Pulmonary Patterns, Localization, Pleural Space

Question 1

Lung Pattern? Where is the hilus?

Answer 1

Normal lungs

Question 2

Lung Pattern? Where is the hilus?

Answer 2

Normal lungs

Question 3

What are characteristics of a bronchial lung pattern?

Answer 3

End on: thick rings, lucent in center
Long axis: paired thick lines, seen more peripherally, thinner than vessels
Doughnuts and tramtracks

Question 4

Lung Pattern?

Answer 4

Bronchial

Question 5

Lung Pattern?

Answer 5

Bronchial

Question 6

Lung Pattern?

Answer 6

Bronchial

Question 7

Lung Pattern?

Answer 7

Bronchial

Question 8

Lung Pattern?

Answer 8

Normal lung

Question 9

Lung Pattern?

Answer 9

Bronchial

Question 10

Lung Pattern?

Answer 10

Bronchial

Question 11

Lung Pattern?

Answer 11

Bronchial

Question 12

Lung Pattern?

Answer 12

Bronchial

Question 13

What is the mechanism of the bronchial lung pattern?

Answer 13

Thickening of airways usually due to chronic inflammation

Question 14

What are causes of a bronchial lung pattern?

Answer 14

Allergic/immune-mediated airway disease
Chronic/previous inflammation
Infection

Question 15

What are the characteristics of an alveolar lung pattern?

Answer 15

Soft tissue opaque lung region with at least one of the following: air bronchogram +/- lobar sign +/- border effacement with soft tissues

Question 16

What is the appearance of an air bronchogram?

Answer 16

Lucent airways with surrounding soft tissue opacity
All regional vessels are border effaced

Question 17

Lung Pattern?

Answer 17

Alveolar
Air bronchogram

Question 18

Lung Pattern?

Answer 18

Alveolar
Air bronchogram

Question 19

What is the appearance of a lobar sign?

Answer 19

Distinct smooth soft tissue opaque margin
At edge of lobe, adjacent to normal lung

Question 20

Lung Pattern?

Answer 20

Alveolar
Lobar sign

Question 21

Lung Pattern?

Answer 21

Alveolar
Lobar sign

Question 22

What is the appearance of border effacement?

Answer 22

Lose visibility of margins of cardiac silhouette, diaphragm, etc.

Question 23

Lung Pattern?

Answer 23

Alveolar
Border effacement

Question 24

What are causes of an alveolar lung pattern?

Answer 24

Edema (cardiogenic or noncardiogenic pulmonary edema)
Blood (trauma, coagulopathy)
Pus (pneumonia, inflammatory)
Neoplasia (primary lung tumor, metastatic neoplasia)
Atelectasis

Question 25

What are characteristics of an interstitial pattern?

Answer 25

Increased background opacity of the lung (not as severe as alveolar - not meeting any of the 3 criteria) Large pulmonary vessels visible but fuzzy

Question 26

Lung Pattern?

Answer 26

Interstitial *Diffuse, marked*

Question 27

Lung Pattern?

Answer 27

Normal lung

Question 28

Lung Pattern?

Answer 28

Right-sided interstitial

Question 29

Lung Pattern?

Answer 29

Interstitial *Diffuse, marked*

Question 30

Lung Pattern?

Answer 30

Interstitial *Diffuse, marked*

Question 31

Lung Pattern?

Answer 31

Interstitial *Diffuse, moderate*

Question 32

Lung Pattern?

Answer 32

Normal

Question 33

Lung Pattern?

Answer 33

Interstitial *Diffuse, moderate*

Question 34

Lung Pattern?

Answer 34

Normal

Question 35

Lung Pattern?

Answer 35

Interstitial *Diffuse, moderate*

Question 36

Answer 36

Normal lung

Question 37

What are special considerations for interstitial lung patterns?

Answer 37

*Stuff in interstitial space* Blood: leptospirosis Neoplasia: lymphoma Fibrosis

Question 38

Lung Pattern?

Answer 38

Vascular *Big arteries and veins, solid tubes*

Question 39

Lung Pattern?

Answer 39

Bronchial *Hollow tubes*

Question 40

Lung Pattern?

Answer 40

Alveolar

Question 41

Lung Pattern?

Answer 41

Interstitial

Question 42

What are radiographic features of underexpansion/atelectasis?

Answer 42

Interstitial or alveolar lung pattern with decreased lung volume *Can be one lobe, one region, or entirely of lungs*

Question 43

Lung Pattern?

Answer 43

Atelectasis *Red = alveolar pattern*

Question 44

Lung Pattern?

Answer 44

Atelectasis *Caudodorsal interstitial pattern*

Question 45

Lung Pattern?

Answer 45

Atelectasis *Moderate caudodorsal interstitial pattern*

Question 46

Which lung is seen better with which view?

Answer 46

Up lung shows lesion better *Right lateral shows left lung better*

Question 47

When should a DV view be used?

Answer 47

Dyspneic Better view of dorsal lungs and pulmonary vessels

Question 48

Answer 48

Right middle lung lobe

Question 49

Which lung lobe is the mass?

Answer 49

Question 50

What is highlighted?

Answer 50

Pleural fissure lines

Question 51

What is the appearance of pleural effusion on radiographs?

Answer 51

Widened pleural fissure lines Lungs retracted and rounded

Question 52

Lung Pattern?

Answer 52

Pleural effusion

Question 53

Lung Pattern?

Answer 53

Moderate right-sided pleural effusion

Question 54

Answer 54

Pleural effusion

Question 55

Answer 55

Pleural effusion

Question 56

What lung patterns are associated with pleural effusion?

Answer 56

Interstitial due to underexpansion or superimposition with soft tissue opaque fluid Alveolar if atelectasis

Question 57

Lung Pattern?

Answer 57

Pleural effusion

Question 58

Lung Pattern?

Answer 58

Pleural effusion

Question 59

Lung Pattern?

Answer 59

Mild pleural effusion

Question 60

Lung Pattern?

Answer 60

Marked pleural effusion

Question 61

How does pleural effusion differ with a VD and DV view?

Answer 61

DV: fluid to ventral thorax, heart more easily border effaced by fluid on this side VD: fluid to dorsal thorax, easier to see pleural fissue lines

Question 62

What does pneumothorax look like on radiographs?

Answer 62

Free gas around retracted lung margins Lack of vessels in gas-filled pleural space

Question 63

Lung Pattern?

Answer 63

Pneumothorax

Question 64

Lung Pattern?

Answer 64

Pneumothorax

Question 65

Lung Pattern?

Answer 65

Pneumothorax

Question 66

Lung Pattern?

Answer 66

Pneumothorax

Question 67

Lung Pattern?

Answer 67

Pneumothorax *Arrows = atelectasis*

Question 68

Lung Pattern?

Answer 68

Pneumothorax *Arrows = atelectasis*