Fig. 2

Bedside CXR and simulated DTS reconstruction for a 26-year old woman, who was admitted to the ICU after a cardiac arrest. Shortly after admission, she developed severe subcutaneous emphysema. a The bedside CXR confirms subcutaneous emphysema in the neck, axillae and lateral chest walls. The symmetric dense areas which overly the midsection of both lung fields are caused by bilateral breast prosthesis. There is no deep sulcus sign, and no clear delineation of a pneumothorax. The left diaphragm is clearly delineated due to a large amount of air in the stomach. The heart contour is relatively sharp, but symmetric on both sides. b Simulated DTS acquisition of a CT examination, performed 30 minutes later. c Slice of the DTS reconstruction of the simulated acquisitions near the back of the patient shows symmetric findings with normal parenchyma on both sides, without areas of consolidation or hyperlucency. d Simulated DTS slice more anterior than that shown in c shows two triangular areas with absence of lung markings; these findings are consistent with a bilateral pneumothorax. Note that these areas have a similar translucency compared to the large amount of air in the stomach. e Coronal reformatted CT image at the same level of the image shown in d, confirming a bilateral pneumothorax and extensive subcutaneous emphysema. f Slice locations of the DTS and CT slices