Quiz 4 imaging Flashcards
Cephalization of flow
Seen with pulmonary edema
-distention is vessels of upper lobe instead of lower lobe
Aortic dissection imaging
thoracic MRI
Loss of sharp definition of pulmonary vessels and peribronchial cuffing = signs of?
Interstitial pulmonary edema
-central interstitium
kerley lines =
A vs B?
thickened interlobular septa
Kerley B
- horizontal and short
- Lower lateral parts of lung
Kerley A
-longer
Fissural thickened is a sign of?
subpleural interstitial edema
Batwing edema (perihilar consolidation) seen in
acute development of pulmonary edema
ARDS progression on imaging
EARLY
Normal -> diffuse ground glass opacity with consolidative opacities in dependent areas of the lung
LATE
-fibrosis: traction bronchiectasis + cysts
First test to do when PE is suspected? Why?
CXR - to rule out other things on the ddx
Westmark sign
SEEN IN PE
Oligemia -> pulmonary vessels distal to obstruction are smaller
Hampton hump
Circumscribed, subpleural opacity with a rounded medial border facing toward the hilum
pulmonary infarct OR hemorrhagic edema
-CHF patients more likely to have true infarct
If PE suspected and normal V/Q scan, what’s the next step?
End workup for PE
Most frequently done test for PE
CTPA
-contrast used
When might CTPA be non-diagnostic? What should be done instead?
If patient can’t hold breath -> do V/Q scan
or if patient can’t get contrast to do CTPA
2 most radiosensitive organs in women?
Breast and Lung
Benign pattern of calcification
-temporal assessment
- central -> bull’s eye
- diffuse solid
- laminated
- “popcornlike”
If nodule hasn’t changed for 2 years -> benign
CT assessment of solitary nodule. More likely to be cancer if: Size Shape Edge Calcification
- Size - larger
- Shape - irregular, lobular
- Edge - spiculated, ill-defined
- Calcification - look for benign pattern
Fat and calcification in nodule think?
Hamartoma
Typical carcinoid tumor CT
Central
associated w/ bronchus -> tip of iceberg sign
PET for nodules greater than or equal to how many cm?
1
Which lung tumors may be PET neg
Carcinoid
Adenocarcinoma
What can be PET + but no tumor
infection granulomatous disease (e.g. histo)
Cavitary nodule in upper lobes or superior segments or lower lobes think?
Tb
cavitation = necrosis
Round pneumonia can be seen in?
younger patients (especially kids) -can mimic tumor
Peripheral lobulated mass along pleural surface think?
malignant mesothelioma or mets
Sarcoid presents in which zone of lung
Upper zone
Sarcoid nodules tend to have a (blank) distrubution
perilymphatic
- around vessels
- subpleural
sometimes interlobular septum
Ill defined “Ground glass” nodules centered around bronchus
hypersensitivity pneumonitis
Imaging technique to distinguish sarcoid for hypersensitivity pneumonitis?
HRCT
UIP effects mostly which lobes?
Lower and peripheral
Organizing pneumonia on CXR
patchy air space opacities
Best imaging for routine sinus eval
non contrast CT
contrast for sinonasal mass lesions
When is MRI preferred for sinus imaging
fungal disease
sinonasal malignancies - distinguish tumor from retained secretions
