RADIOANATO RESPIRASI rista

7/24/2019 RADIOANATO RESPIRASI rista

http://slidepdf.com/reader/full/radioanato-respirasi-rista 1/37

RADIO ANATOMY

RESPIRATORY TRACTAND MEDIASTINUM

Rista D. Soetikno, dr, SpR



Radioanatomy

• Studies of human body seeing through the

roentgenologic examination



Respiratory Tract

– Upper air passage (a!. "asi and pharynx#

– $arynx

– %rachea and bronchus

– $ung & 'ascular (lymph#

– %horacic all & diaphragm

•),*,+ hest xray•$ung -



Lung anatomyRig!t Superior $obe pical Segment (/#

0osterior Segment (1#nterior Segment ()#

2edial $obe $ateral Segment (*#2edial Segment (+#

3nferior $obe picobasal Segment (4#

2ediobasal Segment (5#

nterobasal Segment (6#

$aterobasal Segment (7#

0osterobasal Segment (/8#



Lung AnatomyLe"t

Superior $obe picoposterior Segment (/#

nterior Segment (1#

$ingula Superior Segment ()#3nferior Segment (*#

3nferior $obe pical (+#

ntero medial basal (4#$atero basal (5#

0ostero basal (6#



9ray : ;luoroscopy indication

• ontact person• ough < 1 eeks

• Recurrent respiratory infection

• =emaptoe• >kstra pulmonary %?

• >rytema nodosum : con@unti!itis phlyctenularis

• ;issure:fistula anichronicum• D2

• 0recautionary indication



9ray >xamination

• Routine A 0

• Special A

• $ateral – $eft

– Right

• 0

• BbliCue $eft Right

• $ateral decubitus



Special method of examination

• %omografi

• ?ronchografi• US

• % scan• 2R3



0 0osition

• 0lace patient beteen film – 9 ray source• =a!e the patient stand backard to the 9 ray

source, chest close to film ith hand on the hip,ith elbo flexed. Distance beteen film and 9

Ray$ung– /,+ m

=eart 1 m

• Ray concentrated at

'.%h. 45

E' +848

2.s /818



ood chest 9Ray depend onA/. ood film Cuality

Depending on AE'

2.s

0rocessing

1. Symmetry

). ll part of thorax are included

*. 3dentity :2arking

+. "o artefact4. "o motion artefact

5. 2aximal inspiration



Fhat studied in chest xray

• Soft tissue

• ostae and cla!icle

• %rachea

• SiGe, shape and position of heart

• $ung – =illous

– ?roncho!askuler marking



$ung field A

• $ung apex

• $ung top field

• $ung middle field

• $ung loer field



$ateral chest film

3ndication

• %o study abnormality that is not !isible on

0 film

• %o study mediastinal disorder

• =eart studies



$ateral chest procedure

• 0lace patient beteen film and 9ray

source

• 0lace lateral side of chest (left:right# on film

• =ands behind the head

• Ray centered on %h 45



Fhat studied on lateral chest film

• %rachea and mainbronchial branch radioluscent

• =eart, aortic arch, asc: desc aortic

• $eft: Right $ung broncho!ascular markingsuperposition

• Retrosternal space

• Retrocardial space• ostophrenic sinus

• ardiophrenic sinus



Antero posterior #AP$ c!est "i%m

3ndication A

• Se!erely ill patient

• hildren : babies

• Bbese, pregnancy, ascites, abdominal tumor

0rocedureA

• 0lace patient lying don on table ithelbo abo!e head

• 0lace film on patientHs back

• entered ray on %h 45



%op lordotic chest xray

3ndication A• %o studies disorder located on apex : medial lobe

cla!icle turn upard

0rocedureA

• 0lace patient beteen film and xray source, ha!ethe patient face the xray source

• =a!e the patient stand )8 cm in front ith back placed on the cassette

• Set top part of the cassette / inch abo!e theshoulder

• entered ray on manubrium sterni



BbliCue chest filmA

3ndication A

• =eart studies

• %o study abnormality that is not yet clear on 0studies

0rocedure

• 0lace patient beteen film and ray source

• 0ut !entral left:right side of the patientHs thorax onthe cassette making *+ 8 angle

