Block 1 - Anatomy - Mediastinal Masses; Radiology of the Thorax Flashcards
In what compartment are 50% of mediastinal tumors?
Anterior
What are the four principal masses of the anterior mediastinum?
What percentage of all mediastinal masses are found in the anterior mediastinum?
Thyroid disease, Thymoma, Teratoma, Terrible lymphoma;
50%
What is the most common mass of the posterior mediastinum?
Neurogenic tumors
What is the most common mass of the middle mediastinum?
Congenital cysts
What is the most common mass of the superior mediastinum?
Related to thyroid disease
Where are mediastinal masses most common?
What is the most common mass of the superior mediastinum?
What is the most common mass of the middle mediastinum?
What is the most common mass of the posterior mediastinum?
Anterior;
thyroid-related;
congenital cyst;
neurogenic tumor
What is the appearance of the mediastinal mass in this image?
Homogenous, solid
What is the appearance of the mediastinal mass in this image?
Cystic
What is the appearance of the mediastinal mass in this image?
Heterogenous
Where is the imaginary line of the bottom border of the superior mediastinum?
T4 to the sternal angle
What organs are present in the anterior mediastinum of the adult?
What organs are present in the anterior mediastinum of the child?
None;
the thymus
(extending from the sternal angle to the pericardium)
What is the assumed space of the posterior mediastinum?
From the T4 vertebra extending to the heart and down to the diaphragm
What structures are the primary organs of the middle mediastinum?
The heart and pericardium
What is a type of congenital cyst that can be found in the middle mediastinum?
A pericardial cyst
Identify the trachea on this normal chest CT with contrast.
Identify the clavicle on this normal chest CT with contrast.
Identify the vertebral body on this normal chest CT with contrast.
Identify the spinal cord on this normal chest CT with contrast.
Identify the trachea on this normal chest CT with contrast.
Identify any rib on this normal chest CT with contrast.
Identify the sternum on this normal chest CT with contrast.
Identify the right lung field on this normal chest CT with contrast.
Identify the trachea on this normal chest CT with contrast.
Identify the aortic arch on this normal chest CT with contrast.
Identify the superior vena cava on this normal chest CT with contrast.
Identify the lung field on this normal chest CT with contrast.
Identify the ascending and descending aorta on this normal chest CT with contrast.
Ascending - red;
descending - blue
Identify the left pulmonary artery on this normal chest CT with contrast.
Identify the superior vena cava on this normal chest CT with contrast.
Identify the trachea on this normal chest CT with contrast.
(bifurcated)
Identify the aorta on this normal chest CT with contrast.
Ascending aorta - red;
descending aorta - blue
Identify the right pulmonary artery on this normal chest CT with contrast.
Identify the superior vena cava on this normal chest CT with contrast.
Identify the pulmonary veins and descending aorta on this normal chest CT with contrast.
Pulmonary veins - red;
descending aorta - blue
Identify the right and left ventricles and descending aorta on this normal chest CT with contrast.
Right ventricle - red;
left ventricle - blue;
descending aorta - green
Identify the diaphragm on this normal chest CT with contrast.
Trachea
Right clavicle
Vertebral body
Spinal cord
Trachea
Left rib
Sternum
Right lung field
Trachea
Aortic arch
Superior vena cava
Lung fields
Ascending aorta - red;
descending aorta - blue
Left pulmonary artery
Superior vena cava
Trachea (bifurcated)
Ascending aorta - red;
descending aorta - blue
Right pulmonary artery
Superior vena cava
Pulmonary veins - red;
descending aorta - blue
Right ventricle - red;
left ventricle - blue;
descending aorta - green
Diaphragm
What is interesting about this mediastinal mass (marked by an asterisk)?
The presence of pleural effusion
(medium gray shapes behind white arrows)
What tissue details are not well visualized via plain X-ray?
Soft tissues and fluid details
What terms refer to tissue that absorbs X-rays (and appears bright on X-ray)?
Radiodense, dense, radioopaque, opaque
What terms refer to tissue that does not absorb many X-rays (and appears dark on X-ray)?
Radiolucent, lucent
Name the five main radiodensities (in order of density) and the associated color seen on X-ray.
Name the basic materials/tissues leading to the following radiodensities.
What additional tissue can be somewhat well visualized on CT that could not be easily differentiated on plain X-ray?
Fluid
Identify the basic tissues/materials in the following CT scan based on their respective radiodensities.
What are two potential negative effects of contrast use in imaging?
Allergy and nephrotoxicity
How does contrast appear upon use in CT imaging?
Super-white (similar to metal)
What material type is ultrasound excellent for identifying?
What two types can it not penetrate?
Fluid;
bone, air
What color does fluid appear on ultrasound?
What color does soft tissue appear on ultrasound?
Black (anechoic);
medium-gray
What type of imaging technique is this?
What material type is being indicated in this image?
Ultrasound;
fluid
What imaging types use absolutely no radiation?
MRI and ultrasound
What imaging modality is the gold standard for soft tissue visualization?
MRI
What are some potential contraindications to MRI use?
Pacemakers or other implanted metallic devices (e.g. aneurysm clips), claustrophobia, cost
What are the two MRI radiofrequency pulses that are used?
T1 and T2
What is the difference between T1- and T2-weighted MRIs?
T1-weighted images - fluid is DARK on T1
T2-weighted images - fluid is WHITE on T2
Is this a T1- or T2-weighted MRI?
T1
(fluid is dark)
Is this a T1- or T2-weighted MRI?
T2
(fluid is white)
What metals are often used in contrast dyes?
What spaces is this contrast often used to visualize?
Iodine, barium;
vascular system; bowel, bladder, uterine cavity, joint space, thecal sac
How does nuclear medicine work?
Injected radiopharmaceuticals emit gamma radiation and allow for evaluation of function and structure of certain structures
What type of imaging modality is this?
Nuclear medicine (injected radiopharmaceuticals)
What structures can be visualized via angiography?
The arterial system
Put these imaging modalities in order from least to most radiation exposure:
Ultrasound, nuclear medicine, CT, MRI, angiography, radiography
Ultrasound / MRI <<<< radiography < nuclear medicine < CT < angiography
Put these imaging modalities in order from least to most expensive:
Ultrasound, nuclear medicine, CT, MRI, angiography, radiography
Radiography < ultrasound < CT / nuclear medicine < MRI / angiography
