Pneumothorax is the accumulation of air in the pleural space between the lung and chest wall. It can be caused by trauma, medical procedures, or spontaneously from conditions like bleb rupture. On chest x-ray, it appears as a visceral pleural edge without lung markings peripheral to it, indicating lung collapse. Tension pneumothorax is a medical emergency where pressure within the pleural space exceeds atmospheric pressure. Ultrasound can detect the absence of lung sliding and B-lines in pneumothorax. The size of pneumothorax influences management.
This document discusses methods for assessing small airway function, including spirometry, plethysmography, dynamic compliance testing, inert gas washout tests, impulse oscillometry, and exhaled nitric oxide. Spirometry measures like FEF25-75 and FEV3/FVC ratio provide information about small airways, while plethysmography evaluates gas trapping through residual volume. Dynamic compliance is reduced with uneven ventilation. Inert gas washout tests measure gas mixing efficiency through the lung clearance index. Impulse oscillometry evaluates resistance, reactance, and frequency dependence to detect central and peripheral airway obstruction.
1. The document describes the anatomical locations and classifications of mediastinal lymph nodes. It discusses 10 different lymph node stations located in the mediastinum, including the supraclavicular, upper and lower paratracheal, prevascular, subaortic, para-aortic, subcarinal, paraesophageal, pulmonary ligament, and hilar lymph nodes.
2. Conventional mediastinoscopy allows biopsy of stations 2L, 2R, 4L, 4R, and 7 while extended mediastinoscopy provides access to deeper stations 5 and 6. Endoscopic ultrasound with fine needle aspiration provides sampling of stations 7, 8, and 9.
3. Accurate lymph node
The solitary lung nodule. A diagnostic dilemma. hazem youssef
Incidentally discovered pulmonary nodule are a diagnostic challenge. This presentation is focused on the different features of lung nodules and their management.
1. Pneumothorax is the presence of air in the pleural space causing lung collapse, and pneumomediastinum is the presence of air in the mediastinum.
2. Pneumothorax can be spontaneous, traumatic, or iatrogenic and is classified as primary or secondary depending on underlying lung conditions. Tension pneumothorax is a life-threatening form caused by trapped air that displaces mediastinal structures.
3. Chest x-ray is used to diagnose pneumothorax by identifying the visceral pleural line and lung collapse. Features of tension pneumothorax on x-ray include mediastinal shift and tracheal deviation. Pneum
Bronchopulmonary sequestration (BPS) is a rare congenital lung malformation where non-functioning lung tissue receives its blood supply from systemic arteries instead of the pulmonary circulation. It can be intralobar, located within a normal lung lobe, or extralobar, located outside the normal lung with its own pleura. Intralobar BPS presents most often in childhood or adulthood with recurrent pulmonary infections, while extralobar BPS usually presents in infancy with respiratory distress and has a higher association with other congenital anomalies. CT angiography is the preferred imaging method to evaluate BPS and delineate the anomalous systemic arterial supply.
Collapse & consolidation made simple - chest X-rayzDrNikrish Hegde
This document discusses lung collapse and consolidation. It defines lung collapse as a reduction in air volume within the lung associated with decreased lung volume, known as atelectasis. There are four mechanisms of collapse: passive, cicatrisation, adhesive, and resorption. Consolidation is a decrease in air volume within the lung associated with normal lung volume, where air in the acini is replaced by fluid or solid material. The document outlines signs, causes, and patterns of collapse and consolidation seen on imaging for different lung lobes.
Presentation1.pptx, radiological imaging of chronic obstructive airway disease.Abdellah Nazeer
The document discusses radiological imaging of chronic obstructive pulmonary disease (COPD), specifically chronic bronchitis and emphysema. It describes the different types of emphysema - centrilobular, panlobular, and paraseptal - and how they appear on chest x-rays and CT scans. Centrilobular emphysema is the most common type and presents as focal lucencies in the upper lobes. Panlobular emphysema affects the whole lung lobe and is seen in alpha-1-antitrypsin deficiency. Paraseptal emphysema is adjacent to the pleura. Chronic bronchitis results from excess mucus production and presents with bronchial wall thick
This document discusses methods for assessing small airway function, including spirometry, plethysmography, dynamic compliance testing, inert gas washout tests, impulse oscillometry, and exhaled nitric oxide. Spirometry measures like FEF25-75 and FEV3/FVC ratio provide information about small airways, while plethysmography evaluates gas trapping through residual volume. Dynamic compliance is reduced with uneven ventilation. Inert gas washout tests measure gas mixing efficiency through the lung clearance index. Impulse oscillometry evaluates resistance, reactance, and frequency dependence to detect central and peripheral airway obstruction.
1. The document describes the anatomical locations and classifications of mediastinal lymph nodes. It discusses 10 different lymph node stations located in the mediastinum, including the supraclavicular, upper and lower paratracheal, prevascular, subaortic, para-aortic, subcarinal, paraesophageal, pulmonary ligament, and hilar lymph nodes.
2. Conventional mediastinoscopy allows biopsy of stations 2L, 2R, 4L, 4R, and 7 while extended mediastinoscopy provides access to deeper stations 5 and 6. Endoscopic ultrasound with fine needle aspiration provides sampling of stations 7, 8, and 9.
