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CHEST X-RAYUKK Pencitraan IDAI

Most frequently performed in pediatric

plain film examination

Assist in establishing preliminary

diagnosis

Monitor the progression of respiratorycondition

Assess the effectiveness of any

implemented treatment

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Plain Film

Standard view AP erect AP supine infants or ill children Lateral localizes an abnormality seen on

AP view

Lateral decubitus (RLD/LLD) small pleural

effusions Oblique pleura, chest wall, ribs

Freddy frog (top lordotic)Upperrespiratory

tract/apical

Standard view AP erect

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AP Supine infants or very sick children

Erect Supine

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Lateral (right lung)

Lateral film localizes an abnormality seen

onAP view

R

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Lateral decubitus (Right-LD/Left-LD)

small pleural effusions

Right-LD

Right-LD

Small pleural effusions

Right-LD

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Right Lateral Decubitus AP Supine

Adequate inspiration

Age of child Optimum inspiration

-3 years 8 posterior ribs

3-7 years 9 posterior ribs

> 8 years 10 posterior ribs

Swischuk:judging the degree of inspiration on a chest filmin an infant/very young child is probably never will be

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Good exposure

Pulmonary vessels

central 2/3 lung fields, no blur

Trachea and major bronchi

be visible

Intervertebrae disc of the lower thoracic

spine

visible through the heart

Good A-P

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Lung A-P

How to examineSystematically described

Mediastinum

Hillar shadows

Cardiac shadow

Great vessels

Lungs

Pleura Diaphragms

Skeletal

Soft tissues

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Lateral The side under investigation

closest to the cassette

Ribs posterior aspect should

be superimposed

The vertebrae should be seen

without rotation

Should include the whole

chest from apices to the

diaphragm

R

Shadow of the chest

A-P Lateral

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Foto Toraks Normal (1)

Mediastinum tidak melebar

Trakea relatif di tengah

Batas jantung jelas

Jantung tidak membesar

Bentuk jantung seperti buah pir

Posisi jantung hemitoraks kiri,

mesokardia

Foto Toraks Normal (2)

Tidak ada kelainan paru

Sudut kosto/kardiofrenikus tajam

Tidak ada kelainan tulang dan

jaringan lunak

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Mediastinum

Tidak melebar

Melebar

Trakea

Tertarik Terdorong

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Batas Jantung

Jelas Tidak jelas

Cardio-Thoracic (CT) Index

b + c

a

~ 0,5 0,6

a

b c

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Ukuran Jantung

Tidak membesar

Membesar

Lokasi Jantung

Mesokardi

Dekstrokardi

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Vaskularisasi normal

Vaskularisasi menurun

Vaskularisasi meningkat

Sinus kostofrenikus

Tajam Tumpul

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Tulang dan Jaringan Lunak

Tulang normal Tulang abnormal

Alveolar process

Consolidation Patchy, fluffy infiltrate

Most commonly result ofbacterial infections

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Consolidation

A

Consolidation

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Patchy infiltrate

Alveolar infiltrate

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Alveolar infiltrate air-bronchogram

Interstitial process

Perihilar/peribronchial infiltrates

thickening of bronchial walls and

peribronchial tissues

perihilar streaky radiations

Most commonly result ofviral infections ormycoplasma

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Perihilar/peribronchial infiltrates

Interstitial process

Pneumonitis Reticulonodularity

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Interstitial process

Diffusely, hazy