This presentation is almost a complete Pictoral view of Radiograph chest.
This presentation will help radiologist in daily reporting.
This presentation will help physicians, surgeons, anesthetist and almost all medical professionals in diagnosing commonly presenting cardiac diseases.
This will also help all in preparaing TOACS examination.
The basics of Chest Radiology explained for the undergraduate students. The technical aspects including the various views, exposure, rotation and breath described.
The inside out approach of interpretation explained. The ABCDEFGH description includes Airway, Bones & soft tissue, Cardiac shadow, Diaphragm, Effusion (pleura), Fields (lungs), Gastric bubble and Hila & mediastinum.
The basic cardiac and lung pathologies discussed.
The basics of Chest Radiology explained for the undergraduate students. The technical aspects including the various views, exposure, rotation and breath described.
The inside out approach of interpretation explained. The ABCDEFGH description includes Airway, Bones & soft tissue, Cardiac shadow, Diaphragm, Effusion (pleura), Fields (lungs), Gastric bubble and Hila & mediastinum.
The basic cardiac and lung pathologies discussed.
The condition of your lungs. Chest X-rays can detect cancer, infection or air collecting in the space around a lung (pneumothorax). They can also show chronic lung conditions, such as emphysema or cystic fibrosis, as well as complications related to these conditions. Heart-related lung problems.
Fetal Echocardiography: Basics and AdvancedTarique Ajij
This presentation is for those radiologists and residents who have an interest to perform advanced fetal echocardiography. Simply started and gradually covers the advanced part of it. It includes normal findings only.
This presentation is the first series of the MR imaging of Knee.
In this presentation MRI anatomy has been discussed. As we all know good knowledge of medical imaging three dimensional anatomy is key for good reporting.
Hope we all get benifitted.
Suggestions are most welcome
The condition of your lungs. Chest X-rays can detect cancer, infection or air collecting in the space around a lung (pneumothorax). They can also show chronic lung conditions, such as emphysema or cystic fibrosis, as well as complications related to these conditions. Heart-related lung problems.
Fetal Echocardiography: Basics and AdvancedTarique Ajij
This presentation is for those radiologists and residents who have an interest to perform advanced fetal echocardiography. Simply started and gradually covers the advanced part of it. It includes normal findings only.
This presentation is the first series of the MR imaging of Knee.
In this presentation MRI anatomy has been discussed. As we all know good knowledge of medical imaging three dimensional anatomy is key for good reporting.
Hope we all get benifitted.
Suggestions are most welcome
Role of medical imaging in developemental dysplasia of Hip Dr muhammad Bin Zu...Dr. Muhammad Bin Zulfiqar
In this presentation we will discuss the role of medical imaging---plain Radiography, Ultrasound,Arthrography, CT and MRI in the evaluation of Developemental dysplasia of hip. Our main focuss will be on Sonographic evaluation.
Radiology ----Classical Signs in GIT Dr. Muhammad Bin Zulfiqar.
It is very difficult to learn much in the sea of radiology.
This presentation is the way to memorize classical signs in radiology.
In this presentation we will discuss the basic of axial trauma from head to pelvis. We will discuss the important key points that aids in the diagnosis of axial trauma
Objectives of this presentation are
Introduction to ct
Cross sectional anatomy
Common important pathologies
This presentation is aimed to educate beginers to help in ct interpretetion.
This presentation is from 12th chapter of Grainger and Allison--Diagnostic Radiology A TEXTBOOK OF MEDICAL IMAGING.
My aim behind all these presentation is to provide authentic images. As our all radiology revolve around images of diseases. We can put these ppts in our androids for study and references.
This is a chapter from Grainger and Allison. I have Coolected all images from chapter 20 with caption in this presentation.
In my opinion it will be very benificial to have this in your android. ,
This is a chapter from Grainger and Allison. I have Coolected all images from chapter 21 with caption in this presentation.
In my opinion it will be very benificial to have this in your android.
A chest x ray is a fast and painless imaging test that uses certain electromagnetic waves to create pictures of the structures in and around your chest. This test can help diagnose and monitor conditions such as pneumonia, heart failure, lung cancer, tuberculosis, sarcoidosis, and lung tissue scarring, called fibrosis
Similar to An approach to cardiac xray Dr. Muhammad Bin Zulfiqar (20)
Dislocation of joint is very tricky. In this presentation radiological evaluation of Dislocation of various joints will be discussed.