3. Accurate lymph node
The solitary lung nodule. A diagnostic dilemma. hazem youssef
Incidentally discovered pulmonary nodule are a diagnostic challenge. This presentation is focused on the different features of lung nodules and their management.
1. Pneumothorax is the presence of air in the pleural space causing lung collapse, and pneumomediastinum is the presence of air in the mediastinum.
2. Pneumothorax can be spontaneous, traumatic, or iatrogenic and is classified as primary or secondary depending on underlying lung conditions. Tension pneumothorax is a life-threatening form caused by trapped air that displaces mediastinal structures.
3. Chest x-ray is used to diagnose pneumothorax by identifying the visceral pleural line and lung collapse. Features of tension pneumothorax on x-ray include mediastinal shift and tracheal deviation. Pneum
Bronchopulmonary sequestration (BPS) is a rare congenital lung malformation where non-functioning lung tissue receives its blood supply from systemic arteries instead of the pulmonary circulation. It can be intralobar, located within a normal lung lobe, or extralobar, located outside the normal lung with its own pleura. Intralobar BPS presents most often in childhood or adulthood with recurrent pulmonary infections, while extralobar BPS usually presents in infancy with respiratory distress and has a higher association with other congenital anomalies. CT angiography is the preferred imaging method to evaluate BPS and delineate the anomalous systemic arterial supply.
Collapse & consolidation made simple - chest X-rayzDrNikrish Hegde
This document discusses lung collapse and consolidation. It defines lung collapse as a reduction in air volume within the lung associated with decreased lung volume, known as atelectasis. There are four mechanisms of collapse: passive, cicatrisation, adhesive, and resorption. Consolidation is a decrease in air volume within the lung associated with normal lung volume, where air in the acini is replaced by fluid or solid material. The document outlines signs, causes, and patterns of collapse and consolidation seen on imaging for different lung lobes.
Presentation1.pptx, radiological imaging of chronic obstructive airway disease.Abdellah Nazeer
The document discusses radiological imaging of chronic obstructive pulmonary disease (COPD), specifically chronic bronchitis and emphysema. It describes the different types of emphysema - centrilobular, panlobular, and paraseptal - and how they appear on chest x-rays and CT scans. Centrilobular emphysema is the most common type and presents as focal lucencies in the upper lobes. Panlobular emphysema affects the whole lung lobe and is seen in alpha-1-antitrypsin deficiency. Paraseptal emphysema is adjacent to the pleura. Chronic bronchitis results from excess mucus production and presents with bronchial wall thick
Bronchial Artery Embolization- By Dr.Tinku JosephDr.Tinku Joseph
Bronchial artery embolization (BAE) is a minimally invasive procedure used to control massive or recurrent hemoptysis by occluding the blood supply to the lungs via selective catheterization and embolization of abnormal bronchial vessels. BAE has a high rate of immediate bleeding control of 57-100% and long-term control of 70-88%. Potential complications include tissue infarction if smaller embolic particles are used and transverse myelitis if branches supplying the spinal cord are inadvertently occluded. Careful angiography is required to identify the origin of vessels like the artery of Adamkiewicz to avoid neurologic complications during the procedure.
Cavitary lung lesions can have various causes including cancer, infection, autoimmune disease, vascular embolism, and trauma. On imaging, characteristics like wall thickness, inner contour, location, and other associated findings provide clues to the underlying etiology. Malignant processes tend to have thicker walls over 15mm while benign lesions usually have thinner walls under 4mm. Infectious cavities often have irregular inner walls and may contain fluid levels. Autoimmune diseases typically cause multiple bilateral nodules. The clinical context is also important for determining the most likely diagnosis.
This document discusses radiology signs of pneumomediastinum. It begins by defining pneumomediastinum and listing potential sources where air can originate from, both intrathoracic and extrathoracic. It then describes several common radiographic signs seen with pneumomediastinum, including the thymic sail sign, ring around the artery sign, and ginkgo leaf sign. Examples of each sign are shown through radiograph and CT images. Other signs like the continuous diaphragm sign, tubular artery sign, and Naclerio's V sign are also defined. The document emphasizes the importance of recognizing these signs on imaging for diagnosing pneumomediastinum.
A 45-year-old man presented with a 2-month history of cough and hemoptysis. Imaging showed a 7x7.5x6 cm lobulated cystic lesion in the left lower lobe with surrounding consolidation. CT findings were suggestive of an infected bronchogenic cyst. Bronchogenic cysts are congenital malformations that result from aberrant embryological budding of the tracheobronchial tree. They typically appear on imaging as well-defined smooth lesions and can become infected, leading to symptoms like cough.
The document discusses the radiological findings of tuberculosis based on 7 patient case presentations. It summarizes common findings seen on chest x-rays such as miliary shadows, cavities, consolidation, lymphadenopathy, pleural effusions and changes. Specific findings are described for different stages of TB including primary infection, post-primary infection, and complications such as tuberculoma, pleural thickening and airway involvement. Radiological images are included to demonstrate various manifestations of pulmonary and pleural TB.
An azygos lobe is a normal variation that occurs when the azygos vein indents the right upper lung lobe during development, creating a fissure. This fissure, called the azygos fissure, contains the azygos vein and divides the right upper lobe, appearing tadpole-shaped on chest x-rays. Rather than an accessory lobe, the azygos lobe is simply a variant appearance of the right upper lung lobe due to invagination of the azygos vein during embryonic development.
