Clinical Features and Radiological Findings of Adenovirus Pneumonia Associated with Progression to Acute Respiratory Distress Syndrome: A Single Center Study in 19 Adult Patients

Cha, Min Jae; Chung, Myung Jin; Lee, Kyung Soo; Kim, Tae Jung; Kim, Tae Sung; Chong, Semin; Han, Jungho

Posterior-anterior chest radiographs were obtained with a computed radiography system (FCR 9501; Fuji, Tokyo, Japan) or digital radiography system (Revolution XQi ADS_28.4; GE Medical Systems, Milwaukee, WI, USA) with operating parameters of 70-120 kVp and 2-3 mAs. Serial chest radiographs were acquired for all patients Korean J Radiol 17(6), Nov/Dec 2016 kjronline.org during hospitalization in order to assess the progression of disease. CT studies were performed using various helical CT scanners (Hi Speed Advantage, Light Speed QXi, Light Speed Ultra, Light Speed VCT and Discovery CT750 HD, GE Healthcare, Chalfont St Giles, England; Brilliance 40, Philips, Best, the Netherlands; Aquilion, Toshiba, Tokyo, Japan). CT scans (114-210 mA, 120 kVp, beam width of 10-20 mm, beam pitch of 1.375-1.5) were performed from the lung apices to the level of the middle portions of both kidneys. Intravenous contrast medium injection was used in approximately half of the patients (10 patients), with 1.5 mL/kg (body weight) of Iomeron 300 (iomeprol, 300 mg iodine/mL; Bracco, Milan, Italy) injected at an infusion rate of 3 mL/s using a power injector (MCT Plus; Medrad, Pittsburgh, PA, USA). The imaging data were reconstructed with section thicknesses of 2.5-5 mm using a bone algorithm. The reconstructed images were then interfaced directly to a picture archiving and communication system (Centricity 3.0; GE Healthcare, Mt. Prospect, IL, USA), which displayed all image data on two monitors (1536 x 2048 matrix, 8-bit viewable gray scale, and 60-ft-lambert luminescence). Both mediastinal (width, 400 HU; level, 20 HU) and lung (width, 1500 HU; level, -700 HU) window images were viewed on these monitors.