a 74-year-old man suffering from this emergency ondition with mediastinal hematoma mostly extending to the left-side extrapleural cavity. The patient underwent successful emergency thoracic endovascular aortic repair and an Amplatzer vascular plug was placed into the first segment of the ALSA. Post-procedural imaging showed complete exclusion of the aneurysm. Emergency endovascular repair can be effective in such cases.

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“…Most of the recent articles have classified the EPS pathologies according to their composition into three main categories. The first category is the extra-pleural fat expansion and soft tissue stranding which is caused by inflammatory conditions (either lung or pleural), neoplasms (intrathoracic peripheral malignancies, e.g., malignant pleural mesothelioma, metastases, and bronchogenic carcinoma), systemic conditions (obese people and chronic glucocorticoids users), and mimicking conditions which simulate EPS lesions specially those causing fatty expansion (e.g., Bochdalek's hernia and extra-pleural lipoma) [2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Extra-pleural space on CT: common lesions and diagnostic approach

Sabri

Elroos

Hinnawy

et al. 2023

Egypt J Radiol Nucl Med

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Background The extra-pleural space is challenging to view radiologically and is commonly overlooked. Therefore, it is important to have a comprehensive understanding of its anatomy in order to correctly classify lesions as either pleural or extra-pleural so as to choose the most appropriate treatment. CT with multi-planar reformatting allows the assessment of pathological conditions involving the extra-pleural space. The aim of this cross-sectional study was to assess the role of CT in the detection and evaluation of the extra-pleural space lesions and to classify them according to their CT appearance in order to reach a proper diagnosis and successful management plan. Results This study was conducted on 131 patients who underwent CT scan of the chest for different chest complaints, and the detected extra-pleural space abnormalities were classified according to their CT appearance into three major groups which are fatty expansion and soft tissue stranding group that included 59 cases (45%), abnormal attenuation group that included 13 cases (10%), and soft tissue expansion group that included 59 cases (45%). Out of the 59 cases with increased fatty expansion and soft tissue stranding, 73% were of inflammatory cause (either pulmonary or pleural), 17% were of neoplastic cause, and 3 cases were caused by systemic conditions. The abnormal extra-pleural space attenuation group was classified into air-containing and blood-containing groups, and both were mainly caused by trauma. Soft tissue infiltration of extra-pleural space was classified into neoplastic (85%) and non-neoplastic (15%) lesions, while most of the non-neoplastic pathologies were caused by severe inflammatory processes. The axial images were mostly sufficient to detect extra-pleural space lesions. Conclusions CT has a crucial role in the assessment of extra-pleural space and the different lesions involving it. Those lesions can be classified according to their CT appearance in order to reach a proper diagnosis and as a result aid in better management of these pathologies.

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MDCT and US of intrathoracic extrapleural space soft tissue-containing lesions: US extrapleural fat sign and MDCT fat ghost ribs sign

Cited by 8 publications

References 22 publications

Thoracic abnormal air collections in patients in the intensive care unit: radiograph findings correlated with CT

Thoracic abnormal air collections in patients in the intensive care unit: radiograph findings correlated with CT

First MDCT evidence of ruptured aberrant left subclavian artery aneurysm in right aortic arch, Kommerell’s diverticulum and extrapleural hematoma treated by emergency thoracic endovascular aortic repair

Extra-pleural space on CT: common lesions and diagnostic approach

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