Göğüs duvarı flegmonu ve apsesi BT bulguları

Özet

Göğüs duvarı flegmonu sternoklaviküler eklem enfeksiyonuna eşlik edebilir; torasik aktinomikoz akciğerden plevraya ve göğüs duvarına yayılabilir. Kontrastlı BT, göğüs duvarı koleksiyonunda düşük atenüasyonlu merkez ve periferik kontrastlanmayı gösterebilir; torasik aktinomikozda plevral kalınlaşma, komşu akciğer hastalığıyla devamlılık ve kaburga ya da vertebra yıkımı da izlenebilir. Göğüs duvarı apsesinde düşük atenüasyonlu merkez ve periferik kontrastlanma görülebilir. Torasik aktinomikozda enfeksiyon plevraya ve göğüs duvarına yayılabilir; kaburga veya vertebralarda yıkım görülebilir.

Faz ve pencere

Venöz tanısal: Kontrastlı toraks BT'sinde flegmon kas veya cilt altı yağ dokusunda şişlik, heterojen atenüasyon ve yağ-fasya planlarında silinme yapar; apse düşük atenüasyonlu merkezi sıvı ile çevresel duvar kontrastlanması gösterir. Göğüs duvarı koleksiyonunda gaz-sıvı içeren görünüm eşlik edebilir.

Önerilen pencereler: Yumuşak doku (G 400 / M 40), Mediasten (G 350 / M 50), Kemik (G 1800 / M 400), Akciğer (G 1500 / M -600).

BT bulguları

Nekrotizan fasiit, fasya ve subkütanöz dokuları tutan hızlı ilerleyen, yaşamı tehdit eden bir enfeksiyondur.
Düşük atenüasyonlu koleksiyon merkezi çevresinde kontrastlanan duvar; lokülasyon veya hava-sıvı düzeyi eşlik edebilir.
Göğüs duvarı koleksiyonunda gaz-sıvı içeren görünüm görülebilir.
Komşu kaburgada kortikal erozyon, düzensizlik veya periostal yeni kemik; olası eşlik eden osteomiyelit.
Plevral kalınlaşma ve plevral koleksiyon ile göğüs duvarı arasında fistül traktı izlenebilir.
Sternoklavikuler eklem çevresinde yumuşak doku inflamasyonu ve manubrium ya da medial klavikulada erozyon.
Ön göğüs duvarı koleksiyonunun retrosternal alana veya mediastene uzanması.

Normalde

Göğüs duvarı cilt, subkütan yağ, kaslar ve kemiklerden oluşur. Göğüs duvarı cilt, subkütan yağ, kaslar ve kemiklerden oluşur; değerlendirmede bu yapıları birlikte gözden geçir.

Normal BT ile kıyasla

Aynı bölgenin, kaynak veri setinde patoloji içermediği belirtilen bir BT incelemesini kesit kesit kaydırın; organ sınırlarını açarak anatomiyi hasta görüntüsüyle karşılaştırın. Küçük rastlantısal bulgular tümüyle dışlanmamıştır.

Kaynak: TotalSegmentator v2.01 veri seti (Wasserthal ve ark., Radiology: Artificial Intelligence 2023), CC BY 4.0, vaka s1278; organ sınırları veri setinin otomatik segmentasyonundan, birleştirilerek sadeleştirildi. Görüntüler 2,5 mm kesit aralığına yeniden örneklendi.

Ayırıcı tanı

Göğüs duvarı hematomu, görüntülemede tümör benzeri yumuşak doku kitlesi ayırıcı tanısında düşünülebilir.
Nekrotizan fasiit, fasya ve subkütanöz dokuları tutan hızlı ilerleyen, yaşamı tehdit eden bir enfeksiyondur.
Ampiyem necessitans: plevral koleksiyon göğüs duvarını geçerek dışarı taşar ve plevral hastalıkla doğrudan devamlılık gösterir.
Yumuşak doku kitlesi görünümü taşıyan lezyonlar gerçek tümör olabileceği gibi travmatik, inflamatuar, enfeksiyöz veya vasküler nedenlerle de oluşabilir.