This is one of the best pictoral review of important joint dislocations
Renal Color Doppler Ultrasound.
After studying this presentation one will be able to perform and interpret ultrasound.
This presntation in my opinion is best short analog to text.
In this presentation we will discuss the bone age assessment mainly focusing wrist radiograph.
we shall also highlights some points in adult bone age
Basically it is an introduction. We shall not discuss its judicial importance
This is a chapter from Grainger and Allison. I have Coolected all images from chapter 19 with caption in this presentation.
In my opinion it will be very benificial to have this in your android. ,
In this presentation we will dscuss the imp imaging features of Posterior fossa tumors in pediatric age group.
Medulloblastoma
Pilocytic Astrocytoma
Ependymoma
Brainstem Glioma
Schwanoma
Meningioma
Epidermoid Cyst
Arachnoid Cyst
In this presentation we will discuss about the
Anatomy of Prostate
Technique of Transrectal US
Carcinoma Prostate and
Different modes of prostatic biopsy.
In this presentation we shall discuss all fractures with specific names .
This is a pictoral review.
This presentation will be very helpful for radiologist to have in their androids to help them in rapid reporting
In this presentation all images of Chapter 18 from Grainger and Allison have been discussed.
Our aim is to discuss authentic material .
This is only for educational purposes.
In this chapter air space infilteration have been discussed. Ground glass haze and consolidation are discussed in detail.
This presentation is a selection of images from 17th chapter of grainger and allison.
Our aim is to provide standard and proved cases of the disease process.
This all is for educational purpose
16 High Resolution Computed Tomography of Interstitial and Occupational Lung ...Dr. Muhammad Bin Zulfiqar
This presentation is collection of images from chapter 16 of Grainger and Allison.
Inthis we will discuss the ILD.
This is only for educational purposes.
This Presentation is a collection of chapter 5 images from Grainger and Allison.
Our aim is to study authentic data.
This is only for educational purposes
In this presentation we will discuss role of high resolution in characterizing normal variant and pathologies of spinal pathologies.
This is a pictoral review.
This presentation provides sufficient material for anyone who wants is interested in interventional radiology. Here we will discuss the available facilities, mechanisms and equipments.
In my opinion this presentation will prove a footstep in interventional radiology
Hepatocellular carcinoma—role of interventional radiologist Dr. Muhammad Bin ...Dr. Muhammad Bin Zulfiqar
In these presentation we will discuss the merits, demrits and outcomes of various interventional radiology modalities for the treatment of hepatocellular carcinoma
Pulmonary Lobar Collapse:Essential Considerations 14 Dr. Muhammad Bin ZulfiqarDr. Muhammad Bin Zulfiqar
This presentation is from 15th chapter of Grainger and Allison--Diagnostic Radiology A TEXTBOOK OF MEDICAL IMAGING.
My aim behind all these presentation is to provide authentic images. As our all radiology revolve around images of diseases. We can put these ppts in our androids for study and references.
This presentation is from 13th chapter of Grainger and Allison--Diagnostic Radiology A TEXTBOOK OF MEDICAL IMAGING.
My aim behind all these presentation is to provide authentic images. As our all radiology revolve around images of diseases. We can put these ppts in our androids for study and references.
In this presentation we will focus on aetiological factors that cause infirtility. Our focus is on US depiction of these aetiological factors to help physician in the management of infirtility.
We have nothing to do with direct radiological intervention in the management of infirtility in this presentation.
Imaging Techniques and Fundamental Observations for the Musculoskeletal Sy...Dr. Muhammad Bin Zulfiqar
This presentation is from 45th chapter of Grainger and Allison--Diagnostic Radiology A TEXTBOOK OF MEDICAL IMAGING.
My aim behind all these presentation is to provide authentic images. As our all radiology revolve around images of diseases. We can put these ppts in our androids for study and references.
This presentation is from 11th chapter of Grainger and Allison--Diagnostic Radiology A TEXTBOOK OF MEDICAL IMAGING.
