Lung Patterns Flashcards
What are the 3 most important pulmonary diseases?
Pulmonary edema, pneumonia, hemorrhage/contusions.
What starts out as an interstitial pattern and moves into an alveolar pattern?
Pulmonary edema
Is an interstitial pattern or alveolar pattern more severe?
Alveolar pattern
What disease have ventral distribution?
Aspiration pneumonia
What disease have diffuse distribution with tiny little dots?
Fungal
What disease has a caudal dorsal distribution?
Edema
What cause will make the artery bigger than the vein?
Heart worm disease
What causes the vein to be bigger than the artery leading to venous congestion?
Left sided heart congestive failure
If both sides of the veins and arteries big, what is the disease is it?
PDA or VSD
If both the veins and arteries are small?
Hypovolemia or shock
What are rib fractures caused by?
Pulmonary contusions
What can coughing indicate?
Asthma or bronchial disease
What can dikepnic mean?
Pneumonia or metastatic disease
What is an alveolar pattern?
Air is removed from the alveoli and replaced with fluid which causes increase lung space
What are signs of an alveolar pattern?
1) Homogeneous, uniform fluid opacity (varies from solid and opaque to faint and wipsy)
2) Lobar sign
3) Silhouette effect
4) Air bronchograms
wont see every sign on radiographs
What is the gold standard for an alveolar pattern?
Air bronchograms
What is a lobar sign?
Line of demarcation of a lung lobe where two lungs are next to each other with different opacities
Which lung is a common place for aspiration pneumonia?
Right middle lung lobe
What is the silhouette effect?
Two soft tissue structures in close contact where borders merge (blend together) such as border effacement
Which pattern is the only one that will have a silhouette effect?
Alveolar pattern
Which air pattern causes more loss of air space than any other pattern?
Alveolar
What are causes of alveolar pattern?
1) Pneumonia
-Aspiration
-Bronchopneumonia
-Hematogenous (foals, rare in dogs/cats)
2) Edema
-Cardiogenic
-Non-cardiogenic
3) Hemorrhage
-Trauma
-Coagulopathy
What are the two types of pulmonary edema?
Cardiogenic and non-cardiogenic
What is cardiogenic pulmonary edema?
High pressure edema with left sides congestive heart failure die to large left atrium
What is non-cardiogenic pulmonary edema?
Increased permeability edema and/or high pressure with a normal left atrium
What are causes of non-cardiogenic edema?
Electrocution
Smoke inhalation
Acute hypoxia
Head trauma
Submersion injury
How does cardiogenic edema look like in cats?
No typical distribution
What are pulmonary contusions?
Alveolar infiltrate, can be anywhere
Associated radiographic changes include rib fractures, pneumothorax, pleural effusion
What are less common causes of alveolar pattern?
Lung lobe torsion
Pulmonary thromboembolism
Neoplasia
Bronchial foreign body (with focal pneumonia)
Atelectasis
In alveolar pattern
Loss of volume, removing air and not replacing it (collapsed lung), mediastinal shift
What is a linear (unstructured) interstitial pattern?
Thickening of infrastructure
Overall increase in hazy pulmonary opacity
More lines
Vessels appear smudged/hazy, not as defined
No air bronchograms, silhouette effect or lobar signs
Often the “default” pattern
What can cause a linear interstitial pattern?
Artifact (radiograph taken on expiration)
Geriatric change
Pulmonary edema
Viral pneumonia
Hemorrhage
Neoplasia
Pulmonary fibrosis
How do you know your interstital pattern is from taking a radiograph during expiration?
Lateral view will have an unstructured interstitial pattern but your VD/DV view will be normal
What is a nodular/structured interstitial pattern?
Relatively circumscribed nodule/mass
Single/multiple
Varying sizes: mililary (tiny), nodule (<2 cm), mass (>2 cm)
What are causes of a interstitial nodular pattern?
Artifact of chest wall
Primary neoplasia
Metastatic neoplasia
Fungal granulomas
Abscess (common in horses)
Hematoma
Fluid filled bulla
Parasitic cyst
What disease is commonly seen with a miliary pattern in dogs?
Fungal infection, likely blasto
