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Abnormal Cases

Abnormal Cases. Bone Cardiovascular Airspace Disease including Silhouette Sign Interstitial Disease and Pulmonary Edema Atelectasis Pulmonary Nodule Pleura and Diaphragm Mediastinal Mass. Bone and Soft Tissues. Fractures. Presenting CXR. Pancoast Tumour. MRI. Computed Tomography.

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Abnormal Cases

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  1. Abnormal Cases Bone Cardiovascular Airspace Disease including Silhouette Sign Interstitial Disease and Pulmonary Edema Atelectasis Pulmonary Nodule Pleura and Diaphragm Mediastinal Mass

  2. Bone and Soft Tissues

  3. Fractures

  4. Presenting CXR

  5. Pancoast Tumour MRI Computed Tomography

  6. Cardiovascular

  7. Increased Cardiac Size: Can be Cardiac or Pericardial Dilated Cardiomyopathy Pericardial Effusion 154 slides 9 What imaging would you use to differentiate between the two ?

  8. Left Ventricular Enlargement IVC Left Ventricle 154 slides 10 Enlargement of Left Ventricle

  9. Pulmonary embolism

  10. Pulmonary embolism

  11. Airspace Disease and Silhouette Sign

  12. Normallung Individual alveoli are too small to resolve, but together they appear radiolucent.

  13. Air-space Disease Filling of alveoli by: water, blood, pus, proteinaceous fluid, or cells -opacities -consolidation

  14. Air-space pattern of lung disease

  15. Airspace Disease Filling in of acini (air space) Air space (acinar) nodules Coalesce to consolidation Air bronchograms Silhouette Sign

  16. Air Space Disease: Etiology Water-Pulmonary Edema Pus-Infections, Non-infectious inflammatory process Blood-Pulmonary Hemmorhage Protein-Alveolar Proteinosis Tumour-BAC, Lymphoma

  17. Air Bronchogram Airways are not normally seen in a normal chest radiograph because they are an air structure within an aerated lung When the aerated lung opacify, the bronchii become visualized because of the surrounding contrast effect.

  18. airbronch 154 slides 23

  19. CT Consolidation: Air Bronchograms

  20. Silhouette Sign Definition: The effacement of a normal structure Example: Airspace disease may silhouette: right heart margin with right middle lobe pneumonia diaphragm with lower lobe pneumonia

  21. Silhouette sign sign describes the observation that an intrathoracic lesion will obliterate borders of shadows of similar radiodense structures that it contacts example: right middle lobe pneumonia will obliterate apex of the right heart border

  22. Silhouette sign Normal Pneumonia (-) silhouette sign (visible heart silhouette) Pneumonia (+) silhouette sign (no heart silhouette)

  23. Pulmonary edema + silhouette sign

  24. Pulmonary edema + silhouette sign

  25. Where is the Pneumonia? 154 slides 31

  26. Right Lower Lobe Pneumonia Right: Partially seen Left 154 slides 33

  27. Left Lower Lobe Pneumonia 154 slides 34

  28. Where is the pneumonia? 154 slides 35

  29. Horizontal (minor fissure) Oblique(major) fissure 154 slides 37

  30. Right Middle Lobe Pneumonia 154 slides 38

  31. Interstitial Disease with Emphasison Pulmonary Edema

  32. In a normal chest radiograph, the visible interstitium is the branching pulmonary vessels • The branching disappears peripherally because they are beyond resolution of the xray

  33. Interstitial Disease

  34. Hazy or ill defined interstitial lung disease usually indicates acute disease Sharp, well defined and distorted interstitial lung disease usually indicates chronic disease Interstital dz appears as linear, nodular, or reticular (net-like) Interstitial Disease

  35. Interstitial pattern of lung disease

  36. Interstitial Disease: Pulmonary Fibrosis 154 slides 44

  37. Interstitial Disease Reticular=net-like Nodular Reticulonodular: Combination of the two patterns

  38. Reticular Pattern 154 slides 46

  39. Honeycombing in patient with single lung transplant for pulmonary fibrosis Normal Transplanted Lung Honeycomb Native Lung 154 slides 47

  40. Miliary Nodular Pattern: Miliary 154 slides 48

  41. cuffing 154 slides 55

  42. Normal

  43. Kerley linesare a sign seen on CXR with interstitial pulmonary edema. They are thin linear pulmonary opacities caused by fluid or cellular infiltration into the interstitium of the lungs

  44. Kerly B Lines 154 slides 59

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