Radiologic Anatomy of Thorax Flashcards
What are the anatomical structures of the upper airway?
- Sinuses
- Nasopharnx
- Oropharynx
- Proximal Trachea
- Middle ear
- Mastoids/Temporal Bone
When is imaging appropriate for:
- Sinuses
- Temporal bone
- Sinuses (most common)
- Chronic sinusitis and complications
- Acute sinusitis
- Post operative
- Tumors
- Trauma
- Temporal Bone
- Hearing loss
- Trauma
- Infection
What is used for imaging sinuses?
- Radiographs
- Less commonly used than in past
-
CT
- Axials with reformatted images
- Direct Coronals
What can be suggestive of acute sinusitis?
mucosal thickening within a nasal sinus
What is the most likely diagnosis?
Nasal Polyposis
When would the trachea imaged for an infection?
- Unusual to image for infections
- ‘Trachiitis’ or ‘bronchitis’
-
Exceptions:
- Epiglottitis
- Tracheal papillomatosis
- Croup
Trachitis
Epiglotitis
What can cause the trachea to collapse during expiration?
weak tracheal rings
What are the different views for a chest radiograph?
- PA, lateral
- AP - upright
- AP-Supine
- Decubitus
- pt. lays on their side
- Oblique views
- for rib fx
- Lordotic
- pt. leans back
- looks for lesion underneath clavicle
AP or PA?
AP view
- enlarged heart
- widened mediastinum
- reduced lung volumes (possibly did not inspire properly)
AP or PA?
PA view
- all features are normal (compared to the AP view)
Identify the lung structures:
Identify the lung structures:
Which lung is this?
Right lung
Why is an MRI not good for imaging the lung parenchyma?
- Cannot image lung parenchyma well
- Motion artifact
- How are pulmonary infections evaluated through imaging?
- Are there any clues that can point to a specific infection?
- Often, the pattern of disease can be described
- Usually, the individual pathogen is difficult to discern on imaging
- Any clues?
- Non-resolving pneumonia
- High clinical suspicion
- Unique features
- Chest wall invasion
What is the pattern for bronchopneumonia?
“tree in bud” pattern
- Look for patchy densities
What is a silhoutte sign?
Dense lung and cardiac parenchyma leads to:
- Loss of cardiac border
- Consolodation
What is an air bronchogram?
Patent bronchi in an area of collapsed and consolidated lung
Excluding cancer, what is the most likely diagnosis?
Lobar pneumonia (in RUL)
What is seen in this radiograph?
Multifocal Infiltrates
What is seen in this radiograph?
Lobar consolidation (in RML)
What can be seen on CT if there is lobar consolidation?
Air bronchogram
What is the most likely diagnosis?
Miliary TB
- nodular densities throughout the entire lung
Granulomas that result from histoplasmosis heal by ….
calcification
Blastomycosis
Histoplasmosis
If the lung has a “dirty” appearance, what pathogen is most likely the cause of this?
Aspergillosis
What can be done clinically to tell the difference between cancer vs. aspergilloma?
Aspergillomas move and cancer does not
- Have the patient imaged in two different postions
Describe how Aspergillus presents in the following patients:
- Severely immunosuppressed
- Imunosuppressed
- Normal immunity, abnormal lungs
- Hyperimmune
-
Severely immunosuppressed
- Invasive aspergillus
-
Immunosuppressed
- Semi invasive aspergillus
-
Normal immunity, abnormal lungs
- Aspergilloma
-
Hyper immune
- ABPA - Allergic bronchopulmonary aspergillosis
What will be seen on CT in immunosuppressed patients with a lung infection?
extensive infiltrates of the lung parenchyma
What are radiologic findings for viral infections?
Wide spectrum of non specific findings:
- Normal
- Patchy infiltrates
- Diffuse, severe infiltrates
- Superimposed bacterial pneumonia
How is varicella pneumonia different from miliary TB (as far as imaging is concerned)?
Miliary pattern with calcified lesions instead of soft tissue (unlike TB)
Acute Respiratory Distress Syndrome (ARDS)
Bilateral Pleural Effusions
What is the most likely diagnosis?
Right pleural effusion
