Basics of Chest Imaging
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Transcript of Basics of Chest Imaging
Basics of Chest Imaging
Rebecca Peterson, M. D. Associate Professor Department of Radiology University of Ottawa
Anatomy
Normal PA
Normal Lateral
The Chest X-ray in Disease
Basic Patterns of Disease
Air-Space Disease
VS
Interstitial Disease
Pulmonary Acinus
Air space disease
Consolidation
Means “solid lung”
Implies that there is “air-space disease”
May occur with or without volume loss
Consolidation without
volume loss
Air Bronchogram
Air Bronchogram
Characteristics of Air Space Disease
Acinar shadow
Homogeneous density (consolidation)
“Silouette”sign Loss of distinct margins next to
consolidation
Air bronchogram
Non-segmental distribution
Consolidation RML
normal abnormal
Consolidation RML
normal abnormal
Causes of Airspace Disease
Infection
Hemorrhage
Edema
Neoplasm
Idiopathic
Consolidation withvolume loss
“Atelectasis” or “collapse”
Collapse LLL Normal
Collapse LLL
Direct signs of volume loss
Movement of a fissure
Indirect signs of volume loss
Upward shift of the diaphragm
Mediastinal shift to that side
Movement of main-stem bronchus
Hypovascularity of remaining lung due to hyperinflationLung looks darker
Collapse RUL
incomplete complete
Collapse RUL
incomplete complete
Collapse LUL
incomplete complete
Collapse LUL
incomplete complete
Collapse LLL
Collapse LLL
Collapse RML
Collapse RML
TEST
Basic Patterns of Disease
Air-Space Disease
VS
Interstitial Disease
Interstitial Lung Disease
Perivascular
VS
Parenchymal
Pulmonary Acinus
Perivascular Interstitial Disease
Pulmonary Edema
Interstitial Pulmonary Edema
normal abnormal
Interstitial Pulmonary Edema
Interstitial Pulmonary Edema
normal abnormal
Interstitial Edema
Interstitial Edema
Kerley “B” Lines
Kerley “B” Lines
Signs of Interstitial Edema
Vessels look larger and indistinct
Peribronchial cuffing
Fluid in fissures
Kerley”B” lines
Pleural effusions
Acute Airspace Edema
Airspace Edema
Acute Airspace Edema
Consolidation is bilateral
Consolidation is symmetrical
Consolidation is gravity dependent
Parenchymal Interstitial Disease
Usual Interstitial Pneumonia
Asbestosis
Sarcoidosis
Parenchymal Interstitial Disease
Usual Interstitial Pneumonia
UIP
NORMAL ABNORMAL
UIP
UIP
Asbestosis
Asbestosis
Sarcoidosis
Sarcoidosis
Patterns of Pneumonia
Lobar Pneumonia
Bronchopneumonia
Interstitial Pneumonia
Lobar Pneumonia
Hematogenous spread
Begins at lung periphery
Involves whole lobe of lung
Unilateral
Commonest pathogen Strept Pneumoniae
Lobar Pneumonia
Lobar Pneumonia
Lobar Pneumonia
Bronchopneumonia
Central bronchial inflammation
Patchy airspace consolidation distallyDue to inflammationDue to mucous plugs
Bilateral, asymetrical
Commonest pathogen Staph Aureus
Bronchopneumonia
Bronchopneumonia
Bronchopneumonia
Bronchopneumonia
Bronchopneumonia
Interstitial Pneumonia
Involves interstitial parenchymal space
“ground glass” opacity both lungs
Bilateral, symmetrical
Leads to airspace consolidation
Commonest pathogens mycoplasma and Pneumocystis Carinii
Pattern seen in SARS
Interstitial Pneumonia
Interstitial Pneumonia
Ground Glass
End stage Interstitial Pneumonia
End stage Interstitial Pneumonia
TEST