Tuzaklar

Servikofasiyal emfizem, yüz ve boynun fasyal boşluklarında patolojik hava bulunmasıdır; dental girişimler nadir nedenlerindendir.
BT'de flegmonöz subkütan inflamasyon, daha sonra gelişen apse oluşumlarından önce izlenebilir; yalnız inflamasyon varlığını olgun koleksiyon olarak işaretleme.
Kas içi apse kan veya yoğun proteinli içerik nedeniyle basit sıvıdan daha yüksek atenüasyon gösterebilir; yalnız merkez dansitesine dayanmak yerine duvar kontrastlanması ve çevre inflamasyonu değerlendir.

Kendini dene

Kontrastlı BT'de pektoralis içinde sıvı atenüasyonlu merkez ve çevresel duvar kontrastlanması var. En olası lezyon nedir?
Cevabı göster
İntramüsküler apse. Sıvı merkezi ve çevresel duvar kontrastlanması olgun intramüsküler apseyi destekler. Hematom çoğunlukla kan ürünleriyle heterojen ve yüksek atenüasyonludur; lipom yağ yoğunluğundadır, seromada enfeksiyon duvarı ve çevre inflamasyon tipik değildir.
Plevral ampiyemde irin göğüs duvarına uzanıp burada koleksiyon oluşturuyor. Bu komplikasyonun adı nedir?
Cevabı göster
Ampiyem necessitans. Ampiyem necessitans, plevral ampiyemde irin göğüs duvarına yayıldığında gelişen komplikasyondur. Ampiyem necessitans, plevral ampiyemde plevra boşluğundaki irin göğüs duvarına uzandığında gelişir.

İlgili konular

Kaynaklar

Bu sayfadaki 35 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla otomatik olarak karşılaştırıldı; 9 cümle bu karşılaştırmada düzeltildi (2026-10-09).

