Basics of CT chest

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This document provides an overview of CT chest imaging, including the different types of CT chest scans, chest anatomy visualized on CT, and common abnormalities seen on CT chest exams. It discusses standard CT chest, HRCT, low dose CT, CT angiography, and combined PET/CT scans. It details the mediastinal compartments and lung segments seen on CT. It also provides examples of abnormalities such as pulmonary nodules/masses, pulmonary embolism, interstitial lung disease patterns, emphysema, atelectasis, pneumothorax, pleural effusions, and cardiomegaly. Virtual bronchoscopy and CT-guided biopsy procedures are also summarized.

Mahmoud Elhusseiny Abolmagd MSc, MD
lecturer of Pulmonary & Critical Care Medicine
Mansoura University
Basics of CT Chest

1.CT Chest - Types
2.CT Chest - Anatomy
3.CT Chest - Abnormalities
CT Chest - Tutorials

1.Standard or Conventional CT:
CT Chest - Types

2. High-resolution computed tomography(HRCT)
HRCT
STANDARD CT
CT Chest - Types

5. Paired Inspiratory & Expiratory chest CT scans
CT Chest - Types

6. Paired Supine & Prone chest CT scans
CT Chest - Types

Three views:
1. Axial view
2. Coronal view
3. Sagittal view
CT Chest Anatomy – views

Three Windows:
1. Mediastinal window
2. Lung window
3. Bone window
CT Chest Anatomy – Window settings

(a) Supra-aorticmediastinum
CT Chest Anatomy – Mediastinum

CT Chest Anatomy- mediastinum-
compartments
(a) Supra-aorticmediastinum
CT Chest Anatomy – Mediastinum

CT Chest Anatomy- mediastinum-
compartments
(b) Aorticarch
CT Chest Anatomy – Mediastinum

CT Chest Anatomy- mediastinum-
compartments
(b) Azygos arch & aorto-pulmonary window
CT Chest Anatomy – Mediastinum

(c) Main pulmonary artery
CT Chest Anatomy – Mediastinum

CT Chest Anatomy- mediastinum-
compartments
(c) Right pulmonary artery
CT Chest Anatomy – Mediastinum

CT Chest Anatomy- mediastinum-
compartments
(d) Heart and paracardiacmediastinum
CT Chest Anatomy – Mediastinum

CT Chest Anatomy- mediastinum-
compartments
(d) Heart
CT Chest Anatomy – Mediastinum

(a) At level of trachea (Upper Lobe)
CT Chest Anatomy – lung segments

CT Chest Anatomy – lung segments
(a) At level of trachea (Upper Lobe)

CT Chest Anatomy – lung segments
(a) At level of main stem bronchi ( Carina )

(a) At level of main stem bronchi ( Carina )
CT Chest Anatomy – lung segments

(a) At level of the heart
CT Chest Anatomy – lung segments

CT Chest Abnormalities - Trachea
“frown” sign

Mounier- Kuhn syndrome
 Diagnostic criteria:
Right mainstem > 2.4 cm
Left mainstem > 2.3 cm
Trachea exceed > 3.0 c
CT Chest Abnormalities - Trachea

Saber-sheath trachea
CT Chest Abnormalities - Trachea

CT Chest Abnormalities - The Hilum
Lymph Nodes

Arterial enlargement
CT Chest Abnormalities - The Hilum

Malignancy
CT Chest Abnormalities - The Hilum

Pulmonary embolism
CT Chest Abnormalities - PE

Lung abnormalities:
Abnormal whiteness
(increased density):
 Consolidation
 Interstitial
 Atelectasis
Nodule or mass
Abnormal blackness
(decreased density):
 Cyst
 Emphysema
 Cavity
CT Chest Abnormalities - lung fields

Air Bronchogram
CT Chest Abnormalities - lung fields

 Bat's wing or butterfly pulmonary opacities
 Reverse bat wing pulmonary opacities
CT Chest Abnormalities - lung fields

Post-primary pulmonary Tuberculosis
CT Chest Abnormalities - Tuberculosis

Miliary Tuberculosis
CT Chest Abnormalities - Tuberculosis

Tuberculosis: Imaging Findings
CT Chest Abnormalities - Tuberculosis

Aspergillomas
lung field abnormalities - Cavitation

The Halo sign (HS)
CT Chest Abnormalities - Aspergillosis

Septic emboli
CT Chest Abnormalities – Lung fields

Reticular Pattern
CT Chest Abnormalities - Interstitial

Honeycomb cysts
CT Chest Abnormalities - Interstitial

Nodular pattern
CT Chest Abnormalities - Interstitial

Reticulonodular pattern
CT Chest Abnormalities - Interstitial

Ground-glass opacification/opacity (GGO)
CT Chest Abnormalities - Interstitial

Crazy paving
CT Chest Abnormalities - Interstitial

Sarcoidosis
CT Chest Abnormalities - Sarcoidosis

1. Nodal changes
CT Chest Abnormalities - Sarcoidosis

2. Parenchymal changes
CT Chest Abnormalities - Sarcoidosis

Usual interstitial pneumonia (UIP)
CT Chest Abnormalities - IPF

Bronchiectasis
CT Chest Abnormalities - Bronchiectasis

Pulmonary emphysema
CT Chest Abnormalities - Emphysema

Vanishing Lung Syndrome (BullousEmphysema)
CT Chest Abnormalities - Emphysema

Complete Atelectasis
lung field abnormalities - Atelectasis

Right lower lobe collapse
lung field abnormalities - Atelectasis

Cardiomegaly
CT Chest Abnormalities - Heart

Congestive heart failure
CT Chest Abnormalities - Heart

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Basics of CT chest

1. Mahmoud Elhusseiny Abolmagd MSc, MD lecturer of Pulmonary & Critical Care Medicine Mansoura University Basics of CT Chest

