FFRCT: Current Status.

OBJECTIVE. Fractional flow reserve derived from coronary CT angiography (FFRCT) is an emerging tool for noninvasive evaluation of coronary artery disease that provides a combined anatomic and physiologic evaluation. The goal of this article is to serve as a review of the current status of FFRCT through discussion of existing trials on the modality and to introduce readers to examples of its utility and potential pitfalls. CONCLUSION. This article reviews the current body of evidence on FFRCT and provides case examples illustrating its current uses, limitations, and potential future applications.

Sarcoidosis: A Diagnosis of Exclusion.

OBJECTIVE. This article will review the typical and atypical imaging features of sarcoidosis, identify entities that may be mistaken for sarcoidosis, and discuss patterns and clinical scenarios that suggest an alternative diagnosis. CONCLUSION. Radiologists must be familiar with the characteristic findings in sarcoidosis and be attentive to situations that suggest alternative diagnoses. The radiologist plays a major role in prompt diagnosis and one that may help reduce patient morbidity and mortality.

Improving Quality of Chest Radiographs After Placement of Peripherally Inserted Central Catheters.

The goal of this study was to determine the best method for localizing peripherally inserted central catheters (PICCs) in postplacement portable chest radiographs. A retrospective analysis showed no significant difference in visualization of the PICC tip between different chest radiograph projections. Modifications were made to an institutional PICC protocol to obtain anteroposterior chest views with the guidewire present only. Repeat analysis demonstrated statistically significant increases in the frequency of anteroposterior radiographs performed, the number of chest radiographs with guidewire, and the localization of the catheter. By standardizing the acquisition of PICC placement chest radiographs, fewer variant projection radiographs were performed and the catheter tip was confidently localized in more examinations.

A 29-Year-Old Woman With Severe Sepsis and Hemoptysis.

A 29-year-old woman presented with a 1-week history of fever, weakness, anorexia, darkened urine, and mild cough. The patient described her cough as nonproductive and without hemoptysis. She had no chest pain. The patient's medical history was significant for x-linked hypophosphatemia, renal stones, migraine headaches, and chronic back pain managed on prescribed oral opiates for some time. She reported regular cigarette smoking, but denied illicit or IV drug use or any recent travel or sick contacts. The patient also had no known pertinent family history.