Imaging of Thoracic Wall Abnormalitiespmc.ncbi.nlm.nih.gov
An overview of thoracic actinomycosis: CT featurespmc.ncbi.nlm.nih.gov
Bilateral iliopsoas abscess presenting with abdominal wall cellulitis and left-sided empyema thoracis: a rare presentation.pubmed.ncbi.nlm.nih.gov
[Sepsis after cat bite-How medical history, physical examination and interdisciplinary cooperation influence disease progression].pubmed.ncbi.nlm.nih.gov
Complicated acute appendicitis presenting as a rapidly progressive soft tissue infection of the abdominal wall: a case report.pubmed.ncbi.nlm.nih.gov
Gastrointestinal perforation: clinical and MDCT clues for identification of aetiology.pubmed.ncbi.nlm.nih.gov
A ''not so superficial" skin infection in a patient with diabetes.pubmed.ncbi.nlm.nih.gov
Gastric wall abscess presenting as thoracic pain: rare presentation of an old disease.pubmed.ncbi.nlm.nih.gov
Post-traumatic lateral abdominal wall hernia: a case report.pubmed.ncbi.nlm.nih.gov
MRSA-positive sternoclavicular septic arthritis mimicking mediastinal malignancy in a patient with multiple injection history: a rare case report.pubmed.ncbi.nlm.nih.gov
Acute phlegmonous esophagitis presenting as chest pain: A case report.pubmed.ncbi.nlm.nih.gov
Management and Outcomes of Sternoclavicular Joint Infections: A Retrospective Study.pubmed.ncbi.nlm.nih.gov
Sternoclavicular Tuberculosis: An Unusual Presentation.pubmed.ncbi.nlm.nih.gov
Narrative review of chest wall ultrasound: a practical approach.pubmed.ncbi.nlm.nih.gov
Tuberculous Lymphadenitis Presenting as Chest Wall Cold Abscess: A Case Report.pubmed.ncbi.nlm.nih.gov
Purely osteolytic bone lesions in the early osteoarticular phase of synovitis, acne, pustulosis, hyperostosis and osteitis syndrome.pubmed.ncbi.nlm.nih.gov
Imaging for Pediatric Head and Neck Emergencies: Critical Insights.pubmed.ncbi.nlm.nih.gov
CT of Soft Tissue Infections: Current and Future Perspectives from Diagnosis to Treatment.pubmed.ncbi.nlm.nih.gov
Bacterial Granulomatous Lung Diseases: Radiological Findings and Differential Diagnosis.pubmed.ncbi.nlm.nih.gov
Pictorial Review of Rare Pancreatic Tumors and Tumor-like Lesions: Radiologic-Pathologic Correlation.pubmed.ncbi.nlm.nih.gov
Imaging insights into systemic tuberculosis with cardiac involvement: A rare challenging case of tuberculous chronic constrictive pericarditis and myocarditis.pubmed.ncbi.nlm.nih.gov
Extensive Odontogenic Deep Neck Infection Complicated by Necrotizing Fasciitis and Bilateral Mastitis: A Rare Case Report.pubmed.ncbi.nlm.nih.gov
Extensive MRSA-positive sternoclavicular septic arthritis with uncommon origin: a case report.pubmed.ncbi.nlm.nih.gov
International Society of Paediatric Surgical Oncology (IPSO) Surgical Practice Guidelines.pubmed.ncbi.nlm.nih.gov
Management of Emphysematous Cystitis in the Intensive Care Unit.pubmed.ncbi.nlm.nih.gov
Pneumomediastinum After Third Molar Surgery: A Case Report.pubmed.ncbi.nlm.nih.gov
Case Report: A rare case of oesophageal cellulitis caused by Klebsiella pneumoniae: diagnosis, management, and literature review.pubmed.ncbi.nlm.nih.gov
Meleney's gangrene triggered by suprapubic catheter dislodgment and urine extravasation: A case report and review of management strategies.pubmed.ncbi.nlm.nih.gov
The Usefulness and Limitations of Radiologic Findings for Diagnosis of Infectious Diseases: A Call for Antimicrobial Stewardship.pubmed.ncbi.nlm.nih.gov
Imaging Features of Soft Tissue Tumor Mimickers: A Pictorial Essay.pubmed.ncbi.nlm.nih.gov
Understanding a mass in the paraspinal region: an anatomical approach.pubmed.ncbi.nlm.nih.gov
Management of pneumonia by the emergency radiologist.pubmed.ncbi.nlm.nih.gov
