Pseudocalcification on chest CT scan.

R. Tiruvoipati, S. K. Balasubramanian, J. J. Entwisle, R. K. Firmin, Giles J. Peek

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalBritish Journal of Radiology
Volume80
Issue number955
StatePublished - Jul 2007
Externally publishedYes

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Liquid Ventilation
Thorax
Fluorocarbons
Respiratory Insufficiency
Bronchoalveolar Lavage
Pediatrics
Lung
Miliary Tuberculosis
Extracorporeal Membrane Oxygenation
Pulmonary Fibrosis
Pneumothorax
Intensive Care Units
Gases
perfluorodecalin

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Tiruvoipati, R., Balasubramanian, S. K., Entwisle, J. J., Firmin, R. K., & Peek, G. J. (2007). Pseudocalcification on chest CT scan. British Journal of Radiology, 80(955).

Pseudocalcification on chest CT scan. / Tiruvoipati, R.; Balasubramanian, S. K.; Entwisle, J. J.; Firmin, R. K.; Peek, Giles J.

In: British Journal of Radiology, Vol. 80, No. 955, 07.2007.

Research output: Contribution to journalArticle

Tiruvoipati, R, Balasubramanian, SK, Entwisle, JJ, Firmin, RK & Peek, GJ 2007, 'Pseudocalcification on chest CT scan.', British Journal of Radiology, vol. 80, no. 955.
Tiruvoipati R, Balasubramanian SK, Entwisle JJ, Firmin RK, Peek GJ. Pseudocalcification on chest CT scan. British Journal of Radiology. 2007 Jul;80(955).
Tiruvoipati, R. ; Balasubramanian, S. K. ; Entwisle, J. J. ; Firmin, R. K. ; Peek, Giles J. / Pseudocalcification on chest CT scan. In: British Journal of Radiology. 2007 ; Vol. 80, No. 955.
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