Radiographic Findings of Chest Disease

Question 1

What is the most common type of atelectasis?

Answer 1

Obstructive or resorptive atelectasis.

Question 2

What is the type of atelectasis secondary to complete endobronchial obstruction?

Answer 2

Resorptive or obstructive atelectasis.

Question 3

What is the type of atelectasis that is caused by mass such as bullae, abscess, or tumors?

Answer 3

Compressive atelectasis.

Question 4

What is the type of atelectasis that relies on the natural tendency of the lung to collapse when dissociated with the chest wall?

Answer 4

Passive or relaxation atelectasis.

Question 5

True or False: All complete endobronchial obstructive will cause atelectasis. Why?

Answer 5

No. Collateral airway via pores of Kohn or canals of Lambert.

Question 6

What is the type of atelectasis presenting with reticular opacities and bronchiectasis secondary to fibrosis?

Answer 6

Cicatricial atelectasis.

Question 7

True or False: Surfactant decreases surface tension of the alveoli.

Answer 7

True.

Question 8

What is the morphologic/anatomic type of atelectasis presenting as thin linear opacities that does not abut the interlobar fissure?

Answer 8

Segmental atelectasis.

Question 9

What is the type of atelectasis commonly seen in the patients with hypoventilation?

Answer 9

Subsegmental atelectasis.

Commonly seen in the lung bases, perpendicular to the costal pleura.

Question 10

Radiograph of patient with history of asbestos exposure presenting with well-defined mass with adjacent pleural thickening, and bronchovascular bundle arising in its anterior inferior margin suggest?

Answer 10

Round atelectasis.

Question 11

How would you differentiate a pulmonary neoplasm from atelectatic lung in CECT?

Answer 11

Atelectatic lung: enhances.

Pulmonary neoplasm: hypo- or non-enhancing.

Question 12

What are the two direct signs of lobar atelectasis.

Answer 12

1. Deviation or displacement of fissure.

2. Crowding of vessels.

Question 13

Tenting or peaking of the diaphragm in a right upper lobe collapse is caused by?

Answer 13

Inferior accessory fissure.

Most common pulmonary fissure.

Question 14

What is the sign for a right upper lobe collapse with a central convex mass?

Answer 14

S-sign of Golden.

Question 15

True or False: All forms of lobar collapse will maintain their attachment to costal pleural surface except the right middle lobe.

Answer 15

True.

Question 16

What pulls the lower lobe towards the lower mediastinum when it collapses?

Answer 16

Inferior pulmonary ligament.

Question 17

What is the sign for curvilinear bronchovascular bundle arising from the anterior inferior margins of a round atelectasis?

Answer 17

Comet tail.

Question 18

Differentiate comet tail sign to pleural tail.

Answer 18

Comet tail sign: from round atelectasis; bronchovascular bundle; benign nature.

Pleural tail: from lung adenocarcinoma, fibrosis, malignant nature.

Question 19

What is the sign representing the curvilinear lucency lateral to the arch of aorta in the background of left upper lobe collapse? What does it represent?

Answer 19

Luftsichel sign.

It represents compensatory hyperinflation of the superior segment of the left lower lobe.

Question 20

Define fine reticular pattern of interstitial opacity.

Answer 20

Also known as ground glass opacity.
1-2 mm lucent space.
Seen in the interstitial pulmonary edema, and UIP.

Question 21

Define medium reticular pattern of interstitial opacity.

Answer 21

Also known as honeycombing pattern.
3-10 mm lucent space.
Most commonly seen in pulmonary fibrosis.

Question 22

Define coarse reticular pattern of interstitial opacity.

Answer 22

> 1 cm lucent space.
Most commonly seen in the Langerhans histiocytosis and idiopathic pulmonary fibrosis.
Common in diseases that produce cystic spaces.

Question 23

Differentiate interstitial nodules to air-space nodules.

Answer 23

Interstitial nodules are homogenous in appearance, but heterogeneous in size.

Question 24

Fill up the sizes for each interstitial nodule:

1. Miliary:
2. Micronodule:
3. Nodule:
4. Mass:

Answer 24

1. Miliary: <2 mm
2. Micronodule: 3-7 mm
3. Nodule: 7 mm to 3 cm.
4. Mass: >3 cm.

Question 25

Enumerate disease entities that produce reticulonodular pattern.

Answer 25

Silicosis.
Sarcoidosis.
Lymphangitic carcinomatosis.

Question 26

Identify:

2-6 cm long linear opacities, obliquely oriented and course through the substance toward the lung hila.

Answer 26

Kerley A.

Question 27

Identify:

1-2 cm long linear opacities perpendicular to the costal pleural surface.

Answer 27

Kerley B.

Question 28

What are branching tubular opacities representing mucus-filled, dilated bronchi?

Answer 28

Mucus impaction.
Bronchocele.
Mucocele.
Finger on a glove sign.

Question 29

Identify:

Pulmonary lucency with an irregular or lobulated wall >1mm thick.

Answer 29

Cavity.

Question 30

Identify:

Gas collection, >1 cm in size, <1 mm in wall thickness.

Answer 30

Bullae.

Question 31

Identify:

Gas collection, <1 cm in size, most commonly subpleural in location.

Answer 31

Bleb.

Question 32

Identify:

Well-circumscribed intrapulmonary mass with smooth walls, >1 mm thick.

Answer 32

Air cyst.

Question 33

Identify:

Thin-walled, gas-containing structure distal to the check-valve obstruction.

Answer 33

Pneumatocele.

Question 34

Differentiate hilum overlay and hilum convergence, and which one represent a hilar location.

Answer 34

Hilum overlay: density through which normal hilar vessels can still be seen.
Hilum convergence: vascular structures converge only as far as the lateral margin of increased hilar density.

Hilum convergence represent hilar location.

Question 35

What are other radiographic clues for hila disease?

Answer 35

1. Visualization of RUL bronchial lumen.
2. Lobulated posterior wall of the bronchus, or with thickness >3 mm.
3. Soft tissue mass >1cm in the inferior hilar window.