Cheryl Hsuan Lin MD, Presenter: Nothing to Disclose

Nikhil Goyal MD, Abstract Co-Author: Nothing to Disclose

Gerald F. Abbott MD, Abstract Co-Author: Author, Thieme Medical Publishers, Inc Author, Amirsys, Inc

Rakesh D. Shah MD, Abstract Co-Author: Nothing to Disclose

Jesse Chusid MD, Abstract Co-Author: Nothing to Disclose

Mary Margaret Salvatore MD, Abstract Co-Author: Nothing to Disclose

Review the imaging findings of acute and chronic aspiration on CT and Xray. List conditions that predispose patients to aspiration. Remind radiologists to look for ancillary findings which will increase confidence in the diagnosis of aspiration, if such diagnosis is suspected. Discuss examples of imaging mimickers.

A. Imaging findings of aspiration on CT and Xray from sample cases B. Brief discussion on predisposing conditions: Esophageal motility disorders: achalasia, scleroderma GERD Hiatal hernia Zenker diverticulum Neuromuscular disorders Alcoholism Loss of consciousness Difficult/emergent intubation C. Mimickers of aspiration pneumonia D. Emphasis on familiarity with ancillary findings to help identify subclinical aspirators

Aspiration pneumonia is characterized by tree-in-bud opacities or consolidations in gravity-dependent locations. Chronic or recurrent aspiration may lead to local or diffuse bronchiectasis. Recurrent cases usually favor the same location due to anatomic drainage patterns. Untreated cases often lead to necrotizing pneumonia and lung abscess. Ancillary findings include: dilated esophagus, debris within the airway, reflux seen on barium swallow study, etc.  

Lin, C, Goyal, N, Abbott, G, Shah, R, Chusid, J, Salvatore, M, Imaging Features of Pulmonary Aspiration.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9005747.html