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Thoracic imaging terminology
The document provides definitions for various terms used in thoracic imaging. It defines terms like acinus, air space, aortopulmonary window, bronchiectasis, signet ring sign, bronchiolectasis, bronchocele, bronchocentric, atelectasis, broncholith, bulla, cavity, centrilobular emphysema, cyst, mycetoma, tree-in-bud pattern, air crescent, apical cap, silhouette sign, beaded septum sign, ground-glass opacity, halo sign, reversed halo sign, honeycombing, miliary pattern, reticular pattern, reticulonodular pattern, nodule, crazy-paving pattern, consolidation,
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Thoracic imaging terminology
- 1. Basic terms inThoracic Imaging Dr/AhmedBahnassy Consultant Radiologist MBCHB-MD-FRCR.
- 2. Members of theFleischner Society compiled a glossary of terms for thoracic imaging that replaces previous glossaries published in 1984 and 1996 for thoracic radiography and computed tomography (CT), respectively.
- 3. Acinus • distal toterminal bronchiole. • supplied by respiratory bronchiole. • Each SPL has 3-25 acinus. • largest unit of gas exchange. • site of alveolar diseases.
- 4. Air space • gascontaining space of the lung
- 5. aortopulmonary window The aortopulmonarywindow is the mediastinal region bounded anteriorly by the ascending aorta, Posteriorly by the descending aorta, Cranially by the aortic arch, inferiorly by the left pulmonary artery, medially by the ligamentum arteriosum, and laterally by the pleura and left lung
- 6. bronchiectasis Bronchiectasis is irreversible localized ordiffuse bronchial dilatation, usually resulting from chronic infection, proximal airway obstruction, or congenital bronchial abnormality
- 7. signet ring sign Thisfinding is composed of a ring- shaped opacity representing a dilated bronchus in cross section and a smaller adjacent opacity representing its pulmonary artery, with the combination resembling a signet (or pearl) ring
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- 9. bronchiolectasis Bronchiolectasis is defined as dilatationof bronchioles. It is caused by inflammatory airways disease (potentially reversible) .
- 10. bronchocele A bronchocele is bronchial dilatationdue to retained secretions (mucoid impaction) usually caused by proximal obstruction, either congenital (eg, bronchial atresia) or acquired (eg, obstructing cancer)
- 11. bronchocentric This descriptor isapplied to disease that is conspicuously centered on macroscopic bronchovascular bundles Examples of diseases with a bronchocentric distribution include : sarcoidosis , Kaposi sarcoma , and organizing pneumonia .
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- 14. Atelectasis • reduced volume •increased density • air resorption. • passive..occlusi ve..adhesive
- 15. Broncholith • calcified LN. •eroding into a bronchus. • TB or histoplasmos is
- 16. bulla Airspace measuring more than1 cm—usually several centimeters— in diameter, sharply demarcated by a thin wall that is no greater than 1 mm in thickness. A bulla is usually accompanied by emphysematous changes in the adjacent lung.
- 17. cavity A cavity is agas-filled space, seen as a lucency or low-attenuation area, within pulmonary consolidation, a mass, or a nodule
- 18. centrilobular emphysema Centrilobular emphysema is characterizedby :destroyed centrilobular alveolar walls and enlargement of respiratory bronchioles and associated alveoli
- 19. cyst A cyst isany round circumscribed space that is surrounded by an epithelial or fibrous wall of variable thickness
- 20. mycetoma A mycetoma isa discrete mass of intertwined hyphae, usually of an Aspergillus species, matted together by mucus, fibrin, and cellular debris colonizing a cavity, usually from prior fibrocavitary disease (eg, tuberculosis or sarcoidosis)
- 21. tree-in-bud pattern The tree-in-budpattern represents centrilobular branching structures that resemble a budding tree. The pattern reflects a spectrum of endo- and peribronchiolar disorders, including mucoid impaction, inflammation, and/or fibrosis
- 22. air crescent An aircrescent is a collection of air in a crescentic shape that separates the wall of a cavity from an inner mass. It can represent aspergilloma on top of chronic cavity,partially ruptured hydatid cyst,or fungus ball in cavitary bronchiectasis.
- 23. apical cap An apicalcap is a caplike lesion at the lung apex, usually caused by : intrapulmonary and pleural fibrosis(due to old TB) pulling down of extrapleural fat Or It can be due to superior sulcus tumour.
- 24. silhouette sign The silhouettesign is the absence of depiction of an anatomic soft-tissue border. It is caused by consolidation and/or atelectasis of the adjacent lung
- 25. beaded septum sign Thissign consists of irregular and nodular thickening of interlobular septa reminiscent of a row of beads. Loaded interstitium by fluid or inflammatory ,or malignant cells should be thought (pulmonary edema,Interstitial pneumonias ,sarcoidosis,lymphangitis carcinomatosis)
- 26. ground-glass opacity area ofhazy increased lung opacity, usually extensive,within which margins of pulmonary vessels may be indistinct. On CT scans, it appears as hazy increased opacity of lung, with preservation of bronchial and vascular margins
- 27. halo sign The halosign is a CT finding of ground-glass opacity surrounding a nodule or mass. DD: (1)invasive aspergillosis.
- 28. reversed halo sign Thereversed halo sign is a focal rounded area of ground-glass opacity surrounded by a more or less complete ring of consolidation . A rare sign, it was initially reported to be specific for cryptogenic organizing pneumonia but was subsequently described in patients with paracoccidioidomycosis
- 29. honeycombing Honeycombing represents destroyed andfibrotic lung tissue containing numerous cystic airspaces with thick fibrous walls, representing the late stage of various lung diseases. The cysts range in size from a few millimeters to several centimeters in diameter, have variable wall thickness, and are lined by metaplastic bronchiolar epithelium
- 30. profuse tiny, discrete, rounded pulmonary opacities(3 mm in diameter) that are generally uniform in size and diffusely distributed throughout the lungs miliary pattern
- 31. reticular pattern a reticularpattern is a collection of innumerable small linear opacities that, by summation, produce an appearance resembling a net.
- 32. reticulonodular pattern A combined reticularand nodular pattern, the reticulonodular pattern is usually the result of the summation of points of intersection of innumerable lines, creating the effect on chest radiographs of superimposed micronodules
- 33. nodule The chest radiographic appearance ofa nodule is a rounded opacity, well or poorly defined, measuring up to 3 cm in diameter
- 34. crazy-paving pattern This patternappears as thickened interlobular septa and intralobular lines superimposed on a background of ground-glass opacity , resembling irregularly shaped paving stones. DD:Alveolar proteinosis..what else ?
- 35. consolidation Consolidation refers to An exudateor other product of disease that replaces alveolar air, rendering the lung solid (as in infective pneumonia).
- 36. Pleural plaque • fibrohyalineacellular lesion • from parietal pleura. • 15 years post asbestosis. • TB?
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