1
CVM 6101
Radiographic Anatomy of the
Thorax
Daniel A. Feeney DVM, MS
Professor of Veterinary Radiology
College of Veteri...
2
Normal Lateral View:
inspiration/expiration
Normal Ventrodorsal View:
inspiration/expiration
Normal Cat Normal “FAT” Cat...
3
Veterinary Medical Center
UNIVERSITY OF MINNESOTA
Normal Thoracic Architecture
[dorsal perspective (high)]
Veterinary Me...
4
Normal Dog Lateral View Normal Dog VD View
Cross-section of Thorax @ Heart Thymic “Sail” Sign (VD)
Anterior Mediastinal ...
5
Normal Dog Thorax
Cross-section of Thorax @ Heart
(solid lines are pleura)
Concept of Fluid/Air Shift
[DV]: Air/Fluid
Co...
6
Pleural Fluid Interpretive Background: THORAX
• Pericardial Sac
Veterinary Medical Center
UNIVERSITY OF MINNESOTA
Normal...
7
Diaphragmatic Anatomy
Diagram [From Grandage]
CVM 6101 [Imaging Anatomy]
• Diaphragm:
– V D/D V and R L/L R views
– Bewa...
8
Normal Dog Thorax
Normal Dog Thorax
Right/Left lateral
Normal Dog Thorax
VD/DV
Diaphgram: paralysis
Extrapleural Lesion
...
9
Pleural Disease Classification Normal Dog Thorax
Thoracic Wall: flail chest Interpretive Background: THORAX
• Airways
Ve...
10
Normal Larynx/Pharynx Normal Dog Lateral View
Diagram: Airway Subdivisions
[dog & cat]
Extrathoracic Tracheal Collapse:...
11
Lung Diagram [lateral view] Lung Diagram [VD view]
Alveolar Disease: pneumonia Interpretive Background: THORAX
• Heart ...
12
Normal Dog Lateral View Heart Diagram [VD view]
Cardiac Perspective Ventrodorsal Thoracic View
R L
12:00
3:00
6:00
9:00...
13
Pulmonic Stenosis Pulmonic Stenosis
Interpretive Background: THORAX
• Intrapulmonary Circulatory Pattern:
– ARTERY/BRON...
14
Pulmonary Venous Congestion
[early congestive LEFT heart failure]
Pulmonary Venous Congestion
[early congestive LEFT he...
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Microsoft PowerPoint - a.Thoracic_Anatomy_05

  1. 1. 1 CVM 6101 Radiographic Anatomy of the Thorax Daniel A. Feeney DVM, MS Professor of Veterinary Radiology College of Veterinary Medicine University of Minnesota Veterinary Medical Center UNIVERSITY OF MINNESOTA ???? Veterinary Medical Center UNIVERSITY OF MINNESOTA CVM 6101 [Imaging Anatomy] • Goals & Expectations: – Identify specific structures or parts thereof – Understand why the views (projections) look as they do – Keep in mind that the items listed in the “to know” lists are from the perspective of practicing radiologists – If asked, be able to describe what soft-tissue (muscle, tendon, ligament, vessel, or alimentary/parenchymal) structure(s) attach to, pass through, or lie in contact with a given anatomic landmark or region Veterinary Medical Center UNIVERSITY OF MINNESOTA CVM 6101 [Imaging Anatomy] • Approach: – Introductory lectures defining the important structures and how they are viewed radiographically – Open session, instructor proctored group laboratory exercises wherein actual radiographs of the anatomic structures are viewed and understood – Web-based self-study sets both available on CD and from the web site http://www.academic- server.cvm.umn.edu/radiology// Veterinary Medical Center UNIVERSITY OF MINNESOTA CVM 6101 [Imaging Anatomy] • Sources of Information: – Anatomy Textbooks – Radiographic Anatomy Textbooks – General Veterinary Imaging Textbooks – U-MN Medical Imaging web site http://www.academic- server.cvm.umn.edu/radiology// Veterinary Medical Center UNIVERSITY OF MINNESOTA Veterinary Medical Center UNIVERSITY OF MINNESOTA Normal Thoracic Architecture [lateral perspective]
  2. 2. 2 Normal Lateral View: inspiration/expiration Normal Ventrodorsal View: inspiration/expiration Normal Cat Normal “FAT” Cat Mediastinal Lymph Nodes Veterinary Medical Center UNIVERSITY OF MINNESOTA KEY [for dorsal perspectives]