This document provides an overview of a chest x-ray report. It discusses technical aspects like patient positioning and film quality. It describes the major chest x-ray views including posterior-anterior, anterior-posterior, lateral, and decubitus. Key anatomical structures are identified like the lungs, heart, diaphragm and bones. Common abnormalities seen on chest x-rays are outlined such as opacities, nodules, cavities and effusions. Examples of normal and abnormal x-rays are shown illustrating conditions like pneumonia, collapse, mass and pneumothorax.
This document discusses unilateral hilar enlargement as seen on medical imaging. It provides 4 figures showing examples of right hilar lymph node enlargement due to primary tuberculosis, focal parenchymal lesions and right hilar lymph node enlargement indicative of primary tuberculosis complex, left hilar and mediastinal lymph node enlargement from oat cell lung cancer, and enlargement of the main and right pulmonary arteries coinciding with the onset of pulmonary embolism symptoms.
This document discusses various high attenuation patterns seen on CT scans of the lungs including ground glass opacity, consolidation, and their causes. It provides details on specific signs such as the dark bronchus sign seen with ground glass opacity and complete obscuration of vessels seen with consolidation. Various disease processes that can cause these findings are listed such as infection, chronic interstitial lung disease, and lung cancer.
The document discusses lung collapse (atelectasis) and consolidation. Collapse is a loss of lung volume while consolidation involves fluid filling the alveoli. Collapse can be caused by obstruction of airways or loss of contact between the lungs and chest wall. Consolidation is seen in conditions like pneumonia. Specific patterns of collapse and consolidation are seen on chest x-rays depending on the affected lung lobe. Signs like fissure shifts and volume changes in the unaffected lobes help identify the collapsed lobe.
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.
PowerPoint presentation on the topic HRCT Chest. This presentation is divided into 5 different parts. 1)Introduction to HRCT chest 2)Technichal aspects of HRCT 3) Relevant anatomy for HRCT interpretation 4)Pattern of lung disease in HRCT 5)HRCT pattern in various ILD’s
Hypersensitivity pneumonitis: radiology and pathology aspectThorsang Chayovan
Hypersensitivity pneumonitis in the aspect of radiology and pathology: findings on imaging i.e. HRCT and pathologic characteristics and how to distinguish it from other differential diagnoses.
This document provides an overview of pulmonary cysts and how to differentiate them from other air-filled lung lesions using computed tomography (CT) imaging. It outlines an algorithmic approach involving 5 steps to identify cystic lung diseases based on CT findings. True cysts are defined as round parenchymal spaces surrounded by a thin wall. Other mimics like cavities and emphysema are also described. Cystic lung diseases can present as solitary cysts, subpleural cysts, or multiple intraparenchymal cysts, with or without associated nodules or ground glass opacities. Major cystic lung diseases and their characteristic CT and pathological features are reviewed. Additional testing beyond CT may be needed to
Presentation1.pptx. interpretation of x ray chest.Abdellah Nazeer
This document provides guidance on interpreting chest x-rays from Dr. Nazeer. It outlines common indications for chest x-rays such as evaluating chest symptoms or physical exam findings. It then describes how to analyze x-rays for abnormalities like consolidation, nodules, masses, cavities, and effusions. Specific pathological conditions are also discussed such as pneumonia, tuberculosis, lung cancer, and mediastinal lesions.
Segmental anatomy of lungs , anatomy of mediastinum and secondary lobuleGamal Agmy
The document discusses the segmental anatomy of the lungs and secondary lobule. It notes that there are approximately 23 generations of dichotomous branching from the trachea to the alveolar sacs. The secondary lobule is described as the basic anatomic unit of pulmonary structure and function, measuring 1-2 cm and containing 5-15 pulmonary acini. It is supplied by a terminal bronchiole in the center and surrounded by connective tissue septa and two lymphatic systems. Diseases typically manifest in either the centrilobular or perilymphatic areas based on how they enter the lungs.
This document describes the various types and radiographic appearances of lobar and segmental lung collapse. It discusses intrinsic and extrinsic causes of collapse and describes the typical findings for each lobe, including displacement of fissures, loss of volume, and compensatory changes. Specific signs are outlined to help identify collapse of the different lung lobes based on chest x-ray and CT imaging. Rarer forms of collapse including complete opacification and shifting atelectasis are also covered.
Concise overview of all the information that a Medico must know for his knowledge as well as to appear for entrance exams as well as for physicians for their routine practice.
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.
A systematic, stepwise approach can help arrive at a diagnosis for cystic lung disease. First, cyst mimics must be ruled out. Next, the clinical presentation is characterized. Then, the radiographic features such as cyst distribution are characterized. Finally, all information is combined to determine if cysts are discrete or diffuse and point to conditions like lymphangioleiomyomatosis, Langerhans cell histiocytosis, infection, or congenital abnormalities. This approach facilitates diagnosis of cystic lung disease.
Radiological imaging of pleural diseases Pankaj Kaira
The document discusses the anatomy, imaging, and common diseases of the pleura. It begins by describing the normal anatomy of the pleural layers and thickness. Common pleural diseases are then reviewed, including pleural effusions, pneumothorax, hemothorax, and empyema. Imaging findings on chest x-ray, ultrasound, CT, and MRI are provided for diagnosing and characterizing various pleural conditions. Key signs that help differentiate pleural, pulmonary, and extra-pleural masses are also outlined.
