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CT Chest: Pleural Thickening
CT Chest: Pleural Thickening
CT Chest: Pleural Thickening
CT Chest: Pleural Thickening
CT Chest: Pleural Thickening
CT Chest: Pleural Thickening
CT Chest: Pleural Thickening
CT Chest: Pleural Thickening
CT Chest: Pleural Thickening
CT Chest: Pleural Thickening
CT Chest: Pleural Thickening
CT Chest: Pleural Thickening
CT Chest: Pleural Thickening
CT Chest: Pleural Thickening
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CT Chest: Pleural Thickening

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Transcript

  • 1. IMAGE OF THE WEEK
    Prof.S.SUNDAR’S unit
    Dr.G.Rengaraj.PG
  • 2.
  • 3.
  • 4.
  • 5.
  • 6. CXR
    This xray shows an opacity in the lateral 1/3rd of right lower zone extending up along the lateral costal margin with obliteration of right costophrenic angle
    Patchy opacities in the right lower zone
  • 7. CT
    CT shows pleural effusion on the right side with pleural thickening with fibrotic changes in rt. Middle & lower lobe
  • 8. Pleural thickening
    It represents the organised end stage of various active processes such as infective & noninfective inflammation( including asbestos exposure & pneumothorax) and hemothorax
    When generalised and gross, it is termed as fibrothorax
    Fibrothorax may cause significant ventilatory impairment
  • 9. PLEURAL THICKENING
    Normally no line is visible between the inside of the chest wall and the outer border of the lung.
    In response to inflammation of the pleura & fibrosis, the lung may be separated from the chest wall by a pleural line
    The thickening may be localized or generalized.
    If localized, it most commonly involves the inferior portions of the thoracic cavity
  • 10. Pleural thickening
    With localized pleural thickening the costophrenic angles are partially or completely obliterated
    In such cases decubitus radiographs or USG are indicated to rule out pleural fluid
    In obese pts, subcostal fat may mimic pleural thickening. But it appears as a symmetric,smooth, soft tissue density that parallels over the chest wall and is of greatest thickness over the apices
    In problem cases, with CT it can be identified external to parietal pleura & internal to ribs
  • 11. Pleural thickening
    Pleurodesis can be diff. from other conditions by th ABSENCE of the GLIDING SIGN(the gliding sign is said to be present when one can see visceral pleura glide over the parietal pleura on USG)
    The pleural thickening that follows pleural inflammation results almost exclusively from the fibrosis of the visceral pleura
    In contrast, the parietal pleura is thickened following asbestos exposure
  • 12. Pleural thickening
    Radiologically it gives fixed shadowing of water density
    Viewed en profile, it appears as a band of soft tissue density upto approximately 10-mm thick more or less parallel to the chest wall and with a sharp lung interface
  • 13. Pleural thickening
    USG- homogenous echogenic layer just inside the chest wall. It is not reliably detected unless it is 1 cm or more thick
    CT – very sensitive at detecting pleural thickening. Assessed on the inside of the ribs, where there should normally be no soft tissue density
    The pleural thickening enhances with contrast
  • 14. Thank you

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