  3. 3. 3 Veterinary Medical Center UNIVERSITY OF MINNESOTA Normal Thoracic Architecture [dorsal perspective (high)] Veterinary Medical Center UNIVERSITY OF MINNESOTA Normal Thoracic Architecture [dorsal perspective (mid)] Veterinary Medical Center UNIVERSITY OF MINNESOTA Normal Thoracic Architecture [dorsal perspective (low)] Interpretive Background: THORAX • Pleural space: “potential” space between the visceral pleura (directly surrounding the lungs) and the parietal pleura (lining the thoracic cavity and reflecting over the mediastinum) [not normally visible] • Mediastinal space: “potential” space between the right and left mediastinal (parietal) pleural reflection [not normally visible] • Pericardial sac: sac that directly surrounds the heart [not normally visible] Veterinary Medical Center UNIVERSITY OF MINNESOTA Interpretive Background: THORAX • Pleural space: contains NOTHING • Mediastinal space: contains EVERYTHING except the lungs and the caudal vena cava with its accompanying right phrenic nerve • Pericardial sac: contains only the heart Veterinary Medical Center UNIVERSITY OF MINNESOTA Interpretive Background: THORAX • Mediastinal Space Veterinary Medical Center UNIVERSITY OF MINNESOTA
  4. 4. 4 Normal Dog Lateral View Normal Dog VD View Cross-section of Thorax @ Heart Thymic “Sail” Sign (VD) Anterior Mediastinal Mass Interpretive Background: THORAX • Pleural Space Veterinary Medical Center UNIVERSITY OF MINNESOTA
  5. 5. 5 Normal Dog Thorax Cross-section of Thorax @ Heart (solid lines are pleura) Concept of Fluid/Air Shift [DV]: Air/Fluid Concept of Fluid/Air Shift [VD]: Air/Fluid Diagnostic Pleurogram (From Bhargava) Pleural Disease Classification
  6. 6. 6 Pleural Fluid Interpretive Background: THORAX • Pericardial Sac Veterinary Medical Center UNIVERSITY OF MINNESOTA Normal Dog Thorax Cross-section of Thorax @ Heart (dotted lines are pericardial sac) Pericardial Effusion CVM 6101 [Imaging Anatomy] • Diaphragm: Broad Anatomic Regions – R and L crura – Cupola (dome) Veterinary Medical Center UNIVERSITY OF MINNESOTA
  7. 7. 7 Diaphragmatic Anatomy Diagram [From Grandage] CVM 6101 [Imaging Anatomy] • Diaphragm: – V D/D V and R L/L R views – Beware of superimposed structures including vertebrae, ribs, sternebrae, lungs, stomach, nipples, fascial planes, trachea, etc. – Remember, the diaphragm is a sling-like muscle that “actively” contracts (caudally) and “passively” relaxes (cranially) [numerous influences such as lungs, abdominal fat, etc.] Veterinary Medical Center UNIVERSITY OF MINNESOTA CVM 6101 [Imaging Anatomy] • Diaphragm: – Appearance changes depending on DV vs. VD views (with the X-ray beam is centered on the heart): • On DV views, the diaphragm usually has one broad dome which corresponds to the cupola • On VD views, the diaphragm usually has “3 humps” corresponding to the two crura and the central cupola • Appearance related to beam divergence and diaphragm orientation relative to the diverging beam Veterinary Medical Center UNIVERSITY OF MINNESOTA Diaphragm Appearance: VD vs. DV (From Grandage) CVM 6101 [Imaging Anatomy] • Diaphragm: – Appearance changes depending on R vs. L recumbent lateral views (with the X-ray beam is centered on the heart): • On R lateral views, the diaphragmatic crura are usually parallel with the R crus more cranial and blending with the caudal vena cava • On L lateral views, the diaphragmatic crura usually cross with the L crus being more cranial, but the R crus still blends with the caudal vena cava • Appearance related to right crus being more cranial, but the down-side crus is forced forward by visceral weight Veterinary Medical Center UNIVERSITY OF MINNESOTA Diaphragm Appearance: Right vs. Left Lateral (From Grandage)
  8. 8. 8 Normal Dog Thorax Normal Dog Thorax Right/Left lateral Normal Dog Thorax VD/DV Diaphgram: paralysis Extrapleural Lesion (diaphragmatic hernia) Interpretive Background: THORAX • Thoracic Wall Veterinary Medical Center UNIVERSITY OF MINNESOTA