The document provides an overview of common lung diseases and their radiographic presentations. It describes features of diseases affecting the airways like bronchitis and bronchiectasis, the alveoli such as pneumonia and emphysema, the interstitium including pulmonary fibrosis, and the pleural cavity including pneumothorax. For each condition, it outlines associated symptoms and key radiological findings such as consolidation, nodules, effusions, and lung volume changes that help in diagnosis. Tension pneumothorax is highlighted as a medical emergency where trapped air compresses the mediastinum.
Bronchial Artery Embolization- By Dr.Tinku JosephDr.Tinku Joseph
Bronchial artery embolization (BAE) is a minimally invasive procedure used to control massive or recurrent hemoptysis by occluding the blood supply to the lungs via selective catheterization and embolization of abnormal bronchial vessels. BAE has a high rate of immediate bleeding control of 57-100% and long-term control of 70-88%. Potential complications include tissue infarction if smaller embolic particles are used and transverse myelitis if branches supplying the spinal cord are inadvertently occluded. Careful angiography is required to identify the origin of vessels like the artery of Adamkiewicz to avoid neurologic complications during the procedure.
Cavitary lung lesions can have various causes including cancer, infection, autoimmune disease, vascular embolism, and trauma. On imaging, characteristics like wall thickness, inner contour, location, and other associated findings provide clues to the underlying etiology. Malignant processes tend to have thicker walls over 15mm while benign lesions usually have thinner walls under 4mm. Infectious cavities often have irregular inner walls and may contain fluid levels. Autoimmune diseases typically cause multiple bilateral nodules. The clinical context is also important for determining the most likely diagnosis.
This document discusses radiology signs of pneumomediastinum. It begins by defining pneumomediastinum and listing potential sources where air can originate from, both intrathoracic and extrathoracic. It then describes several common radiographic signs seen with pneumomediastinum, including the thymic sail sign, ring around the artery sign, and ginkgo leaf sign. Examples of each sign are shown through radiograph and CT images. Other signs like the continuous diaphragm sign, tubular artery sign, and Naclerio's V sign are also defined. The document emphasizes the importance of recognizing these signs on imaging for diagnosing pneumomediastinum.
A 45-year-old man presented with a 2-month history of cough and hemoptysis. Imaging showed a 7x7.5x6 cm lobulated cystic lesion in the left lower lobe with surrounding consolidation. CT findings were suggestive of an infected bronchogenic cyst. Bronchogenic cysts are congenital malformations that result from aberrant embryological budding of the tracheobronchial tree. They typically appear on imaging as well-defined smooth lesions and can become infected, leading to symptoms like cough.
The document discusses the radiological findings of tuberculosis based on 7 patient case presentations. It summarizes common findings seen on chest x-rays such as miliary shadows, cavities, consolidation, lymphadenopathy, pleural effusions and changes. Specific findings are described for different stages of TB including primary infection, post-primary infection, and complications such as tuberculoma, pleural thickening and airway involvement. Radiological images are included to demonstrate various manifestations of pulmonary and pleural TB.
An azygos lobe is a normal variation that occurs when the azygos vein indents the right upper lung lobe during development, creating a fissure. This fissure, called the azygos fissure, contains the azygos vein and divides the right upper lobe, appearing tadpole-shaped on chest x-rays. Rather than an accessory lobe, the azygos lobe is simply a variant appearance of the right upper lung lobe due to invagination of the azygos vein during embryonic development.
This document provides an overview of a chest x-ray report. It discusses technical aspects like patient positioning and film quality. It describes the major chest x-ray views including posterior-anterior, anterior-posterior, lateral, and decubitus. Key anatomical structures are identified like the lungs, heart, diaphragm and bones. Common abnormalities seen on chest x-rays are outlined such as opacities, nodules, cavities and effusions. Examples of normal and abnormal x-rays are shown illustrating conditions like pneumonia, collapse, mass and pneumothorax.
This document discusses unilateral hilar enlargement as seen on medical imaging. It provides 4 figures showing examples of right hilar lymph node enlargement due to primary tuberculosis, focal parenchymal lesions and right hilar lymph node enlargement indicative of primary tuberculosis complex, left hilar and mediastinal lymph node enlargement from oat cell lung cancer, and enlargement of the main and right pulmonary arteries coinciding with the onset of pulmonary embolism symptoms.
This document discusses various high attenuation patterns seen on CT scans of the lungs including ground glass opacity, consolidation, and their causes. It provides details on specific signs such as the dark bronchus sign seen with ground glass opacity and complete obscuration of vessels seen with consolidation. Various disease processes that can cause these findings are listed such as infection, chronic interstitial lung disease, and lung cancer.
The document discusses lung collapse (atelectasis) and consolidation. Collapse is a loss of lung volume while consolidation involves fluid filling the alveoli. Collapse can be caused by obstruction of airways or loss of contact between the lungs and chest wall. Consolidation is seen in conditions like pneumonia. Specific patterns of collapse and consolidation are seen on chest x-rays depending on the affected lung lobe. Signs like fissure shifts and volume changes in the unaffected lobes help identify the collapsed lobe.
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.