Imaging of Acute Complications of Community-Acquired Pneumonia in the Paediatric Population-From Chest Radiography to MRI.pubmed.ncbi.nlm.nih.gov
Tuberculosis revisted: classic imaging findings in childhood.pubmed.ncbi.nlm.nih.gov
Conservative management of accidental tracheal perforation during surgery for descending necrotizing mediastinitis: a case report and literature review.pubmed.ncbi.nlm.nih.gov
Pulmonary Abscess Caused by Cutibacterium acnes in an Immunocompetent Patient: A Case Report and Review of the Literature.pubmed.ncbi.nlm.nih.gov
Calciphylaxis Mimicry in End-Stage Renal Disease: Acute Limb Ischemia From Calcific Peripheral Arterial Disease.pubmed.ncbi.nlm.nih.gov
Fungal Infections - a Stealthy Enemy in Patients with Chronic Granulomatous Disease: a 28-years' Experience from North India.pubmed.ncbi.nlm.nih.gov
A pictorial essay of thoracic wall diseases: multiple pathologies in the same anatomical site.pubmed.ncbi.nlm.nih.gov
Empyema necessitans presenting as a chest wall abscess managed with minimally invasive drainage.pubmed.ncbi.nlm.nih.gov
A rare case of bacterial translocation from a renal abscess resulting in empyema necessitans: a case report and literature review.pubmed.ncbi.nlm.nih.gov
B. Bronchiseptica empyema necessitans, a case report.pubmed.ncbi.nlm.nih.gov
Masked invaders: A case series on uncommon manifestations of extrapulmonary tuberculosis.pubmed.ncbi.nlm.nih.gov
An Unusual Cause of Shoulder Pain: Sternoclavicular Joint Septic Arthritis.pubmed.ncbi.nlm.nih.gov
Cervical esophagogastric anastomosis using a retrosternal gastric conduit in an adult patient with congenital type A long-gap esophageal atresia after 18 years of gastrostomy: a case report.pubmed.ncbi.nlm.nih.gov
Septic Arthritis of the Manubriosternal Joint in an Immunocompetent Adult: A Case Report.pubmed.ncbi.nlm.nih.gov
Key Points of Endoscopic Minimally Invasive Surgery for Gynecomastia Based on Refined Anatomy: A Case Series.pubmed.ncbi.nlm.nih.gov
The inframammary fold: Structure, clinical considerations, and reconstructive techniques.pubmed.ncbi.nlm.nih.gov
Intermuscular Adipose Tissue as a Multimodality Quantitative Imaging Biomarker: Evidence Across Metabolic, Cardiovascular and Oncologic Diseases.pubmed.ncbi.nlm.nih.gov
Beyond the Beam: Multimodal Imaging and Surveillance of Post-Radiotherapy Changes in the Breast.pubmed.ncbi.nlm.nih.gov
Case Report: Coexistence of a giant borderline phyllodes tumor of the breast and a contralateral fibroadenoma: a challenging case with clinical manifestations and PET-CT imaging mimicking advanced cancer.pubmed.ncbi.nlm.nih.gov
Bionic breathing-type airway exposure system for inhalation exposure studies.pubmed.ncbi.nlm.nih.gov
Lung Parenchymal and Airway Injuries: Differential Diagnosis and Severity Grading.pubmed.ncbi.nlm.nih.gov
Giant Abdominal Haematoma and Rapid Multidrug-Resistant Infection After Low-Molecular-Weight Heparin in a Patient With COVID-19 and Rheumatoid Arthritis.pubmed.ncbi.nlm.nih.gov
Surgical treatment of intramyocardial dissecting hematoma-a case report and literature review.pubmed.ncbi.nlm.nih.gov
Conservative Management of Invasive Group A Streptococcal Infection With Cervical Necrotizing Fasciitis-Spectrum Disease and Pneumonia in a Healthy Young Adult.pubmed.ncbi.nlm.nih.gov
Multifocal Necrotizing Fasciitis of the Bilateral Chest Wall and Contralateral Lower Limb in a Patient With Diabetes: A Case Report.pubmed.ncbi.nlm.nih.gov
A Rare Case of Empyema Necessitans Due to Streptococcus Anginosus with Necrotizing Fasciitis and Retroperitoneal Abscesses.pubmed.ncbi.nlm.nih.gov
Trans-thoracic Extension of a Lung Abscess With a Pleurocutaneous Fistula: A Report of a Rare Case.pubmed.ncbi.nlm.nih.gov
