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Back to Basics Radiology 2010

Back to Basics Radiology 2010. Rebecca Peterson Department of Radiology University of Ottawa. Routine Technique: PA and Lateral. Normal Chest – PA and Lateral. PA Chest. Trachea. SVC. Aortic arch. Azygous. Lt Pulm Artery. Rt Hilum. Lt Mainstem bronchus. Lt Ventricle. Rt Atrium.

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Back to Basics Radiology 2010

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  1. Back to BasicsRadiology2010 Rebecca Peterson Department of Radiology University of Ottawa

  2. Routine Technique: PA and Lateral

  3. Normal Chest – PA and Lateral

  4. PA Chest Trachea SVC Aortic arch Azygous Lt Pulm Artery Rt Hilum Lt Mainstem bronchus Lt Ventricle Rt Atrium Rt Diaphragm Lt Diaphragm

  5. Lateral Chest Aortic Arch Trachea Lt Pulm Artery Rt Pulm Artery Lt upper lobe bronchus Rt Ventricle Lt atrium Rt Diaphragm Lt Ventricle Lt Diaphragm

  6. Consolidation • Without volume loss • Pneumonia, Pulmonary edema, Hemorrhage • With volume loss • “Atelectasis” or “Collapse”

  7. Consolidation Without Volume Loss

  8. Consolidation With Volume Loss

  9. Means “solid lung” Characteristics: Increased density Acinar shadow Silhouette sign Air bronchogram Consolidation

  10. Consolidation and Air Bronchogram CT Scan

  11. Consolidation, Air Bronchogram and Silouhette Sign PNEUMONIA

  12. Consolidation Without Volume Loss Airspace Disease

  13. LLL Pneumonia Consolidation Sharp interface Loss of diaphragm LLL PNEUMONIA NORMAL

  14. LLL Pneumonia consolidation Sharp interface Loss of lt diaphragm NORMAL LLL PNEUMONIA

  15. Normal RML Consolidation Loss of heart border

  16. Normal RML Consolidation Consolidation

  17. RLL Pneumonia PA View Lateral

  18. Lingular Pneumonia Lateral PA View

  19. Right Lower Lobe Pneumonia

  20. LLL Pneumonia

  21. Causes of Airspace Disease • Pneumonia • Hemorrhage • Pulmonary Edema • Neoplasm • Other

  22. Consolidation With Volume Loss Atelectasis or Collapse

  23. Passive Atelectasis

  24. Endobronchial Lesion

  25. Signs of Volume Loss • Direct Signs: Movement of a fissure • Indirect Signs: • Elevated diaphragm • Tracheal shift • Mediastinal shift • Elevated or lowered mainstem bronchus • Movement of hilum • Fewer vessels in aerated lung

  26. Right upper lobe collapse Tracheal shift Hilum displaced Elevation of diaphragm Movement of the Fissures, a DIRECT sign of volume loss

  27. RLL Collapse Tracheal shift Fissure displaced Collapsed lung Hilum pulled down

  28. Normal Atelectasis LLL No diaphragm Diaphragm reappears Portable Chest X-ray

  29. LLL Atelectasis

  30. Complete collapse Tracheal shift Bronchus amputated Diaphragm

  31. Pleural Effusion

  32. Pleural Diseases Pneumothorax and Pleural Effusions

  33. Pneumothorax

  34. Tension Pneumothorax INSPIRATORY VIEW EXPIRATORY VIEW

  35. Pneumothorax CT SCAN

  36. Pleural Effusion Meniscus sign

  37. Infrapulmonary Effusion Stomach NORMAL EFFUSION Stomach

  38. Pleural Effusion DECUBITUS VIEW

  39. Large Right Pleural Effusion PA VIEW Chest X-ray CT SCAN

  40. Pulmonary Edema Interstitial and Airspace Edema

  41. Interstitial Pulmonary Edema

  42. Vascular Indistinctness Normal Interstitial Edema

  43. Vascular Indistinctness Normal Abnormal

  44. Interstitial Pulmonary Edema • Kerley “B” Lines • Peribronchial cuffing • Hila look larger • Vessels are ill-defined • Upper lobe vessels are larger • Fluid in fissures • Small pleural effusions

  45. Interstitial Pulmonary Edema NORMAL INTERSTITIAL EDEMA

  46. Minimal Changes Lateral View NORMAL INTERSTITIAL EDEMA

  47. Interstitial Edema PA View Lateral

  48. Pulmonary Edema

  49. Interstitial Edema Kerley “B”s

  50. Kerley “B” Lines CT SCAN

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