Imaging of the thorax

Question 1

what is a CXR

Answer 1

2d image of all the thorax

Question 2

what is an advantage of chest radiography

Answer 2

cheap and accessible

Question 3

what is a disadvantage of chest radiography

Answer 3

projectional

Question 4

what is an advantage of ultrasound

Answer 4

non ionising radiation

Question 5

what is the disadvantage of ultrasound?

Answer 5

operator dependant

Question 6

what is an advantage of CT

Answer 6

cross sectional

Question 7

what is a disadvantage of CT

Answer 7

ionising radiation

Question 8

what is an advantage of radionuclide imaging

Answer 8

offers physiological information

Question 9

what is a disadvantage of radionuclide imaging

Answer 9

poor anatomical visualisation

Question 10

when is CT of the chest performed

Answer 10

Performed in the trauma setting, cancer staging or further investigation of respiratory pathology.

Question 11

why is contrast added to CT chest

Answer 11

imrpove diagnostic information from vessels

Question 12

what plane is this ct from

Answer 12

axial

Question 13

what plane is this CT from

Answer 13

coronal

Question 14

what plane is this CT from

Answer 14

Saggital

Question 15

what major structures are in this CT

Answer 15

Apices of the lungs.
Superior mediastinum:
Arch of the aorta (and branches).
SVC (and branches).
Trachea.
Oesophagus.

Question 16

what major structures are in this CT

Answer 16

Lungs.
Ascending and descending thoracic aorta.
Carina.
Hila.
Main pulmonary arteries and veins.
Heart.

Question 17

what major structures are in this CT

Answer 17

Bases of lungs.
Descending thoracic aorta.
Heart.
Oesophagus.
Liver.

Question 18

what is wrong with this CTPA

Answer 18

Pulmonary embolus

Question 19

what is wrong with this CT

Answer 19

bronchogenic carcinoma (SCLC)
Cavitating right lung mass (necrotic areas). CT biopsy and subsequent histology confirmed SCLC

Question 20

what is wrong with this CT

Answer 20

pericardial effusion
fluid buildup in the pericardial space

Question 21

what is wrong with this CT

Answer 21

ascending thoracic aorta aneurysm

Question 22

when are thoracic ultrasounds used

Answer 22

Ultrasound is commonly used for patient assessment in ITU settings and for image-guided biopsy.

Question 23

what is POCUS

Answer 23

• POCUS = point of care ultrasound
• Use is increasing in respiratory medicine.
• POCUS = ultrasound that is simultaneously performed, interpreted and utilised by a suitably qualified clinician at the time of consultation with the patient.

Question 24

what are ultrasounds very senstive to

Answer 24

small pleural effusions

Question 25

what is an echocardiogram used for

Answer 25

• Specialised cardiology investigation.
• Useful for functional information on cardiac function (especially valvular).

Question 26

when is radionuclide imaging of the chest predominantly used

Answer 26

Predominantly lung ventilation/perfusion imaging (V/Q).

Question 27

what does radionuclide imaging of the chest do

Answer 27

Offers physiological information on correlation between areas of the lung that are receiving air and those receiving adequate blood supply.

Question 28

how do you asses image quality for chest radiography

Answer 28

• Patient ID
• Take note of annotations
• Correct area included.
• Rotation.
• Inspiration.
• Artefacts.

Question 29

what is the search strategy for chest radiography

Answer 29

• An example of a format for this is “Are There Many Lung Lesions Detectable?”:
• Abdomen
• Thorax
• Mediastinum
• Lung – right then left
• Lung – compare
• Devices

Question 30

what is wrong with this chest radiograph

Answer 30

Pneumoperitoneum

Question 31

what is wrong with this chest radiograph

Answer 31

fractured right clavicle

Question 32

what is wrong with this chest radiograph

Answer 32

cardiomegaly

Question 33

what is wrong wth this chest radiograph

Answer 33

left pleural effusion

Question 34

what is wrong with this chest radiograph

Answer 34

left pneumothorax