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MODULE 15 - Cardiorespiratory and Haematopoietic Disease > IMAGING - Thoracic Radiograph Interpretation > Flashcards

IMAGING - Thoracic Radiograph Interpretation Flashcards

1
Q

Identify the following features on this normal right lateral radiograph of the thorax

A
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2
Q

What are the five classifications of lung patterns?

A

Bronchial
Alveolar
Interstitial
Nodular
Vascular

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3
Q

What are the five main distributions of lung patterns?

A

Perihilar
Patchy
Cranioventral
Focal
Diffuse

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4
Q

What is perihilar distribution?

A

Perihilar distribution is distribution around the lung hilus

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5
Q

What are bronchial lung patterns?

A

Bronchial lung patterns are when the walls of the bronchi appear more visible and radio-opaque due to thickening and/or mineralisation. End-on bronchi will appear as radio-opaque rings, and the walls of the longitudinal bronchi will appear as thickened radio-opaque parallel lines

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6
Q

List five common differentials for bronchial lung patterns

A

Age-related mineralisation
Normal feature in chondrodystrophic breeds
Chronic bronchitis
Bronchopneumonia (presents with bronchio-alveolar pattern)
Asthma (presents with bronchio-interstitial pattern)

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7
Q

What are alveolar lung patterns?

A

Alveolar lung patterns are when the alveoli have a coalescing fluid/soft tissue opacity resulting in a loss of detailing of the pulmonary vessels (as the vessels are composed of soft tissue and fluid so will blend into the alveolar pattern)

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8
Q

What are two hallmarks of alveolar lung patterns?

A

Air bronchogram
Lobar sign

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9
Q

What is an air bronchogram?

A

An air bronchogram is where there are well delineated gas-filled bronchi and bronchioles surrounding by alveoli with a fluid/soft tissue opacity

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10
Q

What is the lobar sign?

A

The lobar sign is a sharply demarcated border between a normal lung lobe and a lung lobe with increased opacity

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11
Q

List six common differentials for alveolar lung patterns

A

Atelectasis
Neoplasia
Pulmonary oedema
Pulmonary haemorrhage/contusions
Aspiration pneumonia
Bronchopneumonia (presents with bronchio-alveolar pattern)

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12
Q

How do lung patterns typically distribute in left-sided congestive heart failure in dogs?

A

Perihilar distribution

Perihilar distribution of alveolar lung patterns. Note the cardiomegaly also present
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13
Q

How do lung patterns typically distribute in left-sided congestive heart failure in cats?

A

Patchy distribution

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14
Q

How do lung patterns typically distribute in bronchopneumonia?

A

Cranioventral distribution

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15
Q

Identify the lung patterns on this radiograph of a dog with aspiration pneumonia

A

The radio-opaque rings and parallel lines are signs of bronchial lung patterns - this only occurs if there is bronchial inflammation associated with the aspiration pneumonia - and the air bronchogram and coalescing area of fluid/soft tissue opacity alevoli are signs of an alveolar lung pattern.

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16
Q

How do lung patterns typically distribute in pulmonary heamorrhage/contusions?

A

Patchy distribution

Patchy distribution of alveolar lung patterns
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17
Q

How do lung patterns typically distribute in with lung masses?

A

Focal distribution

Lung mass with focal distribution of an alveolar lung pattern
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18
Q

What are interstitial lung patterns?

A

Interstitial lung patterns are an increase in interstitial opacity caused by cellular, fluid or fibrotic change. There will be no loss of detailing of pulmonary vessels

Image of interstitial lung pattern, note how the pulmonary vessels are still visible. Also note the presence of alveolar lung patterns also
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19
Q

List four common differentials of interstitial lung patterns

A

Age-related changes
Early stage left-sided congestive heart failure
Neoplasia
Asthma (presents with bronchio-interstitial pattern)

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20
Q

Why do young animals present with interstitial lung patterns?

A

Young animals have increased fluid within their insterstitium, causing an increase in interstitial opacity

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21
Q

Why do older animals present with interstitial lung patterns?

A

Older animals have fibrosis of the insterstitium, causing an increase in interstitial opacity

22
Q

What is a nodular lung pattern?

A

A nodular lung pattern is the presence of interstitial nodules. The nodules can either be solid or filled with gas

23
Q

List three common differentials of nodular lung-patterns

A

Age-related changes (pleural plaques)
Metastaic neoplasia
Parasitic

24
Q

At what size of nodules would you be concerned about metastatic neoplasia?

A

Nodules between 5 - 40mm can be indicative of metastatic neoplasia

25
Q

What are vascular lung patterns?

A

Vascular lung patterns are increased or decreased pulmonary vessel size

26
Q

How can you tell if the pulmonary vessels are a normal size?

