this describes the Radiology of the chest

1. Cardio Respiratory system
Dr. E. Kiguli-Malwadde
Assoc Prof
Department of Radiology
Faculty of Medicine
Makerere University

2. Objectives
• To describe the normal radiological
anatomy of the CVS
• To outline the radiological and imaging
techniques of the CVS
• To relate normal to abnormal features of
the chest.

3. • Radionuclide imaging-Ventilation/perfusion
studies
• Bronchography
• Ultrasound/ echocardography
• Angiography/ Venography
• Fluoroscopy

4. Technique of chest x-ray adults
• A Chest X-ray (CXR) is normally taken
erect and PA (posterior anterior)
• at a distance 150 or 200cm.
• anterior chest wall is against the film
cassette
• the X-ray tube behind the patient aimed
towards the film.

5. Why erect film
• It reproduces the normal state of the lungs & mediastinum.
• When the patient is lying down the upper lobe vessels are
wider than in the erect position.
• The mediastinum may look to be pathologically widened
and is more difficult to assess.
• Air rises to the apical region: easy to recognise a
pneumothorax.
• Fluid runs downwards, producing a level at the base with a
curved line (meniscus).
• The diaphragms are lower showing more of the lung bases
• heart size can be accurately assessed.

6. The PA position
• It is easier to clear the scapulae from the lung
fields by moving the shoulders forward
• There is less magnification of the heart because
the heart is lying adjacent to the film
• When the patient is too sick to stand unaided or
unable to keep still, the X-ray is taken supine.
• It is better to have a good AP semi erect or supine
film than a poor quality or rotated PA.

7. Left heart border
Aortic arch
Main (left) PA
Left atrial appendage
Left ventricle
Right heart border
Brachiocephalic v
SVC
Right atrium
IVC

8. Which fissures are shown?

9. Which fissures are shown?

10. PA view

11. Lateral view

12. Interpretation of CX-rays
5 Basic steps
1. Documentary
Information
Name, date,age,
hospital
2. Technical
considerations
Side marker
projection is it PA or
AP

13. PA and Lt Lat

14. • Position erect and
supine
– Air/Fluid levels
– Rotation
– Tube film distance
– Degree of Penetration
High Kv VS Low Kv

15. Full inspiration
6-7 anterior ribs; 10-11 posterior
ribs

17. CTR
a
b
c
a+b/c
1:2

18. 3. Detection and description of
abnormalities
Silhouette sign…loss.
4. Generic abnormalities
-Lobar consolidation
5. Specific abnormalities
-Staphyloccal
-Pneumococcal

22. Rt upper lobar collapse

23. RIGHT MIDDLE LOBAR
COLLAPSE

24. Consolidation Lt Lower lobe

25. Upper lobar consolidation

26. Lung abscess

28. Metastases

30. PNEUMOTHRAX

31. PLEURAL EFFUSION

32. CT - Mass

33. Metastases

44. T5

45. T6/7

46. T7/8

47. T10/11