  9. 9. 9 Pleural Disease Classification Normal Dog Thorax Thoracic Wall: flail chest Interpretive Background: THORAX • Airways Veterinary Medical Center UNIVERSITY OF MINNESOTA Interpretive Background: THORAX • Upper Airways (extrapulmonary): nasal passages, pharynx. larynx • Lower Airways (extrapulmonary): extrathoracic trachea intrathoracic trachea proximal mainstem bronchi • Intrapulmonary Airways: distal mainstem bronchi bronchioles [airways distal to 3rd order bronchi not normally visible] Veterinary Medical Center UNIVERSITY OF MINNESOTA Pharyngeal Collapse: Diagram
  10. 10. 10 Normal Larynx/Pharynx Normal Dog Lateral View Diagram: Airway Subdivisions [dog & cat] Extrathoracic Tracheal Collapse: Expiration/Inspiration Interpretive Background: THORAX • Lungs Veterinary Medical Center UNIVERSITY OF MINNESOTA Interpretive Background: THORAX • Left Lobes (radiologist’s functional perspective): cranial portion of left cranial (left cranial) caudal portion of left cranial (left middle) left caudal (left caudal) • Right Lobes: right cranial right middle right caudal accessory Veterinary Medical Center UNIVERSITY OF MINNESOTA
  11. 11. 11 Lung Diagram [lateral view] Lung Diagram [VD view] Alveolar Disease: pneumonia Interpretive Background: THORAX • Heart and Vessels Veterinary Medical Center UNIVERSITY OF MINNESOTA Interpretive Background: THORAX • Thoracic Circulatory Pattern: cranial/caudal* vena cava right atrium* tricuspid valve right ventricle* pulmomary trunk* lobar pulmonary arteries* lobar pulmonary veins* left atrium* mitral value left ventricle* aorta* • * sufficiently visible to be survey radiographically useful Veterinary Medical Center UNIVERSITY OF MINNESOTA Heart Diagram [lateral view] Cardiac Perspective Lateral Thoracic View Aorta Vena CavaCaudal Trachea HEART 12:00 3:00 6:00 9:00 Cranial Cardiac Waist: Aorta, Rt. Atrium, Pulmonary Trunk Caudal Cardiac Waist: Lt. Atrium Right Ventricle Left Ventricle
  12. 12. 12 Normal Dog Lateral View Heart Diagram [VD view] Cardiac Perspective Ventrodorsal Thoracic View R L 12:00 3:00 6:00 9:00 Main Pulmonary Trunk Aorta (hidden in mediastinum) Left Auricle Left VentricleRight Ventricle Right Atrium HEART Normal Dog VD View Normal Non-selective Angiocardiogram (dog) Normal Cranial Vena Cavogram (dog) Normal Caudal Vena Cavogram (dog)
  13. 13. 13 Pulmonic Stenosis Pulmonic Stenosis Interpretive Background: THORAX • Intrapulmonary Circulatory Pattern: – ARTERY/BRONCHUS/VEIN TRIAD (one in each major lung lobe) – USED AS INDIRECT INDICATOR OF LEFT HEART FUNCTION (vein) and pulmonary flow resistance (artery) • lobar pulmonary arteries – Dorsal to veins on lateral views – Lateral to veins on VD/DV Views • lobar pulmonary veins – Ventral to veins on lateral views – Medial to veins on VD/DV Views Veterinary Medical Center UNIVERSITY OF MINNESOTA Lung Vessel Diagram [lateral view] Lobar Pulmonary Vessels (left lateral view) artery vein bronchus Pulmonary Hypertension [heartworm disease] Pulmonary Hypertension [canine heartworm disease]
  14. 14. 14 Pulmonary Venous Congestion [early congestive LEFT heart failure] Pulmonary Venous Congestion [early congestive LEFT heart failure] Specific References: THORAX • Grandage J: Posture, gravity and radiographic interpretation. J Am Vet Radiol Soc 22:80, 1979. • Grandage J: Radiology of the dog’s diaphragm. J Small Anim Pract 15:1, 1974. • Bhargava AK, Rudy JL, Diesem CD: Radiographic anatomy of the pleura in dogs as visualized by contrast pleurography. J Am Vet Radiol Soc 10:61, 1969. Veterinary Medical Center UNIVERSITY OF MINNESOTA General References: THORAX • Thrall DE (ed): Textbood of Veterinary Diagnostic Radiology. WB Saunders, Philadelphia, 2002. • Burk RL, Feeney DA: Small Animal Radiology and Ultrasonography. Saunders/Elsevier, Philadelphia, 2003 Veterinary Medical Center UNIVERSITY OF MINNESOTA And you think this is tough??? Veterinary Medical Center UNIVERSITY OF MINNESOTA

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