Cardio - Thoracic Rads

Question 1

What are the 5 steps to assessing thoracic rads?

Answer 1

1. Film quality
2. Extra-cardiac structures
3. Cardiac sihouette
4. Intrathoracic vessels
5. Pulmonary parenchyma and airways

Question 2

What are the components of film quality?

Answer 2

TPR:

Technique, Positioning, Respiratory Phase

Question 3

What is kVP?

What is mAs?

Answer 3

kVp = energy/heat

mAs = time

Question 4

What is the technique quality in A?

Answer 4

Underexposed;

kVP is too low or mAs is too short

Question 5

What is the technique quality in B?

Answer 5

Just right

Question 6

What are the optimal thoracic settings?

Answer 6

high kVp and low mAs

Question 7

What is the technique quality in C?

Answer 7

overexposed

kVp is too high or mAs is too long

Question 8

How can you tell that an xray was taken during inspiration?

Answer 8

Cranial lung lobe is extended pretty far cranially;

Diaphragm is not overlapping the cardiac silhouette;

Crust to pizza slice ratio is appropriate

Question 9

What measurement can be used to evaluate for enlargement?

Answer 9

vertebral heart scores

Question 10

What is a vertebral heart score?

Answer 10

Sum of width and length of heart (S and L) in terms of # of vertebrae

Question 11

What is the normal VHS for dogs?

Cats?

Answer 11

Dogs = 8.5-10.5

Cats = ~7.5

Question 12

How “tall” and “wide” should a normal heart be in a dog?

Answer 12

Tall = 2/3 height of chest cavity

Wide = 2/3 width of chest cavity (but this is breed-dependent)

Question 13

How “tall” and wide should the heart be in a normal cat?

Answer 13

Tall = 2/3 height of chest cavity

Wide = 1/2 width of chest cavity

Question 14

What is different about the apex-diaphragm relationship between cats and dogs?

Answer 14

Apex DOES NOT touch the diaphragm in cats

Question 15

What can too wide of a heart indicate?

Answer 15

RV enlargement

Question 16

What can too tall of a heart indicate?

Answer 16

LV enlargement > RV enlargement

Question 17

What is the tracheal elevation pattern in LV enlargement?

Answer 17

trachea is consistently elevated

Question 18

What is the tracheal elevation pattern in RV enlargement?

Answer 18

Sharp upward deviation of trachea just cranial to the corina

Question 19

What is used to ID specific chamber/vessel dilation?

Answer 19

the clock face

Question 20

What structure lies at 12:00 - 2:00 on a lateral view?

Answer 20

LA

Question 21

What structure lies at 2:00 - 5:00 on a lateral view?

Answer 21

LV

Question 22

What structure lies at 5:00 - 9:00 on a lateral view?

Answer 22

RV

Question 23

What structure lies at 9:00 - 10:00 on a lateral view?

Answer 23

MPA, R auricle

Question 24

What structure lies at 10:00 - 11:00 on a lateral view?

Answer 24

Aortic arch

Question 25

What structure lies at 11:00 - 1:00 on a VD view?

Answer 25

Aortic arch

Question 26

What structure lies at 1:00 - 2:00 on a VD view?

Answer 26

MPA

Question 27

What structure lies at 2:00 - 3:00 on a VD view?

Answer 27

L auricle

Question 28

What structure lies at 3:00 - 5:00 on a VD view?

Answer 28

LV

Question 29

What structure lies at 5:00 - 9:00 on a VD view?

Answer 29

RV

Question 30

What structure lies at 9:00 - 11:00 on a VD view?

Answer 30

RA

Question 31

What does a “reverse D” appearance indicate?

Answer 31

R heart pressure overload disease

Question 32

What 4 changes are seen in the reverse D?

Answer 32

1. Main PA dilation
2. RA enlargement
3. RV enlargement
4. Apex pushed to the L

Question 33

What are possible radiographic findings in R heart enlargement?

Answer 33

RA/Raur dilation, wide cardiac silhouette (RVE), elevated trachea cranial to carina, MPA dilation, apex shifted to L on DV/VD (dogs only), reverse D shape on DV/VD

Question 34

What are possible radiographic findings for L heart enlargement?

Answer 34

LA/Laur dilation, loss of cd waist, tall cardiac silhouette (LVE), elevated trachea cranial and caudal to carina, Ao dilation, rounded apex

Question 35

What are the 3 radiographic features of L-CHF?

Answer 35

1. Mod to severe LA dilation
2. Pulm venous dilation
3. Interstitial to alveolar pulmonary pattern

Question 36

What are the 4 features of R-CHF?

Answer 36

1. Mod to severe R heart enlargement
2. Dilated caudal vena cava
3. Fluid accumulation (ascites, pleural effusion, small vol pericardial effusion)
4. Pulm vasculature size varies dep on type of R heart diz

Question 37

What can you compare the caudal vena cava to when you are concerned about R-CHF?

Answer 37

the aorta - should be the same size normally;

can also see “rainbow” shape to CdVC