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DI4 > COMPLEX IMAGING OF THE CHEST > Flashcards

COMPLEX IMAGING OF THE CHEST Flashcards

1
Q

WHAT MODALITIES ARE USED FOR CHEST IMAGING?

A
  1. x-ray
  2. CT
  3. MRI
  4. nuclear medicine
  5. PET
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2
Q

WHAT ARE THE SIX GENERAL CATEGORIES FOR CHEST EXAMINATION?

A
  1. CXR follow up
  2. vascular
  3. trauma
  4. malignancy
  5. infection
  6. lung disease
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3
Q

WHAT ARE THE COMMON INDICATION FOR IMAGING THE CHEST?

A
  1. SOB
  2. cough
  3. haemoptysis ( coughing of blood)
  4. PUO (Pyrexia of unknown origin)
  5. pain
  6. trauma
  7. hypertension
  8. heavy smoker
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4
Q

WHAT SHOULD WE LOOK FOR IN A CONVENTIONAL CHEST X-RAY?

A
  1. Evaluate heart size, location and morphology
  2. Infection
  3. Highlight other potential pathologies/incidental findings
  4. Tumours/Metastases
  5. FBs
  6. Pleural Effusions (if more than 500mls)
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5
Q

WHAT ARE THE BENEFITS OF CONVENTIONAL X-RAY?

A
  1. Cheap
  2. Quick
  3. Low radiation
  4. Easy accessible
  5. Gives a general overview
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6
Q

WHAT ARE SOME PROS AND CONS OF MRI CHEST IMAGING?

A
  1. Highly specific e.g chest wall tumours, MRI shows fat plans and muscle involvement better than CT
  2. No radiation, but other safety concerns
  3. Less availability than CT
  4. Longer scans than CT – think about moving structures within the chest
  5. Expensive
  6. Unlikely to be the first line of investigation
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7
Q
  1. IN VASCULAR CT IMAGING - WHICH ANATOMY IS LOOKED AT? / WHAT ARE THE COMMON PATHOLOGIES?
A
  1. anatomy:
    - Aorta
    - Pulmonary arteries
    - Pulmonary veins
    - Vena Cava (Superior and inferior)
  2. common pathologies:
    - PE
    - Aneurysm
    - Dissection
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8
Q

WHAT IS ARTERIAL PHASE IMAGING?

A
  1. High-pressure injection, 100mls contrast at 4/5 mls/sec

2. Timing of the contrast = Inject & scan at 25-35 seconds or bolus tracking region of interest

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9
Q

WHAT IS AN AORTIC ANEURYSM?

A
  1. Scanning to check for any enlargements within the diameter of the Aorta.
  2. Normal range 2.5-3.5cm
  3. Anything greater than 6cm very high risk of rupture
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10
Q

WHAT IS AORTIC DISSECTION?

A
  1. An aortic dissection occurs when the inner layer of the aorta tears. Blood then pushes through the tear, causing the inner and middle layers of the aorta to separate
  2. Type A dissection involves the ascending aorta
  3. Type B dissection involves the descending aorta
  4. Often referred to a Slazenger ball sign
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11
Q

WHAT IS PULMONARY EMBOLISM?

A
  1. Apulmonary embolismis a blood clot that occurs in the lungs. Which can lead to restricted blood flow and decreased oxygen levels
  2. Appear as filling defects
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12
Q

INFECTION CT IMAGING OF THE CHEST - WHICH ANATOMY IS BEING LOOKED AT? / WHAT ARE SOME OF THE COMMON PATHOLOGIES?

A
  1. Anatomy:
    - lung
  2. common pathologies:
    - Pneumonia
    - COVID
    - TB
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13
Q

WHAT IS THE PORTAL VENOUS PHASE?

A
  1. 100 mls contrast, ideally at 3mls/sec
  2. 50 second delay
  3. Looking for consolidation
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14
Q

WHAT IS THE APPEARANCE OF COVID ON CT CHEST SCAN?

A
  1. Distinctive appearance
  2. Crazy paving
  3. Ground glass opacities
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15
Q

WHAT IS THE APPEARANCE OF TUBERCULOSIS IN A CT CHEST SCANN?

A
  1. Severe infection can lead to pus-filled cavities within the chest
  2. Look for fluid levels
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16
Q

MALIGNANCY CT IMAGING OF THE CHEST - WHICH ANATOMY IS BEING LOOKED AT? / WHAT ARE SOME OF THE COMMON PATHOLOGIES?

A
  1. Anatomy:
    - Heart
    - Lungs
    - Great vessels
    - Surrounding organs
  2. common pathologies:
    - Primary tumours
    - Metastatic spread
    - Nodules
17
Q

TRAUMA CT IMAGING - WHICH ANATOMY IS BEING LOOKED AT? / WHAT IS THE COMMON ABNORMALITIES?

A
  1. Anatomy?
    - Heart
    - Lungs
    - Great vessels
    - Bony thorax
    - Surrounding organs
  2. Common abnormalities:
    - Fractures
    - Pneumothorax
    - Flail Chest
    - Vessel ruptures
    - FBs
    - Haemothorax
18
Q

WHAT ARE SOME OF THE FEATURES REQUIRED FOR TRAUMA CT IMAGING OF THE CHEST?

A
  1. With or without contrast dependant on clinical details.
  2. Generally portal venous phase if with contrast
  3. Bony windowing in addition to soft tissue and lung

DI4 (6 decks)

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