• enter ray on 'ert. %h 45



Latera% decu&itus c!est "i%m

3ndication A

• %o study fluid in pleural ca!ity that is around /88188cc

• Br fluid accumulation that is not yet determined on 0studies

0rocedure

• =a!e the patient lying don on left:right side ithelbo abo!e the head

• enter ray on !ert. %horacal 45 from anterior:posterior aspect



Mediastinum 'orders

SuperiorA pertura thoracis sup.

Dorsal A 'ertebral olumn.

'entral A Sternum. 3nferior A Diaphragm.

$ateral A 2ediastinal pleura.



/. nterior superior med

1. nterior medius med

). nterior inferior med

*. Superior medius med

+. 2iddle med

4. 0osterior superior med

5. 0osterior medius med

6. 0osterior inferior med

Mediastina%



/. Radiograph A

• hest filmA 0.

• $ateral.

• esophageal contrast studies.

1. ;luoroscope A

• %o study pulsation• %o study placement of organ in chest

ca!ity

Mediastina% Studies



%o study mass relation ith ad@acent organ

Diaphragm

>sophagus

=eart and ma@or !essel

%o study pericardial effusion



). %omografi.

*. ngiografi Usually ith

%.+. % Scan : 2R3.

4. US A 2ass close todiaphragm : 0ericard effusion.



5. "uclear med. Radioisotop.

• Radio isotop angiogram.

• %o study localiGation of tumor .

• >C A thymoma, thyroid, lymph

node.



nterior superior med

•neurisma aorta•%hymus =yperplasia

•$ymphoma

• 3ntrathoracal Struma

•%hymoma

Location o" mediastina%

disorder



nterior middle med.

ο• Dermoidο• %eratoma

Location o" mediastina% disorder



Ant( In"erior( Med

• %hymoma.

• 0ericardial cyst.

• =ernia diafragmatica.

Superior Mid( Med

• neurisma.

• Dermoid.

• %eratoma.

• 2ediastinal trauma



Midd%e Mediastina%

• Dermoid

• %eratoma

• $ymphoma

• %umor metastasis ($ymph

spread#



Post superior med(

• Besophageal disorder

• neurism

• "eurinoma, neurofibroma.• 0ancoast tumor



Anterior In"erior med(

)( T!ymoma(• <;emale

• ould turn 2alignant.

• Round:lobulated.

*( Pericardia% cyst(

• ystic tumor that connected ith pericardium.

• Bn right cardiophrenic sinus



Midd%e Mediastina%

)( In"ection

• Sarcoidosis

• %?• 2ycosis.

• >rythema nodosum

*( Tumor Metastasis

). Lymp!oma



Posterior mediastina%

>sophagus disorder A• Di!erticle.

• chalasia : halasia

0ancoast tumor

neurisma.

"eurogenic tumor ("eurofibroma, "eurinoma#



Post medius med(

• "eurogenic tumor.

• ?ronchial defect enteric cyst.

Post in"erior med(

• "eurogenic origin primary tumor.

• Diaphragmatic hernia.



Anterior superior Med(

/. O"ten A %hymic =yperplasia.

•$obuler type, flag fusiform.

•?ilat:unilat.

•Bn children (%hymic 0ersistent#

1. Aneurisma A ardio!ascular

section). Lymp!oma Ma%igna



RoA tracheo bronchial node enlargement

lobulated ould cause superior cavavein. Syndrome.

+( Intrat!oraca% Struma

*8 years

Usually compress A trachea,oesophagus, phrenic ner!e.



Ro,

$ung apex mass compresstrachea.

Mediastinum anterior medius

Dermoid cystA %umor that consist of

multiple tissue hair, teeth benign.

RADIOANATO RESPIRASI rista

Documents

Transcript of RADIOANATO RESPIRASI rista