My aim behind all these presentation is to provide authentic images. As our all radiology revolve around images of diseases. We can put these ppts in our androids for study and references.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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5. ROTATION
The medial ends of both clavicles
should be equidistant from the
spinous process of the vertebral
body projected between the
clavicles
6. The increase in blackness
(radiolucency) of one
hemithorax is always on
the side to which the
patient is rotated,
irrespective of whether the
CXR has been taken PA or
AP
7. DEGREE OF INSPIRATION
It is ascertained by counting either the
number of visible anterior or posterior
ribs
Adequate inspiratory effort – five to
seven complete anterior or ten posterior
ribs are visible
Poor inspiratory effort - fewer than five
anterior ribs
Hyperinflated lung-more than seven
anterior ribs
8. IMPORTANCE OF AN INSPIRATORY FILM
POOR INSPIRATORY FILM NORMAL INSPIRATORY FILM
1
2
3
1. Mediastinal Widening 2.Cardiomegaly 3.Lower lobe patchy opacification
9. PROJECTION OF X-RAY
Projection is defined as the direction of x-ray with
relation to the patient
If the direction of x-ray projection is from front – AP
projection
If the direction of x-ray projection is from behind –PA
projection
11. PA VIEW AP VIEW
In erect patients
Vertebral spines more
prominent
Scapulae clear of lungs
Clavicles are horizontal
In supine patients
Vertebral bodies clear
Apparent cardiomegaly
Scapulae overlap
Clavicles are oblique
12. ERECT SUPINE
Gas bubble in fundus with a
clear air fluid level
Gas bubble in antrum
Apparent cardiomegaly
13. EXPOSURE OF X-RAY
Normal exposure - the vertebral bodies should just be
visible at the lower part of cardiac shadow
Underexposed -If the vertebral bodies are not visible ,
insufficient number of x-ray photons have passed
through the patient to reach the x-ray film
Similarly, if the film appears too ‘black’, then too many
photons have resulted in overexposure of the x-ray film.
15. SYSTEMATIC APPROACH
Technical factors
Skeletal abnormalities and hardware
Situs: gastric air bubble, cardiac apex, and aortic knob
Heart: position, size, and shape
Great vessels: position, size, and shape
Lung fields and vascularity by zone
Search for calcifications
26. HOW TO MEASURE MAIN PULMONARY ARTERY
If we draw a
tangent line from the apex
of the left
ventricle to the
aortic knob(red line)
and measure along
a perpendicular
to that tangent
line (yellow line)
The distance between the
tangent and the main
pulmonary artery
(between two small green
arrows) falls in a range
between 0 mm (touching
the tangent line) to as
much as 15 mm away from
the tangent line
27.
28. PROMINENT MPA
Main pulmonary artery projects
more than the tangent
Causes:
1. Increased pressure
2. Increased flow
29. HYPOPLASTIC PA
MPA > 15 mm from the tangent
Concave PA segment
Causes:
1. TOF
2. TRUNCUS ARTERIOSUS
32. CARDIOMEGALY
The cardiothoracic ratio should be less
than 0.55 on PA view. i.e. A+B/C<0.55
A cardiothoracic ratio > 0.55 suggests
cardiomegaly in adults
A cardiothoracic ratio > 0.6 suggests
cardiomegaly in newborn
33. CTR is more than 50% but heart is normal
Spurious causes of cardiac enlargement
Portable AP films
Obesity
Pregnant
Ascites
Straight back syndrome
Pectus excavatum
34. CTR is less than 50% but heart is
abnormal
Obstruction to outflow of the
ventricles
Ventricular hypertrophy
Must look at cardiac contours
< 50%
ASCENDING AORTA DILATED LV CONTOUR
35. CRITERIA'S FOR CARDIOMEGALY
Cardiothoracic ratio >0.55 in adults on PA view
Cardiothoracic ratio >0.6 in newborn on PA view
Any increase in transcardiac diameter > 2 cm compared
to old x-ray
In old age and emphysema a transcardiac diameter
more than 15.5 cm in males &>12.5 cm in females
37. CRITERIA FOR RA ENLARGEMENT
Rt. Cardiac border becomes more
convex > 50% of right border
Rt. Atrial border extends >3
intercostal spaces
Measurement from mid vertical line
to max. convexity in rt. Border>5 cm
in adult & >4cm in children
Lateral view – fullness in space
between sternum and front of
upper part of cardiac silhouette
38. CRITERIA FOR LA ENLARGEMENT
Widening of carina( normal 45-75 degree)
Elevation of left bronchus
Straightening of left border
Double atrial shadow( shadow within shadow)
Grade 1 –double cardiac contour
Grade2 - LA touches RA border
Grade 3 – LA overshoots the Rt. Cardiac border
Displaces the descending aorta to the left and esophagus to
right seen in barium swallow
40. LEFT ATRIAL ENLARGEMENT
DOUBLE ATRIAL SHADOW
WIDENING OF CARINA
ELEVATION OF LEFT
BRONCHUS
Left atrial appendage
enlargement
41.