Suspected chest malignancy hiding Aggregatibacter actinomycetemcomitans lung infection - case report and review of literature.pubmed.ncbi.nlm.nih.gov
Primary hepatic leiomyosarcoma diagnosed after right hepatectomy: A rare case report.pubmed.ncbi.nlm.nih.gov
Cavitary Pulmonary Adenocarcinoma in a Young Adult With a History of Treated Hodgkin Lymphoma: A Case Report.pubmed.ncbi.nlm.nih.gov
Coexistence of rectal adenocarcinoma and rectal and lymph node tuberculosis: a case report with a limited narrative review.pubmed.ncbi.nlm.nih.gov
Diagnostic and Management Challenges in a Non-Infectious Pacemaker Pocket Swelling: A Case Report and Literature Review.pubmed.ncbi.nlm.nih.gov
Beyond the lung: recognizing incidental breast lesions on chest computed tomography.pubmed.ncbi.nlm.nih.gov
Soft tissue hematomas on ultrasound: a case-based review and practical guide to diagnosis.pubmed.ncbi.nlm.nih.gov
Multimodal ultrasound in the diagnosis and treatment of caudate lobe Klebsiella pneumoniae liver abscess complicated by rare gas-containing inferior vena cava thrombosis: a case report.pubmed.ncbi.nlm.nih.gov
Vacuum-Assisted Closure-Assisted Reconstruction of Extensive Anterior Cervical Necrotizing Fasciitis: A Case Report.pubmed.ncbi.nlm.nih.gov
The first CT-based classification system for pulmonary actinomycosis: correlating imaging patterns with therapeutic strategies and prognosis in a highly misdiagnosed disease.pubmed.ncbi.nlm.nih.gov
Granulicatella adiacens Causing a Parapharyngeal Abscess in a 10-Month-Old Infant: A Rare-Case Report and Literature Review of Deep Neck Infections (DNIs) in Children.pubmed.ncbi.nlm.nih.gov
Rhinosinusitis: Evidence and experience - 2024.pubmed.ncbi.nlm.nih.gov
Multimodal imaging features to diagnose abdominal complications of sickle cell disease.pubmed.ncbi.nlm.nih.gov
Non-Infectious Spinal Diseases Mimicking Infection: A Pictorial Essay.pubmed.ncbi.nlm.nih.gov
Metagenomic next-generation sequencing-guided management of descending mediastinitis and empyema caused by Segatella baroniae: a case report.pubmed.ncbi.nlm.nih.gov
Recognizing Descending Necrotizing Mediastinitis in Adults: A Narrative Review of Diagnostic Dilemmas and Barriers.pubmed.ncbi.nlm.nih.gov
Foregut mediastinal cysts: a narrative review.pubmed.ncbi.nlm.nih.gov
Purulent Pericarditis Complicated With Cardiac Tamponade, Multiorgan Failure, and Constrictive Pericarditis.pubmed.ncbi.nlm.nih.gov
Acute and chronic complications of cesarean delivery: An update for the general radiologist.pubmed.ncbi.nlm.nih.gov
Silent Intruders: A Dual Case Report of Retained Foreign Bodies in the Breasts.pubmed.ncbi.nlm.nih.gov
Thoracic Extension of an Odontogenic Deep Neck Space Infection: A Case of Carbapenem-Resistant Acinetobacter baumannii (CRAB) Empyema in an Immunocompetent Patient.pubmed.ncbi.nlm.nih.gov
Sub-threshold hypoalbuminemia, anemia, and occult infection trigger post-lobectomy bronchopleural fistula: a case report.pubmed.ncbi.nlm.nih.gov
Multifocal community-acquired MRSA infection: a rare case involving urinary tract, bloodstream, chest wall, and pleura.pubmed.ncbi.nlm.nih.gov
Chronic Expanding Hematoma of the Postmastectomy Axilla: A Pictorial Review of Long-Term Multimodality Imaging.pubmed.ncbi.nlm.nih.gov
Cryptogenic brain abscess: Right-to-left shunt in pulmonary arteriovenous malformation and hepatopulmonary syndrome.pubmed.ncbi.nlm.nih.gov
Contrast-Enhanced CT Finding of Hot Spot Sign Secondary to Supra Hilar Mass Causing Superior Vena Cava Syndrome: A Case Report.pubmed.ncbi.nlm.nih.gov
Nasal Myiasis Associated With E. coli Bacteremia, Spinal Osteomyelitis, and Epidural Abscess: A Case Report.pubmed.ncbi.nlm.nih.gov
