Limits...
Serial CT findings of Paragonimus infested dogs and the Micro-CT findings of the worm cysts.

Lee CH, Im JG, Goo JM, Lee HJ, Hong ST, Shen CH, Chung DH, Son KR, Chang JM, Eo H - Korean J Radiol (2007 Sep-Oct)

Bottom Line: Thereafter, subpleural ground-glass opacities and nodules with or without cavitary changes were persistently observed until day 180.After cavitary change of the nodules, the migratory features of the subpleural or peribronchial nodules were seen on all the serial CT scans.The CT findings of paragonimiasis depend on the migratory stage of the worms.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and the Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

Objective: To investigate the serial CT findings of Paragonimus westermani infected dogs and the microscopic structures of the worm cysts using Micro-CT.

Materials and methods: This study was approved by the committee on animal research at our institution. Fifteen dogs infected with P. westermani underwent serial contrast-enhanced CT scans at pre-infection, after 10 days of infection, and monthly thereafter until six months for determining the radiologic-pathologic correlation. Three dogs (one dog each time) were sacrificed at 1, 3 and 6 months, respectively. After fixation of the lungs, both multi-detector CT and Micro-CT were performed for examining the worm cysts.

Results: The initial findings were pleural effusion and/or subpleural ground-glass opacities or linear opacities at day 10. At day 30, subpleural and peribronchial nodules appeared with hydropneumothorax and abdominal or chest wall air bubbles. Cavitary change and bronchial dilatation began to be seen on CT scan at day 30 and this was mostly seen together with mediastinal lymphadenopathy at day 60. Thereafter, subpleural ground-glass opacities and nodules with or without cavitary changes were persistently observed until day 180. After cavitary change of the nodules, the migratory features of the subpleural or peribronchial nodules were seen on all the serial CT scans. Micro-CT showed that the cyst wall contained dilated interconnected tubular structures, which had communications with the cavity and the adjacent distal bronchus.

Conclusion: The CT findings of paragonimiasis depend on the migratory stage of the worms. The worm cyst can have numerous interconnected tubular channels within its own wall and these channels have connections with the cavity and the adjacent distal bronchus.

Show MeSH

Related in: MedlinePlus

Serial CT findings of a dog infected with P. westermani.A. At 30 days, subpleural (long black arrow) and peribronchial nodules (short black arrows in A-C) are seen. A small amount of pneumothorax (white arrows in A-C) is also seen.B. At 60 days, the size of the subpleural nodule is increased and the peribronchial nodules show cavitary change.C. At 90 days, the size of the subpleural nodule is increased. The cavitary change disappeared in the peribronchial nodule. Note the newly appeared nodule in the right lung (arrowhead).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2626818&req=5

Figure 3: Serial CT findings of a dog infected with P. westermani.A. At 30 days, subpleural (long black arrow) and peribronchial nodules (short black arrows in A-C) are seen. A small amount of pneumothorax (white arrows in A-C) is also seen.B. At 60 days, the size of the subpleural nodule is increased and the peribronchial nodules show cavitary change.C. At 90 days, the size of the subpleural nodule is increased. The cavitary change disappeared in the peribronchial nodule. Note the newly appeared nodule in the right lung (arrowhead).

Mentions: The sequential CT findings are summarized in Table 1. The findings observed at the early stage of disease were pleural effusion (27%, 4/15), and/or subpleural nodular lesion with or without ground-glass opacities and linear opacities at day 10 (Fig. 1). At day 30, subpleural or peribronchial nodules appeared with an increased rate of the pleural effusion (73%, 11/15), pneumothorax (93%, 14/15), and abdominal or chest wall air bubbles (93%, 14/15) (Fig. 2). Pneumoperitoneum was not seen in any of the cases. Cavitary changes of the nodules started to be seen on the CT scan at day 30 (7%, 1/15) and mostly at day 60 (86%, 12/14) (Fig. 3). Bronchial dilatation was seen after day 60. Most nodules were seen with peripheral ground-glass opacities and some showed rim enhancement along the capsular wall with internal low density on the contrast-enhanced CT scan (Fig. 4). Subpleural ground-glass opacities and subpleural nodules with or without cavitary changes were consistently demonstrated untill termination of the experiment at day 180, and after they were seen on CT scans. After the cavitary changes of the nodules, the migratory features of the subpleural or peribronchial nodules were seen on all the serial CT scans (Fig. 5). The mediastinal lymph nodes were also enlarged after 60 days and this mostly occurred in the subcarinal and left paratracheal regions (Fig. 4). The incidence of pneumothorax and air bubbles in the abdominal or chest walls was significantly decreased at day 90 (p = 0.02, odd ratio = 0.11, 95% CI: 0.003-0.802). The incidence of pleural effusion also slightly decreased, but this was not statistically significant (p = 0.26, odd ratio = 0.44, 95% CI: 0.1-1.5) at day 90.