42. Widening of carina
Elevation of lt.
bronchusAneurysmal LA
Aneurysmal LA – When La enlarges to left and right and approaches within
an inch of lateral chest wall
44. LEFT VENTRICULAR ENLARGEMENT
PA view
(a)Left cardiac border gets enlarged and becomes more convex
resulting in cardiomegaly
(b)Lt. cardiac border dips into lt. dome of diaphragm
(c) rounded apical segment
(d) cardiophrenic angle is obtuse
45. LEFT VENTRICULAR ENLARGEMENT
Lateral view
(a) Left ventricle enlarges inferiorly and posteriorly
(b)Rigler’s measurement A is >17 mm
(c)Rigler,s measurement B is< 7.5 mm
(d) Eyeler’s ratio becomes > 0.42
46. RIGLER’S MEASUREMENT
Rigler’s A & B used to differentiate left
ventricular and right ventricular
enlargement
Possible only when IVC shadow is
present
Jn. Of IVC with Lt. Atrium – J point
Rigler’s A- from J point along line of IVC
draw a line of 2 cm above and mark the
point X.
47. Draw a horizontal line from pt. A to posterior
Cardiac border and mark that pt. y
Distance between points x & y is Rigler’s
measurement A
NORMAL<17 mm
Rigler’s B-from the pt. J drop a perpendicular
line to the dome and this distance is Rigler’s
measurement B
NORMAL>7.5 mm
RIGLER’S MEASUREMENT
48. When LV enlarges,
Posterior cardiac border gets displaced
posteriorly & IVC shadow gets included in
cardiac shadow, without getting displaced
posteriorly
Rigler’s measurement A >17 mm in lt.
ventricular enlargement
RIGLER’S MEASUREMENT
49. EYELER’S RATIO
To differentiate lt. & rt. Ventricular
enlargement
Valid when IVC shadow is absent or cannot
be visualised
Mark the point of jn. where postero inferior
cardiac border meets the dome as B
From this point B draw a horizontal line to
the posterior border of sternum-AB
50. From pt.B - draw another horizontal line
posteriorly to the inner border of the rib-
BC
Ratio of AB/BC is Eyeler’s ratio < 0.42
EYELER’S RATIO
51. LA Oblique view
There is a retrocardiac space( prevertebral)
(a)Mild lt. Ventricular enlargement-obliteration
of retrocardiac space
(b) mod. Lt.ventricular enlargement-cardiac
shadow overlaps vertebral column
(c)Marked Lt.ventricular enlargement-cardiac
shadow overshoots vertebral column
52. Chest X ray shows left ventricular
enlargement.
Left heart border is displaced
leftward, inferior and posteriorly.
Rounding of the cardiac apex.
53. RV ENLARGEMENT
PA VIEW
Cardiophrenic angle is acute
Clockwise rotation of heart causes RV to form
the middle portion of the left heart border.