PowerPoint presentation on the topic HRCT Chest. This presentation is divided into 5 different parts. 1)Introduction to HRCT chest 2)Technichal aspects of HRCT 3) Relevant anatomy for HRCT interpretation 4)Pattern of lung disease in HRCT 5)HRCT pattern in various ILD’s
Hypersensitivity pneumonitis: radiology and pathology aspectThorsang Chayovan
Hypersensitivity pneumonitis in the aspect of radiology and pathology: findings on imaging i.e. HRCT and pathologic characteristics and how to distinguish it from other differential diagnoses.
This document provides an overview of pulmonary cysts and how to differentiate them from other air-filled lung lesions using computed tomography (CT) imaging. It outlines an algorithmic approach involving 5 steps to identify cystic lung diseases based on CT findings. True cysts are defined as round parenchymal spaces surrounded by a thin wall. Other mimics like cavities and emphysema are also described. Cystic lung diseases can present as solitary cysts, subpleural cysts, or multiple intraparenchymal cysts, with or without associated nodules or ground glass opacities. Major cystic lung diseases and their characteristic CT and pathological features are reviewed. Additional testing beyond CT may be needed to
Presentation1.pptx. interpretation of x ray chest.Abdellah Nazeer
This document provides guidance on interpreting chest x-rays from Dr. Nazeer. It outlines common indications for chest x-rays such as evaluating chest symptoms or physical exam findings. It then describes how to analyze x-rays for abnormalities like consolidation, nodules, masses, cavities, and effusions. Specific pathological conditions are also discussed such as pneumonia, tuberculosis, lung cancer, and mediastinal lesions.
Segmental anatomy of lungs , anatomy of mediastinum and secondary lobuleGamal Agmy
The document discusses the segmental anatomy of the lungs and secondary lobule. It notes that there are approximately 23 generations of dichotomous branching from the trachea to the alveolar sacs. The secondary lobule is described as the basic anatomic unit of pulmonary structure and function, measuring 1-2 cm and containing 5-15 pulmonary acini. It is supplied by a terminal bronchiole in the center and surrounded by connective tissue septa and two lymphatic systems. Diseases typically manifest in either the centrilobular or perilymphatic areas based on how they enter the lungs.
This document describes the various types and radiographic appearances of lobar and segmental lung collapse. It discusses intrinsic and extrinsic causes of collapse and describes the typical findings for each lobe, including displacement of fissures, loss of volume, and compensatory changes. Specific signs are outlined to help identify collapse of the different lung lobes based on chest x-ray and CT imaging. Rarer forms of collapse including complete opacification and shifting atelectasis are also covered.
Concise overview of all the information that a Medico must know for his knowledge as well as to appear for entrance exams as well as for physicians for their routine practice.
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.
A systematic, stepwise approach can help arrive at a diagnosis for cystic lung disease. First, cyst mimics must be ruled out. Next, the clinical presentation is characterized. Then, the radiographic features such as cyst distribution are characterized. Finally, all information is combined to determine if cysts are discrete or diffuse and point to conditions like lymphangioleiomyomatosis, Langerhans cell histiocytosis, infection, or congenital abnormalities. This approach facilitates diagnosis of cystic lung disease.
Radiological imaging of pleural diseases Pankaj Kaira
The document discusses the anatomy, imaging, and common diseases of the pleura. It begins by describing the normal anatomy of the pleural layers and thickness. Common pleural diseases are then reviewed, including pleural effusions, pneumothorax, hemothorax, and empyema. Imaging findings on chest x-ray, ultrasound, CT, and MRI are provided for diagnosing and characterizing various pleural conditions. Key signs that help differentiate pleural, pulmonary, and extra-pleural masses are also outlined.
The document provides an overview of common lung diseases and their radiographic presentations. It describes features of diseases affecting the airways like bronchitis and bronchiectasis, the alveoli such as pneumonia and emphysema, the interstitium including pulmonary fibrosis, and the pleural cavity including pneumothorax. For each condition, it outlines associated symptoms and key radiological findings such as consolidation, nodules, effusions, and lung volume changes that help in diagnosis. Tension pneumothorax is highlighted as a medical emergency where trapped air compresses the mediastinum.
Chest trauma can involve injuries to multiple structures in the chest cavity. Common injuries include pneumothorax, hemothorax, rib fractures, lung contusions and lacerations. On chest x-ray, a pneumothorax appears as a thin white line along the edge of the lung with no lung markings extending past it. A tension pneumothorax causes mediastinal shift away from the affected side. CT is useful for evaluating lung injuries like contusions, which appear as non-segmental areas of opacity, and lacerations, which may form pneumatoceles. Proper diagnosis requires understanding the mechanisms and radiographic appearances of various chest trauma injuries.
This document discusses chest trauma, including injuries to the thoracic cage, diaphragm, pleura, lungs, trachea/bronchi, mediastinum, and vascular structures. It outlines common causes of chest trauma like falls, blows, blunt force impacts, penetrating injuries, and surgery. Specific injuries covered include rib fractures, flail segments, pneumothorax, hemothorax, pulmonary contusions, lacerations, and fat embolism. Imaging techniques for evaluation such as CT, ultrasound, and aortography are also discussed.