A

Normal pulmonary vessels should be no wider than the width of the fourth rib on a lateral radiograph, and no wider than the ninth rib on a ventrodorsal (VD) radiograph

Note how the arteries are always dorsal (on lateral radiograph) or lateral (on VD radiograph) and the veins are always ventral (on lateral radiograph) or medial (on VD radiograph)
27
Q

How can you use the summation shadow to assess the size of the pulmonary vessels?

A

When the pulmonary vessels overlap the ninth rib, the shadow should form a square shape. When the vessel is larger, the summation shadow will elongate horizontally (look more rectangular), when the vessel is smaller, the shadow will elongate vertically

28
Q

Which three differentials should you consider if the pulmonary arteries appear larger than the pulmonary veins on a radiograph?

A

Heartworm
Lungworm
Pulmonary thromboembolism

29
Q

Which two differentials should you consider if the pulmonary veins appear larger than the pulmonary arteries on a radiograph?

A

Left-sided heart failure
Left-to-right shunt

30
Q

Which two differentials should you consider if the pulmonary arteries and veins are both enlarged?

A

Left-sided congestive heart failure
Left-to-right shunt

31
Q

Which three differentials should you consider if the pulmonary arteries and veins are decreased in size?

A

Overinflation of the lungs
Hypovolaemia
Hypoperfusion

32
Q

What size should a normal heart be in a dog?

A

Should take up 2.5 to 3.5 intercostal spaces
2/3 of the height of the thorax on lateral view
2/3 of the width of the thorax on ventrodorsal view

33
Q

What size should a normal heart be in a cat?

A

Should take up 2 intercostal spaces
2/3 of the height of the thorax on lateral view
2/3 of the widge of the thorax on ventrodorsal view

34
Q

Identify the specific heart chambers on this normal lateral radiograph of the thorax

A
35
Q

Identify the specific heart chambers on this normal ventrodorsal radiograph of the thorax

A
36
Q

What are two of the key signs of cardiomegaly on a radiograph?

A

Enlarged cardiac silouette
Dorsal displacement of the trachea

37
Q

What is the most common cardiomyopathy seen in cats?

A

Hypertrophic cardiomyopathy

38
Q

(T/F) It is easy to detect hypertrophic cardiomyopathy in cats on radiographs

A

FALSE. Cardiac enlargement due to hypertrophic cardiomyopathy is usually only obvious in severe cases

39
Q

How can hypertrophic cardiomyopathies present on ventrodorsal radiographs?

A

Hypertrophic cardiomyopathies may appear ‘valentine heart shaped’ on ventrodorsal radiographs

40
Q

What is the characteristic feature of a pericardial effusion on a radiograph?

A

Large rounded heart with undefined margins

41
Q

What are the characteristic features of a mediastinal mass on a radiograph?

A

Increased soft tissue opacity at the mediastinum and displacement of neighbouring structures

Soft tissue opacity in the cranio-ventral thorax indicative of a mediastinal mass. Note the dorsal displacement of the trachea and the caudo-dorsal displacement of the heart
42
Q

Where are masses most commonly seen within the mediastinum?

A

Cranial mediastinum

43
Q

(T/F) The oesophagus is normally not visible on radiography

A

TRUE.

44
Q

What are the characteristic signs of megaoesophagus on a radiograph?

A
  • Dilated, air filled oesophagus with increased visibility of the oesophageal walls
  • Ventral displacement of the trachea
  • Tracheal stripe sign
45
Q

What is the tracheal stripe sign?

A

The tracheal stripe sign is the increased visibility of the tracheal wall as a result of gas in the oesophagus

46
Q

Which radiograph finding is commonly associated with megaoesophagus?

A

Aspiration pneumonia as megaoesophagus causes regurgitation which can cause aspiration

47
Q

What are three characteristic signs of pulmonary effusion on a radiograph?

A

Decreased visualisation of the cardiac shadow
Retraction of the lung lobes surrounded by fluid opacity
Scalloped margins of the lung

48
Q

What are the three characteristic signs of a pneumothorax on a radiograph?

A
  • Heart elevated from the sternum
  • Retraction of the lung lobes with free gas between the lung and the thoracic wall
  • Increased lung opacity
49
Q

What are two characteristic features of a diaphragmatic rupture on a radiograph?

A

Presence of abdominal structures in the thorax
Loss of visualisation of the diaphragm

50
Q

What are the characteristic signs of a peritoneopericardial diaphragmatic hernia on a radiograph?

A

Presence of abdominal contents within the pericardium

MODULE 15 - Cardiorespiratory and Haematopoietic Disease (21 decks)

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