An_Introduction_to_Chest_Imaging (maysaloon)_b5512831f1eed1ebd41216e37565f197

. . .B. - F.I.B.M.S. (Diag.Rad.) Duhok -College of Medicif.

. . . . . . . . . . st x-ray (CXR) etation nical aspects.

. . 9 Postal "tess ievoga LS13RT Po:tal Addre:s LS2 RAY kint How well is pati he was trans o • Data of patient(name, date region to be examined,..etc). • of events in hospital(lab investigation) • Clinical indication(cough, fever, sweating), • Relevant past medical history PMH, past surgical history, past Imaging • Pregnancy status/ LMP(until 3rd month of pregnancy the CXR is conypind!cated) • How well is patient and how he was transported(because the CXR is done stand position but is he cant stand we will do in supine position.

. The Chest X - Ray - technical factors n Photographic film and X - Ray Physics n Shadows seen on an X - Ray n Bone/metal bright ( opaque) n Water/soft tissue white n Fat grey n Air black ( lucent) خڵەت ،كيرات ،نشۆڕان ،ڵێل.

. . 109 epoe 6upuøosea. . . Splenic flexure of Descendng aorta cobn.

. . Trachea is clear and centrally located and any deviation means underlying pathology.

. . PA vs AP views PA view • seen in periph«y of • Clavicles fields • Posterior distinct • Position Of m AP view • are lung fields • Clavicles are above ttæ of fields • Of markers • ribs are.

. . we can see 75cc of fluid effusion while at AP OR PA we 200 cc of fluid effusion.

. . . . . . . . . . . . . . . Q: CAN YOU NAME THE ANTERIOR , MIDDLE , POSTERIOR.

. . di dame. . . . . . . . should be tess than i. c, A.B/C€O.5 A cardiothoracic ra O.S suggests cardkxn.egaty in ad' a, A cardiothoracic 0.6 suggests caroccnegaty in neaboen.

. . . . . . . . . . . . . ADIOPAQUE - too white ( opaque ) • RADIOLUCENT - too black ( lucent).

. n Technical aspects - both lungs of equal transradiancy - Divide the lungs into 3 zones - Trachea should be centrally located - Identify the horizontal fissure ,It should run from the hilum to the sixth rib in the axillary line. - Both hila - Costophrenic , cardiophrenic angles 1 2 3 4 5 6 7 8 7 9.

. . • Inspiration • Markings (dextf(. . . . . . .

. . )sed Underexpose(. . . . . . . . . . . obes5D.

. . . . . . . . . . . . . . Non rotated Rotated. .

. . . . . . . . . . . . . Inspiratory Expiratory.

. . . . . . . . . . . . . Ceebr Hyper inflated chest 5-6 Under inflated chest.

. . . . . . . . . . C l': Consolidation. C l': Consolidation.

. . . . . 000. 000. . . . . . . Si:houette : is the loss of normally sharp interface of lung and soft tissues by a pathology that obscures the borders of the lung with these soft tissues (diaphragms, cardiac and aortic outlines , silhouette means border, loss of silhouette means pathology ..

. 1 - air space filling, acinar , alveolar pattern (Consolidation): n Replacement of the air in the alveoli by transudate , exudate , blood , protein ,cells. n Seen in pneumonia , TB , inflammations ,benign and malignant tumours, alveolar proteinosis , heart failure ,contusion . n uniform and non - uniform shadowing n Air bronchogram presence or not. n Retained lung volume or loss of volume.

. . . . . . . . . . . . . Collapse consolidation.

. . . . . . . . . . . . . . . ANSWER : DUE TO OBLITERATION OF A MAJOR OR MINOR.

. . . . . . . . . . shifted ipsilateral to the kPSED LUNG , THE ING AIR SO THE RAL SPACE WILL PULL •OWARDS IT..

. . • Obscured right (silhouette s•gn) Compensatory • of let lung Prominent len pulmonzy artery (cardiac output passnng through smgleo rum artery).

. . . . . . . . . . . . . . . . n. . Right UL collapse Left lower lobe collapse.

. . . . . . . . . . LEFT LOWER LUNG JSION OF THE LEFT IR IN THE LUNG RBED LEADING To.

. . . . . Oon. . . . . . . . . is diffuse non- homogenous and 2-diffuse lung dise•ase (interstitial) includes various patterns such as linear, septal lines, miliary, reticulo- nodular, nodular, honeycomb shadowing, cystic , ground-glass pattern. LEFT.

. . . . . . . . . . . . . . . . Miliary Reticulonodular.

. . . . . . . . . . . . . . . . Honey comb. . Diffuse Cystic.

. . . . . . . . . . . . . . . . Ground glass appearance.

. . . . . . . . . . . . . . . . 3. . . nodules / masses/cavities.

. . . . . . . . . . . . . . . . Pulmonary mass: when lesion measure more than 3 cm. 1-brochogenic CA. 2-hydatid cysts. 3-lung metastases..

. . . . . . . . . . . . . . . . Nodule. . TB focus.

. Pulmonary cavities: 1 - cavitating tumours (squamous cell CA) . 2 - cavitating pneumonia(staph. Coccus strepto . , klebseilla ) , TB cavity , fungus ball . 3 - complicated hydatid cyst, abscess ( air fluid level ).

. . . . . . . . . . . . . . . . 4. . . air ways related disorders: COAD (asthma ,.

. . . . . . . . . . . . . . . over inflation of the lungs causes excessive hyperlucency of the lungs , flattening of the diaphragms ,increased rib spaces ,small looking heart shadow , prominent hila ..

. . . . . . . . . . . . . . . . Bronchectasis. . : irreversible dilatation of terminal.

. . . . . . . . . . . . . . . . Pleural abnormalities.

. . . . . . . . . . . . . . . . n. . Fluid is white.

. . . . . . . . . . . . . . . . Pneumothorax. . n.

. . . . . . . . . . . . . . . . Pneumothorax. . n.

. . . . . . . . . . . . . . . 5-vascular pattern: A-Pulmonary plethora: due to increased pulmonary vascular flow, seen in cases of left to right shunts (ASD, VSD & PDA). B-Pulmonary oligaemia: due to decreased pulmonary vascular flow , seen in pulmonary artery stenosis..

. . . . . . . . . . . . . . . . Heart failure. . .

. . . . . . . . . . . . . . . . Butterfly. . Batwing.

. . . . . . . . . . . . . . . . THANK YOU. . for your attention.