Presentation1.pptx, radiological signs in thoracic radiology.Abdellah Nazeer
The document discusses various radiological signs seen in thoracic diseases. It describes signs such as the silhouette sign, air bronchogram sign, signet ring sign, popcorn calcification, tram-track sign, tree-in-bud sign, CT angiogram sign, finger-in-glove sign, halo sign, reverse halo sign, coin lesion, miliary shadowing, Monod's sign, fallen lung sign, bulging fissure sign, flat waist sign, Golden S sign, bat wing appearance, ground glass pattern, crazy paving sign, mosaic pattern, sandstorm appearance, and honeycomb lung. Each sign is accompanied by an illustration and description of associated diseases.
This document discusses imaging of the chest in trauma patients. It describes the use of chest radiographs and CT scans to evaluate for fractures, dislocations, pneumothoraces, hemothoraces, pulmonary contusions and lacerations, diaphragm injuries, and vascular injuries following chest trauma. Key findings on imaging include rib fractures indicating underlying organ injury, flail chest, scapula fractures requiring CT, pneumothorax appearance varying with patient position, and indirect signs of aortic injury on CT such as mediastinal hematoma.
This document provides information about interpreting HRCT scans of the chest. It describes bronchial and lobar anatomy, Hounsfield units, and patterns seen on HRCT such as ground glass opacity, consolidation, reticulation, nodules, honeycombing, and vascular anatomy. Common diseases that can cause each pattern are listed, such as sarcoidosis presenting with perilymphatic nodules or pulmonary edema seen as smooth septal thickening. The document emphasizes using patterns and distributions to narrow the differential diagnosis on HRCT scans.
This document discusses pneumothorax, beginning with the causes and types. Primary spontaneous pneumothorax is usually caused by a ruptured bleb and occurs more often in young, thin males who smoke. Secondary spontaneous pneumothorax has an underlying lung disease like emphysema. Traumatic pneumothorax results from blunt or penetrating chest trauma or medical procedures. Imaging findings and complications are also described, including recurrent pneumothorax, tension pneumothorax, and re-expansion pulmonary edema. Ultrasound is a sensitive test for pneumothorax diagnosis.
Chest radiographs are commonly used to identify critical findings. Pneumothorax appears as a discrete airspace with no lung markings beyond. Tension pneumothorax causes lung collapse and tracheal deviation. Pneumomediastinum outlines structures with air. Foreign bodies like earrings may be directly seen in the airway. Pneumoperitoneum produces dark crescents between the liver and diaphragm. Pericardial effusions cause an enlarged cardiac silhouette.
This document provides a summary of key findings that may be seen on chest x-rays. It begins with examples of normal chest x-rays and describes the basic knowledge needed to interpret x-rays. It then discusses specific lung diseases and findings, including pleural diseases, pneumothorax, tuberculosis, pneumonia, interstitial pulmonary fibrosis, COPD, sarcoidosis, and pericardial effusion. Each section provides examples of chest x-rays demonstrating the relevant findings. The document is intended as a study aid for medical exams.
- Chest radiography is useful for assessing pulmonary edema, infiltrates, effusions, pneumothorax, and positioning of lines and tubes in intensive care patients. Common findings include air bronchograms, hilar enlargement, Kerley lines, and increased vascular pedicle width.
- Pneumomediastinum is suggested by findings like the continuous diaphragm sign, Naclerio's V sign, and double bronchial wall sign. A pneumothorax may be occult or demonstrated by a pleural line with absent lung markings.
- Proper positioning of central lines is important but can be challenging due to anatomical variability. The tip should lie in the SVC above the pericardial
This document discusses differentials and radiological signs of conditions presenting with a unilateral hypertransradiant hemithorax. It provides two mnemonics, SAFE POEM and CRAWLS, listing potential causes such as rotation, pneumothorax, emphysema, bullous lung disease, Swyer-James syndrome, pulmonary embolism, and abnormalities of the chest wall or contralateral lung. For each condition, the document describes associated radiographic findings and example images. It aims to educate radiologists on evaluating and differentially diagnosing this common pediatric chest x-ray finding.
Congenital anomalies of respiratory system A Radiological approachArif S
This document summarizes various congenital abnormalities of the respiratory system, including abnormalities of the upper and lower airways. It describes tracheobronchial abnormalities such as tracheal agenesis, stenosis, and tracheoesophageal fistula. Pulmonary abnormalities discussed include lung agenesis, hypoplasia, scimitar syndrome, and congenital lobar emphysema. The document also reviews bronchopulmonary foregut malformations, pulmonary sequestration, bronchogenic cysts, and pulmonary arteriovenous malformations. It concludes with a brief overview of congenital diaphragmatic hernia.
This document discusses lung ultrasound findings for various lung conditions. It provides images and descriptions of normal lung ultrasound appearance as well as findings for:
- Interstitial lung disease showing multiple B-lines
- Pneumonia appearing as hypoechoic consolidations with potential air or fluid bronchograms
- Lung abscesses appearing as anechoic lesions that may contain air or show no enhancement with contrast
- Pulmonary embolism appearing as triangular hypoechoic lesions often in a subpleural location without blood flow
- Atelectasis appearing as liver-like consolidations that may contain static air bronchograms
- Bronchial carcinoma appearing as hypoechoic lesions that may enhance heterogeneously with contrast
Radiological signs in chest medicine Part 1Gamal Agmy
This document discusses various radiological signs seen on chest imaging. It provides examples of different signs seen on chest x-ray and CT scan related to masses, atelectasis, vascular structures, esophageal disorders, pneumomediastinum, extrapulmonary masses, interstitial lung disease, and pulmonary nodule patterns. It also discusses CT features of different lung diseases and conditions including sarcoidosis, Langerhans cell histiocytosis, lymphangioleiomyomatosis, and others. Finally, it examines histopathological definitions and CT appearance of various types of emphysema.