RIGHT LATERAL VIEW
Obliteration of retrosternal spac
54. RV ENLARGEMENT
LEFT LATERAL VIEW
Rigler’s measurement will be17mm or less
Rigler’s measurement will be 7.5mm or more
Eyeler’s ratio is 0.42 or less
55. PERICARDIAL EFFUSION
Narrow vascular pedicle
Cardiomegaly directly proportional to severity of pericardial
effusion
This shadow has a rounded, globular appearance with no
particular chamber enlargement
Cardiophrenic angle become more and more acute
Oligaemic pulmonary vascular markings
Marked change in cardiac silhouette in decubitus posture
‘Epicardial fat pad sign’- anterior pericardial strip bordered
by epicardial fat post. and mediastinal fat ant.>2mm
57. DILATED CARDIOMYOPATHY VS
PERICARDIAL EFFUSION
Chambers can be identified
Cardiophrenic angle is obtuse
Increased pulmonary venous hypertension
No change in cardiac silhouette in decubitus
Vascular pedicle is dilated or normal
Fluoro shows cardiac pulsation
58. CONSTRICTIVE PERICARDITIS
1.Straightening of the right
border
2.Pericardial thickening > 4
mm
3.Pericardial calcification (50%
cases)
4.Dilatation of SVC and
azygous vein
Pericardial calcification
59. CONGENITAL ABSENCE OF PERICARDIUM
Focal bulge in area of main pulmonary
artery
Sharply marginated
Absent right cardiac border
Increased distance between sternum
and heart due to absence of sterno
pericardial ligament
63. PULMONARY VENOUS HYPERTENSION
LARRY ELLIOT’S CLASSIFICATION OF PVH
RADIOGRAPHIC
GRADE OF PVH
ACUTE DISEASE
PCWP
CHRONIC DISEASE
PCWP
1 13-17 MMHG 13-17 MMHG
2 18-25 MMHG 18-30 MMHG
3 >25 MMHG >30 MM HG
4 HEMOSIDEROSIS
AND OSSIFICATION
LONG STANDING
PVH
64. GRADE 0 -PCWP< 12 MM HG
Upper lobe pulmonary veins are less prominent than lower lobe veins
GRADE 1- PCWP 13-17MMHG
Redistribution of blood flow with cephalization-’ANTLER SIGN’
1) increased resistance to flow due to interstitial odema
2) alveolar hypoxia in lower lobes causes reflex vasoconstriction
3) vasoconstriction of the arterioles due to LA or pulmonary vein reflex
PULMONARY VENOUS HYPERTENSION
66. KERLEY A LINES
Distended lymphatic channels within
edematous septa coursing from
peripheral lymphatics to central hilar
nodes
Towards the hilum
Less specific for Pulmonary venous
hypertension
KERLEY A LINES
67. KERLEY B LINES
Horizontal lines
1-3 mm thick
Perpendicular to pleural surface
Towards the costophrenic angle
Accumulation of fluid in interlobular
septa and lymphatics
Highly specific for PVH
KERLEY B
68. Crisscross lines seen between A &B
GRADE 3 – pcwp > 25mm hg
Alveolar odema
Bilateral diffuse patchy
cotton wool opacities
KERLEY C LINES
69.
70. Pulmonary circulation
Pulmonary plethora – features
Enlargement of central pulmonary artery , lobar and segmental
artery
Prominent nodular vascular shadows in frontal CXR- shunt vessels
that course ventral to dorsal
Upper & lower lobe vessels prominent
RPDA > 17mm
Right descending pulmonary artery> tracheal diameter Ratio of
RPDA to diameter of trachea > 1
Plethora seen if shunt size >2:1
72. Decreased flow proximal to orgin of main pulmonary artery
Small pulmonary artery
Empty pulmonary bay
Pulmonary vessels small
Lung hypertranslucent
Lateral view shows diminution of hilar vessels
Pulmonary oligaemia
74. High pressure left to right shunts are associated with
obliterative changes in the smaller pulmonary arteries &
arterioles
Large main & large central pulmonary arteries taper down
rapidly to very small vessels
Seen in Eisenmenger’s syndrome
Precapillary PAH
Pruning
86. Linear or railroad track
calcification at site of ductus may
be seen in adults with PDA
PROMINENT
MPA
LV APEX
PLETHORA
AORTIC KNOB
PDA
87. • “FIGURE OF 3” in CXR
• “REVERSE 3” or “E sign” in Barium
meal
COARCTATION OF AORTA
88. DD OF INFERIOR RIB NOTCHING
1)Aortic obstruction- Takayasu arteritis
Coarctation of aorta
2) Subclavian artery obstruction –Classic BT shunt
Takayasu arteritis
3)Chronic Svc obstruction
4)Intercostal Av fistula
5)Neurofibromatosis
89. Cyanosis With Decreased
Vascularity
Tetralogy of Fallot
Truncus-type IV
Tricuspid atresia
Transposition of great arteries
Ebstein’s anomaly
Cyanosis With Increased
Vascularity
Truncus types I, II, III
TAPVC
Tricuspid atresia
Transposition
Single ventricle
Cyanotic Congenital Heart Disease
92. ‘figure of 8’ “snowman”
Rt border-SVC
Upper border-left innominate
Left border-left vertical vein
Body of snowman-RA
CYANOTIC CHD—TAPVC (supracardiac)
93. The scimitar sign is produced
by an anomalous pulmonary
vein that drains any or all of
the lobes of the right lung.