Serial CT findings of Paragonimus infested dogs and the Micro-CT findings of the worm cysts.

Lee CH, Im JG, Goo JM, Lee HJ, Hong ST, Shen CH, Chung DH, Son KR, Chang JM, Eo H - Korean J Radiol (2007 Sep-Oct)

Serial CT findings of a dog infected with P. westermani.A. At 30 days, subpleural (long black arrow) and peribronchial nodules (short black arrows in A-C) are seen. A small amount of pneumothorax (white arrows in A-C) is also seen.B. At 60 days, the size of the subpleural nodule is increased and the peribronchial nodules show cavitary change.C. At 90 days, the size of the subpleural nodule is increased. The cavitary change disappeared in the peribronchial nodule. Note the newly appeared nodule in the right lung (arrowhead).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2626818&req=5

Figure 3: Serial CT findings of a dog infected with P. westermani.A. At 30 days, subpleural (long black arrow) and peribronchial nodules (short black arrows in A-C) are seen. A small amount of pneumothorax (white arrows in A-C) is also seen.B. At 60 days, the size of the subpleural nodule is increased and the peribronchial nodules show cavitary change.C. At 90 days, the size of the subpleural nodule is increased. The cavitary change disappeared in the peribronchial nodule. Note the newly appeared nodule in the right lung (arrowhead).
Mentions: The sequential CT findings are summarized in Table 1. The findings observed at the early stage of disease were pleural effusion (27%, 4/15), and/or subpleural nodular lesion with or without ground-glass opacities and linear opacities at day 10 (Fig. 1). At day 30, subpleural or peribronchial nodules appeared with an increased rate of the pleural effusion (73%, 11/15), pneumothorax (93%, 14/15), and abdominal or chest wall air bubbles (93%, 14/15) (Fig. 2). Pneumoperitoneum was not seen in any of the cases. Cavitary changes of the nodules started to be seen on the CT scan at day 30 (7%, 1/15) and mostly at day 60 (86%, 12/14) (Fig. 3). Bronchial dilatation was seen after day 60. Most nodules were seen with peripheral ground-glass opacities and some showed rim enhancement along the capsular wall with internal low density on the contrast-enhanced CT scan (Fig. 4). Subpleural ground-glass opacities and subpleural nodules with or without cavitary changes were consistently demonstrated untill termination of the experiment at day 180, and after they were seen on CT scans. After the cavitary changes of the nodules, the migratory features of the subpleural or peribronchial nodules were seen on all the serial CT scans (Fig. 5). The mediastinal lymph nodes were also enlarged after 60 days and this mostly occurred in the subcarinal and left paratracheal regions (Fig. 4). The incidence of pneumothorax and air bubbles in the abdominal or chest walls was significantly decreased at day 90 (p = 0.02, odd ratio = 0.11, 95% CI: 0.003-0.802). The incidence of pleural effusion also slightly decreased, but this was not statistically significant (p = 0.26, odd ratio = 0.44, 95% CI: 0.1-1.5) at day 90.

Bottom Line: Thereafter, subpleural ground-glass opacities and nodules with or without cavitary changes were persistently observed until day 180.After cavitary change of the nodules, the migratory features of the subpleural or peribronchial nodules were seen on all the serial CT scans.The CT findings of paragonimiasis depend on the migratory stage of the worms.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and the Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

Objective: To investigate the serial CT findings of Paragonimus westermani infected dogs and the microscopic structures of the worm cysts using Micro-CT.

Materials and methods: This study was approved by the committee on animal research at our institution. Fifteen dogs infected with P. westermani underwent serial contrast-enhanced CT scans at pre-infection, after 10 days of infection, and monthly thereafter until six months for determining the radiologic-pathologic correlation. Three dogs (one dog each time) were sacrificed at 1, 3 and 6 months, respectively. After fixation of the lungs, both multi-detector CT and Micro-CT were performed for examining the worm cysts.

Results: The initial findings were pleural effusion and/or subpleural ground-glass opacities or linear opacities at day 10. At day 30, subpleural and peribronchial nodules appeared with hydropneumothorax and abdominal or chest wall air bubbles. Cavitary change and bronchial dilatation began to be seen on CT scan at day 30 and this was mostly seen together with mediastinal lymphadenopathy at day 60. Thereafter, subpleural ground-glass opacities and nodules with or without cavitary changes were persistently observed until day 180. After cavitary change of the nodules, the migratory features of the subpleural or peribronchial nodules were seen on all the serial CT scans. Micro-CT showed that the cyst wall contained dilated interconnected tubular structures, which had communications with the cavity and the adjacent distal bronchus.

Conclusion: The CT findings of paragonimiasis depend on the migratory stage of the worms. The worm cyst can have numerous interconnected tubular channels within its own wall and these channels have connections with the cavity and the adjacent distal bronchus.

Show MeSH
Related in: MedlinePlus