This document provides information on pleural lesions, including pleural effusions, hemothorax, empyema, and chylothorax. Key points include:
- Pleural effusions can be transudative or exudative based on protein and LDH levels, and can be caused by tumors, inflammation, cardiovascular issues, congenital defects, trauma or metabolic problems.
- Empyema is an infected pleural effusion that progresses through exudative, fibrinopurulent and fibrinous stages. It appears lenticular on x-ray and CT shows thickened, enhancing pleura.
- Chylothorax is the presence of chylous fluid in the ple
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Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
7. Pneumothorax X-Ray
Typically demonstrate:
• visible visceral pleural edge is
seen as a very thin, sharp
white line
• no lung markings are seen
peripheral to this line
• peripheral space is
radiolucent compared to the
adjacent lung
• lung may completely collapse
• subcutaneous emphysema
and pneumomediastinum may
also be present
9. Tension Pneumothorax
Hyperexpanded ipsilateral chest
Mediastinal shift to contralateral side
Contralateral displacement of anterior
junction line
“deep sulcus” sign = on frontal view larger
lateral costodiaphragmatic recess than
on opposite side
Flattening / inversion of ipsilateral
hemidiaphragm
Total / subtotal collapse of ipsilateral lung
Collapse of SVC / IVC / right heart border
decreased systemic venous return +
decreased cardiac output
Sharp delineation of visceral pleural by
dense pleural space
N.B.: Medical emergency!
10. Fractures of the ribs 3-8 with obvious displacement of the 5th and
6th ribs. The thin pleural line and the lack of the pulmonary vessels
in the right apex are clearly visible reflecting a pneumothorax
13. Pneumothorax in Supine Patient
• 1. Anteromedial pneumothorax
(earliest location)
• 2. Subpulmonic / anterolateral
pneumothorax (2nd most
common location)
• 3. Apicolateral pneumothorax
(least common location)
• 4. Posteromedial pneumothorax
(in presence of lower lobe
collapse)
• 5. Pneumothorax → outlines
pulmonary ligament
FIGURE 2. Anatomic localization of the pleural recesses according to the hilum
and lung. A, Suprahilar anteromedial pleural recess. B, Infrahilar anteromedial
pleural recess. C, Subpulmonic pleural recess. D, Posteromedial pleural recess. E,
Apicolateral pleural recess.
14. Anteromedial pneumothorax (earliest location)
• outline of medial diaphragm under cardiac silhouette
• Improved definition of mediastinal contours (SVC, azygos
vein, left subclavian artery, anterior junction line, superior
pulmonary vein, heart border, IVC, pericardial fat-pad)
15. Subpulmonic Pneumothorax
• Signs of subpulmonic pneumothorax
1.Hyperlucent upper quadrant of the abdomen
2.Deep lateral costophrenic sulcus
3.Visualization of the anterior costophrenic sulcus
4.A sharply outlined diaphragm in spite of parenchymnal disease has also
been used as a sign of subpulmonic pneumothorax
16. Sonographic Features of Normal Lung
• • BATWING SIGN
• • PLEURAL LINE
• • SLIDING LUNG
• • A LINES AND B LINES
• • LUNG PULSE
18. PLEURAL LINE/SLIDING SIGN:
• Most important finding in
normal aerated lung
• Two different patterns are
displayed: motionless portion
above the pleural line –
Horizontal waves
• • Sliding below the pleural line
– granular pattern (sand) in M
mode.
• • The resulting picture
resembles waves crashing
onto the sand – Seashore
sign (indicating normal
aerated lung)
Stratosphere sign/Barcode Sign
25. Catamenial Pneumothorax
• [kata, Greek = according to; men, Greek = month]
• = recurrent spontaneous pneumothorax during
menstruation associated with endometriosis of the
diaphragm; R >> L
CT Anterior junction line
Xray 1 posterior junction line
1. Primary / idiopathic spontaneous pneumothorax (80%)
Cause: rupture of subpleural blebs in lung apices
Age: 20.40 years; M€F = 8€1; esp. in patients with tall asthenic stature; mostly in
smokers
. chest pain (69%), dyspnea
Prognosis: recurrence in 30% on same side, in 10% on contralateral side
Rx: simple aspiration (in > 50% success) / tube thoracostomy (in 90% effective)
2. Secondary spontaneous pneumothorax (20%):
(a) Air-trapping disease: spasmodic asthma, diffuse emphysema, Langerhans cell
histiocytosis, lymph-angiomyomatosis, tuberous sclerosis, cystic fibrosis
. Chronic obstructive pulmonary disease is the most common predisposing disorder
of secondary spontaneous pneumothorax.
