Diagnostic Procedures in Respiratory Disease

Question 1

Lateral decubitus views are useful for what?

Answer 1

determining whether pleural abnormalities represent freely flowing fluid

Question 2

Apical lordotic views are useful for what?

Answer 2

apical lordotic views can visualize disease at

the lung apices better than the standard PA view

Question 3

Portable equipment limitations (x ray)

Answer 3

(1) the single anteroposterior (AP) projection obtained; (2) variability in overand underexposure of film; (3) a shorter
focal spotfilm distance leading to lack of edge sharpness and loss of fine detail; and (4) magnification of the
cardiac silhouette and other anterior structures by the AP projection

Question 4

Diagnostic ultrasound (US) can be used for what?

Answer 4

It can detect and localize pleural abnormalities and is a quick and effective way of guiding percutaneous needle
biopsy of peripheral lung, pleural, or chest wall lesions. US is also helpful in identifying septations within loculated collections.

Question 5

CT offers several advantages over routine chest radiography

Answer 5

First, the use of crosssectional images allows distinction between densities that would be superimposed on plain radiographs. Second, CT is far better than routine radiographic studies at characterizing tissue density and providing accurate size assessment of lesions.

Question 6

What is the difference between a highresolution CT (HRCT) and a conventional CT?

Answer 6

In highresolution CT (HRCT), the thickness of individual crosssectional images is ~1–2 mm, rather than the
usual 7–10 mm in conventional CT.

Question 7

Benefits of helical TC?

Answer 7

Helical CT technology results in faster scans
with improved contrast enhancement and thinner collimation. Images are obtained during a single breathholding maneuver that allows less motion artifact

Question 8

Problem with MDCT?

Answer 8

there is an increase in radiation dose compared to singledetector CT to consider

Question 9

FDGPET can differentiate benign from malignant lesions of what size?

Answer 9

lesions as small as 1 cm

Question 10

Compare MRI to CT in imaging of the thorax.

Answer 10

Magnetic resonance (MR) provides poorer spatial resolution and less detail of the pulmonary
parenchyma and, for these reasons, is currently not considered a substitute for CT in imaging the thorax.

Question 11

indications for pulmonary angiography

Answer 11

pulmonary embolism; suspected pulmonary arteriovenous malformation and assessment of pulmonary arterial invasion by a neoplasm

Question 12

how can you locate the origin of a sputum sample?

Answer 12

the finding of alveolar macrophages and other
inflammatory cells is consistent with a lower respiratory tract origin of the sample, whereas the presence of
squamous epithelial cells in a “sputum” sample indicates contamination by secretions from the upper airways.

Question 13

Emerging techniques

Answer 13

video/autofluorescence bronchoscopy
(AFB), narrow band imaging (NBI), optical coherence tomography (OCT), and endomicroscopy using confocal
fluorescent laser microscopy (CFM)