Scimitar vein empties into the
inferior vena cava
CYANOTIC CHD—PAPVC(Scimitar sign)
95. LV apex
Rt pulmonary artery has a superior
orgin (20%)
‘waterfall sign’
‘Hilar comma sign’
Associated right aortic arch (33%)
Concave PA segment
ELEVATED
RIGHT HILUM
CYANOTIC CHD—TRUNCUS ARTERIOSUS
96. CYANOTIC CHD
Eisenmenger’s syndrome
• Chest xray show dilation of central
pulmonary arteries and pruning of peripheral
pulmonary arteries, right ventricular and
atrial enlargement. Left heart would return
to normal size.
• Left to right shunts such as atrial septal
defect, ventricular septal defect and patent
ductus arteriosus, cause increased
pulmonary blood flow. With time, high
pulmonary vascular resistance will
develop, ultimately causing right to left
shunt.
106. PERICARDIAL VS MYOCARDIAL CALCIFICATION
PERICARDIAL
SEEN IN BOTH SIDES OF HEART MOST
COMMONLY IN AV GROOVE
DIFFUSE CALCIFICATION AROUND THE
HEART
CALCIFICATION IS CHUNKY & UGLY
MYOCARDIAL
SEEN IN ONLY LEFT SIDE
MOST COMMON SITE IS ANT.
WALL
LOCALIZED TO THE LEFT
CALCIFICATION IS FINE &
CURVILINEAR
115. MISCELLENOUS X-RAYS
LEFT SVC
Occurs in less than 0.5% of people
Failure of regression of L common
and Ant. Cardinal veins
Drains left jugular and left subclavian
vein
Most patients also have right sided
SVC
Drains into dilated coronary sinus
LEFT SVC
116. RIGHT AORTIC ARCH
Leftward displacement of barium filled
esophagus
Rt. Indentation of trachea
Aortic knob is absent from left side
Aorta descends on right
Associated with TOF
Truncus arteriosus
117. AORTIC NIPPLE
Left superior intercostal vein
Seen in 5% of cases
To be differentiated from a mass
Also called pseudo dissection
It drains into hemiazygous vein
Hartman T .Pearls & Pitfalls in Thoracic imaging,Variants and other difficult diagnosis
118. CERVICAL AORTIC ARCH
Left sided cervical aortic arch
Aortic knob at apex of lung
Descend on the left
CERVICAL AORTIC ARCH
123. BIBLIOGRAPHY
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(2) Lipton MJ. Plain film diagnosis of heart disease: cardiac enlargement. Contemporary Diagnostic Radiology 1988;11:1-6.
(3) Boxt LM, Reagon K, Katz J. Normal plain film examination of the heart and great arteries in the adult. J Thorac Imaging
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(4)Murray G. Baron,Wendy M. Book .Congenital heart disease in the adult.North American Clinics of Radiology 2004;3
(5) Ramesh M. Gowda,Lawrence M. Boxt. Calcifications of the heart.North American Clinics of Radiology 2004;4
(6) Martin J. Lipton, Lawrence M. Boxt. How to approach cardiac diagnosis from the chest radiograph.North American Clinics
Of Radiology 2004;5
(7) Murray G. Baron .PLAIN FILM DIAGNOSIS OF COMMON CARDIAC ANOMALIES IN THE ADULT.North American Clinics Of
Radiology 2004;6
(8) Radiology imaging – sutton 6th edition
(9) Pediatric cardiology- Perloff’s clinical recognition of congenital heart disease
(10)Radiology of congenital heart disease-Amplatz
(11)Grainger & Allisons- diagnostic radiology vol1 , 4th edition
(12)Cardiac Xrays- v.Chockalingam
(13)Braunwald heart diseases 9th edition
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(15)www.learningradiology.com