2. 1.CT Chest - Types 2.CT Chest - Anatomy 3.CT Chest - Abnormalities CT Chest - Tutorials

3. Types of CT Chest

4. 1.Standard or Conventional CT: CT Chest - Types

5. 2. High-resolution computed tomography(HRCT) HRCT STANDARD CT CT Chest - Types

6. 3. Low Dose CT CT Chest - Types

7. 4. CT Angiography CT Chest - Types

8. 5. Paired Inspiratory & Expiratory chest CT scans CT Chest - Types

9. 6. Paired Supine & Prone chest CT scans CT Chest - Types

10. 6. Paired Supine & Prone chest CT scans CT Chest - Types

11. Anatomy of CT Chest

12. Three views: 1. Axial view 2. Coronal view 3. Sagittal view CT Chest Anatomy – views

13. Three Windows: 1. Mediastinal window 2. Lung window 3. Bone window CT Chest Anatomy – Window settings

14. CT Chest Anatomy – Hounsfield unit

15. (a) Supra-aorticmediastinum CT Chest Anatomy – Mediastinum

16. CT Chest Anatomy- mediastinum- compartments (a) Supra-aorticmediastinum CT Chest Anatomy – Mediastinum

17. CT Chest Anatomy- mediastinum- compartments (a) Supra-aorticmediastinum CT Chest Anatomy – Mediastinum

18. (a) Supra-aorticmediastinum CT Chest Anatomy – Mediastinum

19. CT Chest Anatomy- mediastinum- compartments (b) Aorticarch CT Chest Anatomy – Mediastinum

20. CT Chest Anatomy- mediastinum- compartments (b) Azygos arch & aorto-pulmonary window CT Chest Anatomy – Mediastinum

21. (c) Main pulmonary artery CT Chest Anatomy – Mediastinum

22. CT Chest Anatomy- mediastinum- compartments (c) Right pulmonary artery CT Chest Anatomy – Mediastinum

23. CT Chest Anatomy- mediastinum- compartments (d) Heart and paracardiacmediastinum CT Chest Anatomy – Mediastinum

24. CT Chest Anatomy- mediastinum- compartments (d) Heart CT Chest Anatomy – Mediastinum

25. CT Chest Anatomy- mediastinum- compartments (d) Heart CT Chest Anatomy – Mediastinum

26. (a) At level of trachea (Upper Lobe) CT Chest Anatomy – lung segments

27. CT Chest Anatomy – lung segments (a) At level of trachea (Upper Lobe)

28. CT Chest Anatomy – lung segments (a) At level of main stem bronchi ( Carina )

29. (a) At level of main stem bronchi ( Carina ) CT Chest Anatomy – lung segments

30. (a) At level of the heart CT Chest Anatomy – lung segments

31. (a) At level of the heart CT Chest Anatomy – lung segments

32.

33. Abnormalities in CT Chest

34. CT Chest Abnormalities - Trachea “frown” sign

35. Mounier- Kuhn syndrome  Diagnostic criteria: Right mainstem > 2.4 cm Left mainstem > 2.3 cm Trachea exceed > 3.0 c CT Chest Abnormalities - Trachea

36. Saber-sheath trachea CT Chest Abnormalities - Trachea

37. Goiter CT Chest Abnormalities - Thyroid

38. CT Chest Abnormalities - The Hilum Lymph Nodes

39. CT Chest Abnormalities - The Hilum Lymph Nodes

40. Arterial enlargement CT Chest Abnormalities - The Hilum

41. Malignancy CT Chest Abnormalities - The Hilum

42. Pulmonary embolism CT Chest Abnormalities - PE

43. Lung abnormalities: Abnormal whiteness (increased density):  Consolidation  Interstitial  Atelectasis Nodule or mass Abnormal blackness (decreased density):  Cyst  Emphysema  Cavity CT Chest Abnormalities - lung fields

44. Air Bronchogram CT Chest Abnormalities - lung fields

45.  Bat's wing or butterfly pulmonary opacities  Reverse bat wing pulmonary opacities CT Chest Abnormalities - lung fields

46. Post-primary pulmonary Tuberculosis CT Chest Abnormalities - Tuberculosis

47. Miliary Tuberculosis CT Chest Abnormalities - Tuberculosis

48. Tuberculosis: Imaging Findings CT Chest Abnormalities - Tuberculosis

49. Aspergillomas lung field abnormalities - Cavitation

50. The Halo sign (HS) CT Chest Abnormalities - Aspergillosis

51. Septic emboli CT Chest Abnormalities – Lung fields

52.

53. Reticular Pattern CT Chest Abnormalities - Interstitial

54. Honeycomb cysts CT Chest Abnormalities - Interstitial

55. Nodular pattern CT Chest Abnormalities - Interstitial