(b) Pulmonary infection: lung abscess, necrotizing pneumonia, hydatid disease,
pertussis, acute bacterial pneumonia, Staphylococcus aureus, Pneumocystis carinii
pneumonia
(c) Granulomatous disease: tuberculosis, coccidioidomycosis, sarcoidosis, berylliosis
(d) Malignancy: primary lung cancer, lung metastases (esp. osteosarcoma, pancreas,
adrenal, Wilms tumor)
(e) Connective tissue disorder: scleroderma, rheumatoid disease, Marfan syndrome,
Ehlers-Danlos syndrome
(f) Pneumoconiosis: silicosis, berylliosis
1423
(g) Vascular disease: pulmonary infarction
(h) Catamenial pneumothorax
(i) Neonatal disease: meconium aspiration, respirator therapy for hyaline membrane
disease
(j) Cx of honeycomb lung: pulmonary fibrosis, cystic fibrosis, sarcoidosis,
scleroderma, eosinophilic granuloma, interstitial pneumonitis, Langerhans cell
histiocytosis, rheumatoid lung, idiopathic pulmonary hemosiderosis, pulmonary
alveolar proteinosis, biliary cirrhosis
hyperexpanded ipsilateral chest
√ mediastinal shift to contralateral side
√ contralateral displacement of anterior junction line
√ “deep sulcus” sign = on frontal view larger lateral costodiaphragmatic recess than
on opposite side
√ flattening / inversion of ipsilateral hemidiaphragm
√ total / subtotal collapse of ipsilateral lung
√ collapse of SVC / IVC / right heart border ← decreased systemic venous return +
decreased cardiac output
√ sharp delineation of visceral pleural by dense pleural space
N.B.: Medical emergency!
Skin folds mimicking a right pneumothorax (arrows). The laterally located blood vessels, the wide margin of the lines, and the orientation of the lines that is inconsistent with the edge of a slightly collapsed lung help to differentiate them from a real pneumothorax.
. Large, avascular bullae or
thin-walled cysts have concave rather than convex inner
margins and do not exactly conform to the normal shape of
the costophrenic sulcus when they occur at the lung base
Large bullae simulating pneumothorax. The left lung is
lucent, devoid of vessels, and almost completely replaced by bullae. The
bullae have concave margins (arrows), unlike pneumothorax, in which the
lung margin is convex and parallels the chest wall.
In a patient with adult respiratory distress syndrome (ARDS)and an
anteromedial pneumothorax (arrowheads), the contour of the
ascending aorta, AO, azygos vein, AZ, and superior vena cava,
SVC, remain sharply defined even when parenchymal disease is
present in the right upper lobe.
In the presence of an anteromedial pneumothorax, the lateral
wall ofthe left subclavian artery, SCA, and aortic knob become
sharply outlined. A pleural line is seen which is displaced laterally
(arrowheads).
The cardiophrenic sulcus becomes the
preferential site for pleural air collection
in the supine position, when the air
volume is small. In this young patient
with head and chesttrauma, a deep
anterior cardiophrenic angle is the first
evidence of pneumothorax (arrowhead).
The hyperlucent right and left upper quadrants with well defined,
deep costophrenic sulci are secondary to a subpulmonic
pneumothorax in this patientwith head and chesttrauma. The clear
outline of the apex of the heart is also due to the subpulmonic
pneumothorax.
In this patient with head and myocardial
trauma, deep costophrenic sulci
bilaterally raise the suspicion of bilateral
n spite of parenchymal disease in
this patient with ARDS, the
hemidiaphragms are sharply outlined
by bilateral subpulmonic
pneumothoraces to the level of the
posterior costophrenic sulci (arrowheads).
The undersurfaces of the
uplifted lower lobes
NORMAL LUNG FINDINGS IN THORACIC
ULTRASOUND
• BATWING SIGN
• PLEURAL LINE
• SLIDING LUNG
• A LINES AND B LINES
• LUNG PULSE
• POWER/ DOPPLER SLIDE SIGN
PLEURAL LINE/SLIDING SIGN: Most important finding in
normal aerated lung
• Sonographer visualizes the hyperechoic pleural line in
between two ribs moving back and forth
• Lung sliding corresponds to the to and fro movement of the
visceral pleural on the parietal pleura occuring with
respiration.
• Two different patterns are displayed: motionless portion
above the pleural line – Horizontal waves
• Sliding below the pleural line – granular pattern (sand) in M
mode.
• The resulting picture resembles waves crashing onto the
sand – Seashore sign (indicating normal aerated lung)
Stratosphere sign/Barcode Sign
• B-LINES OR COMET-TAIL ARTIFACTS: are reverberation artifacts
appearing as hyper echoic vertical lines that extend from the pleura to
the edge of the screen.
• Comet-tail artifacts move with lung sliding and respiratory movements
• These artifacts are seen in normal lung due to acoustic impedance
differences between the water and air
• Excessive “B-lines” on the other hand may be abnormal – indicating
interstitial edema
A-lines are a type of reverberation artifact, equally
spaced, horizontal lines originating from the hyperechoic
pleural line.
In normal lung, B-lines extend out and erase the “A-lines”
A-LINES
• “A-lines” are thoracic artifacts that help in the diagnosis of
pneumothorax.
• The space between each A-line corresponds to the same distance
between the skin surface and the parietal pleura.
• In the normal patient, B lines extend from the pleural line and erase
the A lines
• “A-lines” will be present in a patient with pneumothorax but “B -lines”
will not be seen.
• If lung sliding is absent with the presence of “A-lines” the sensitivity
and specificity for occult pneumothorax is 95 and 94 % respectively
Two lesser known signs of neonatal pneumothorax are
presented : the “large, hyperlucent hemithorax” sign and
the “medial stripe” sign. I