Pseudomonal sternal abscess and osteomyelitis as an initial manifestation of common variable immunodeficiency.pubmed.ncbi.nlm.nih.gov
Case report: Colonic actinomycosis - A rare cause of a locally advanced colonic tumour.pubmed.ncbi.nlm.nih.gov
A Case of Cervical Necrotising Fasciitis Precipitated by Hypopharyngeal Squamous Cell Carcinoma.pubmed.ncbi.nlm.nih.gov
Imaging of acute musculoskeletal infections in children and their differential diagnoses.pubmed.ncbi.nlm.nih.gov
Benign Pneumoperitoneum: A Case Report and Literature Review.pubmed.ncbi.nlm.nih.gov
Minimally Invasive Surgery for Sternoclavicular Joint Infection with Osteomyelitis, Large Abscesses, and Mediastinitis.pubmed.ncbi.nlm.nih.gov
Diagnosis and management of sternoclavicular joint infections: a literature review.pubmed.ncbi.nlm.nih.gov
Chest wall stabilization in trauma patients: why, when, and how?pubmed.ncbi.nlm.nih.gov
Common and Rare Radiological Findings of Pulmonary and Thoracic Hydatid Cysts.pubmed.ncbi.nlm.nih.gov
ESR Essentials: acute infections of the head and neck-practice recommendations by the European Society of Head and Neck Radiology.pubmed.ncbi.nlm.nih.gov
Retropharyngeal Abscess in an Adult Patient Presenting with Neck Fullness and Dysphagia: A Case Report.pubmed.ncbi.nlm.nih.gov
CT of acute abdomen in the elderly.pubmed.ncbi.nlm.nih.gov
Unusual manifestations of chest wall tuberculosis: diagnostic challenges in two cases from a low-incidence tuberculosis country.pubmed.ncbi.nlm.nih.gov
High-Grade Chondrosarcoma Involving the Xiphoid Process and Lower Sternum-The Continuing Role of Extended Open Chest Wall Surgery in the Era of Minimally Invasive Thoracic Surgery: A Case Report.pubmed.ncbi.nlm.nih.gov
Biomechanics of chest wall injury: implications for surgical stabilization and failure prevention.pubmed.ncbi.nlm.nih.gov
Treatment failure in suspected community-acquired pneumonia revealing a pulmonary abscess.pubmed.ncbi.nlm.nih.gov
Diagnostic Value of Non-contrast Lung CT in Evaluating Pulmonary Cavitary Lesions in Children and Adolescents: With a Specific Focus in Perforated Hydatid Cyst, Necrotizing Pneumonia, and Lung Abscess.pubmed.ncbi.nlm.nih.gov
EVT-Inspired Simplified Negative-Pressure Nasoesophageal Drainage for Cervical Abscess Secondary to Esophageal Perforation.pubmed.ncbi.nlm.nih.gov
CT Appearances of Ketamine-Induced Uropathy: A Guide to General Radiologists.pubmed.ncbi.nlm.nih.gov
Imaging Findings of Testicular Tuberculosis: A Case Report and Pictorial Review.pubmed.ncbi.nlm.nih.gov
Lumbosacral necrotizing fasciitis after thoracic drainage: a case report documenting subcutaneous and fascial spread.pubmed.ncbi.nlm.nih.gov
Streptococcal Toxic Shock Syndrome: Persistent Diagnostic and Therapeutic Challenges.pubmed.ncbi.nlm.nih.gov
Role of thoracostomy in the management of postoperative empyema following lung resection: a narrative review of surgical strategies, evolving techniques, and outcomes.pubmed.ncbi.nlm.nih.gov
Comparison between direct puncture trocar and Seldinger technique in ultrasound-guided drainage of pleural fluid collections (DIESEL study): A prospective observational study.pubmed.ncbi.nlm.nih.gov
Thoracoscopic resection of the second rib via a periareolar approach: a case report.pubmed.ncbi.nlm.nih.gov
Fascial Plane Blocks for Analgesia in Non-Operating Room Anesthesia Settings.pubmed.ncbi.nlm.nih.gov

Eğitim amaçlıdır; hasta başında tanı ve tedavi kararının yerine geçmez, tıbbi tavsiye değildir. Metinler yapay zekâ desteğiyle yazıldı ve otomatik bir adımda kaynak alıntılarıyla karşılaştırıldı; bu bir tıbbi doğrulama değildir ve içerik uzman radyolog incelemesinden geçmedi. Klinik kararlarda güncel kılavuzları, kurum protokollerini ve radyoloji raporunu esas alın.