Rm. Shah et Ac. Friedman, CT ANGIOGRAM SIGN - INCIDENCE AND SIGNIFICANCE IN LOBAR CONSOLIDATIONS EVALUATED BY CONTRAST-ENHANCED CT, American journal of roentgenology, 170(3), 1998, pp. 719-721
OBJECTIVE. The CT angiogram sign-that is, the ability to see normal pu
lmonary vasculature within parenchymal consolidations-was initially re
ported as specific for the diagnosis of bronchioloalveolar cell carcin
oma. Our purpose was to establish the frequency of this sign in lobar
consolidations of varied causes as revealed by contrast-enhanced CT. W
e also sought to determine if the presence of this sign contributed to
the specificity of radiographic diagnosis. MATERIALS AND METHODS. All
consecutive contrast-enhanced thoracic CT examinations performed for
evaluation of lobar consolidations between May 1994 and April 1997 wer
e reviewed. The CT angiogram sign was considered present when segments
of pulmonary vessels could be identified within alveolar consolidatio
ns. Medical records were reviewed to establish the causes of the conso
lidations. RESULTS. Fifty-one patients (24 women, mean age = 59 years;
27 men, mean age = 46 years) had lobar or multilobar consolidations d
ue to pneumonia without central obstruction (n = 20), pneumonia or pne
umonitis with central obstruction (it = 19), passive atelectasis (n =
7), and (one case each) mucus plugging, lipoid pneumonia, pulmonary ly
mphoma, bronchioloalveolar cell carcinoma, and pulmonary hemorrhage. T
he CT angiogram sign was present in 15 (29%) of 51 consolidations, inc
luding seven (37%) of 19 postobstructive consolidations, four (20%) of
20 cases of pneumonia without central obstruction, one (14%) of seven
cases of passive atelectasis, and each single case of lymphoma, bronc
hioloalveolar cell carcinoma, and lipoid pneumonia. CONCLUSION. The CT
angiogram sign is a common finding in lobar consolidations evaluated
by contrast-enhanced CT. However, the sign does not add specificity to
the radiographic diagnosis.