chest x ray interpretation
Post on 07-May-2015
1.447 Views
Preview:
DESCRIPTION
TRANSCRIPT
Chest X-ray interpretationChest X-ray interpretation
Harindu Udapitiya,Temporary Lecturer,Division of Pharmacology.
Overview
Before interpreting……
1. Proper labelling
2. Proper positioning
3. Veiw-PA? AP? Lateral?
4. Exposure
5. Rotation
6. Adequacy of inspiratory effort
Normal Anatomy
Normal Chest X-ray
Cardiac Structures Position
More central in younger infants and children More on the L side in older infants and teens
Size The cardiothoracic ratio should be less than 0.5 A cardiothoracic ratio of greater than 0.5 (in a good
quality film) suggests cardiomegaly.
A/B<0.5
Cardiomegaly
Trachea The trachea is placed usually just to the right of
the midline
Mediastinum
Lungs There are three lobes in the right lung and two in
the left. Right lung
1. Upper lobe
2. Middle lobe
3. Lower lobe.
Left lung1. Upper lobe; this contains the lingula
2. Lower lobe.
Pleura There are two layers of pleura: the parietal
pleura and the visceral pleura. The parietal pleura lines the thoracic cage and
the visceral pleura surrounds the lung.
Diaphragm Contour Rounded with sharp pointed costophrenic and
costocardiac angles. Blunting of costalphrenic or costocardiac angles suggests plueral effusion.
Right diaphragm is usually 1-2 cm higher
Abnormal Chest X-ray
Radiopacity (whiteness) means increased density
Radiotranslucency (blackness) means decreased density
Radiopacity can be of 3 causes Alveolar pattern – fluffy, soft, poorly demarcated
opacifications < 1 cm in diameter Possible causes:
Pulmonary edema Viral pneumonia Pneumocystis Alveolar cell carcinoma
Pneumonia
Abnormal Chest X-ray
Interstitial pattern Consolidation of interstitial tissue (alveolar walls,
intralobular vessels, interlobar septa and connective tissue)
Looks like branching lines radiating toward the periphery of the lung
Possible causes: Interstitial pneumonitis Pulmonary fibrosis
Pulmonary Fibrosis
Abnormal Chest X-ray
Vascular pattern – assessment of the pulmonary arteries and capillaries If there is an increase in the size of the
pulmonary arteries as they extend out into the lung – pulmonary hypertension
If there is a decrease in size, truncation, or obliteration of a pulmonary artery – embolus
Lack of vascular making in the periphery - pneumothorax
Pulmonary Hypertension
Pulmonary Embolism
Lung pathologies
White Lung field Black lung Field
Well defined
Ill defined
Collapse Pleural Effusion
Consolidation Fifrosis Pulmonary Edema Infiltration
Pathological Conditions
1. Consolidation
2. Abscess
3. Bronchial Asthma
4. Bronchiectasis
5. COPD
6. Lung Collapse
7. Heart Failure
8. Pulmonary fibrosis
9. Hiatus hernia
10. Pleural Effusion
11. Pneumothorax
12. TB
13. Carcinoma
14. Lymphoma
15. Pericardial Effusion
16. Mitral Stenosis
17. ASD
1.Consolidation
Causes Pneumonia Bronchial carcinoma Lymphoma Inflammatory conditions
Radiological features Airbronchogram Silhouette sign Lower border
R.Middle lobe Pneumonia
R.Lower Lobe pneumonia
2.Abscess
3.Bronchial asthma
I. HyperinflationII. Diaphragmatic
flatteningIII. Bronchial wall
thickeningIV. Hilar
enlargement
4.Bronchiectasis
I. Tram line opacification
II. “Bundle of graphes appearance”
5.COPD
7.Lung Collapse
DDI. Lung collapse
II. Lower lobe consolidation
III. Pleural effusion
IV. Raised hemi diaphragm
8.Pulmonary fibrosis
9.Pleural Effusion
10.Pneumothorax
11.Hiatus hernia
12.TB
Miliary TB
13.Bronchial carcinoma
14.Lymphoma
15.Pericardial effusion
16.Mitral Stenosis
17.ASD
1.Basics on normal chest x ray 2.Basics on Abnormal chest x ray 3.Pathological conditions
top related