الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
This prospective study was conducted on 20 patients referred to Radiodiagonsis Department of Alexandria University Hospital for imaging. They were presented with fever, productive cough, hemoptysis and chest pain referred for MDCT of the chest. They were 15 males (75%) and five females (25%) with male to female ratio of 3: 1. Their ages ranged between 15 and 83years.
The aim of the work is to assess the role of multi-detector computed tomography as a non invasive technique in differentiating benign and malignant lung abscesses.
In the present prospective study, Relevant history in relation to the causes was obtained, including history of dental extraction, aspiration pneumonia, smoking, DM, history of unconsciousness, alcoholism and epilepsy. Clinical data were reviewed. Investigations including sputum examination and culture sensitivity were done. In selected cases, fiberoptic bronchoscopy, acid fast bacilli culture from BAL fluid, CT guided FNAC were done whenever needed. All patients were subjected to chest radiographs (posterio-anterior and lateral views) and MDCT.
All patients were examined using four and sixteen multi-detector CT scanners – GE light speed and Philips MX 16-slice CT scanner respectively. The scan parameters used were 120 kVp and ≤ 240 mA per slice; tube rotation 0.75s and slice thickness 1.25 mm.
Lung abscess is one of the most important and potentially life-threatening disorders and is defined as a localized area of destruction of lung parenchyma with radiologically detectable opacity showing an air fluid level. Lung abscesses are classified as primary or secondary and by the duration of symptoms prior to diagnosis as acute, sub-acute, or chronic.
The study was conducted on 20 patients with lung abscesses, 16 patients of them with benign lung abscesses including six patients with pyogenic lung abscess, three patients with septic emboli, two patients with tuberculous lung abscess, (one with medical caseouctomy lung abscess), two patients with necrotizing pneumonia, one patient with near drowning aspiration, one patient with lung abscess on top of chronic obstructive pulmonary disease, one patient with infected infarction. And four patients with malignant abscess three of them were squamous cell carcinoma and one patient with adenocarcinoma.
With the recent advance in CT, MDCT became the modality of choice in the evaluation of lung abscess. Benign lung abscess may have thin or thick regular or irregular wall. Malignant abscess always have eccentric cavity and internal bossing. Tuberculous abscess are usually associated with tree-in-bud pattern.