Radiology of the Upper and Lower Airway - Baynes Flashcards
What is the most commonly imaged portion of the upper airway?
Name some general conditions for which upper airway radiologic examination may be useful.
Sinuses
Chronic sinusitis, acute sinusitis, post-operative evaluation, tumors, trauma
Unexplained or traumatic hearing loss may require radiologic examination of which bone?
Temporal bone
Identify
Nasal Polyposis
Tracheal imaging - more common in adults or children?
Why is epiglottitis especially concerning (for both children and adults)?
Children
Epiglottitis is a medical emergency because the infected epitglottis may completely compromise the airway
Why is an PA projection chest radiograph often preferred to an AP projection?
Because of the heart’s proximity to the sternum, an AP (source anterior, detector posterior) may cause the hear to look larger than normal, leading to inappropriate suspicion of cardiomegaly.
Why is MRI not typically useful for imaging of the lungs?
Imaging artifacts - MRI requires minimal motion in the object being imaged. Therefore, something like the lungs that must move continuously (the patient must breathe) are difficult to image
What is the disease pictured here, featuring ‘tree in bud’ foci of infection?
bronchopneumonia
What is the silhouette sign (in the context of a CXR)?
Loss of normal borders between thoracic structures, such as the heart and lungs.
What is the air bronchogram sign?
Air bronchogram refers to the phenomenon of air-filled bronchi (dark) being made visible by the opacification of surrounding alveoli (grey/white). It is almost always caused by a pathologic airspace/alveolar process, in which something other than air fills the alveoli. Air bronchograms will not be visible if the bronchi themselves are opacified (e.g. by fluid).
(source: http://radiopaedia.org/articles/air-bronchogram)
Blunting of what anatomical feature may be indicative of pleural effusion?
costodiaphragmatic recesses
Identify
Miliary TB
The attached image looks like metasases, but is in fact a fungal infection. Identify.
Invasive aspergillosis
How might the aspergilloma pictured here be easily differentiated from a tumor (radiologically)
Flip the patient over and see of the mass/fluid changes position of repeat CT (aspergillosis would be a ‘free’ mass within the cavity)
Name the type of aspergillus infection seen in the following patient populations:
- Severely immunocompromised
- Immunosuppressed
- Normal immunity, abnormal lungs
- Hyper-immune
- Invasive aspergillus
- Semi-invasive aspergillus
- Aspergilloma
- ABPA (allergic bronchopulmonary aspergillosis)
Why might viral lung disease lead to a superimposed bacterial pneumonia?
lung tissue injured by the viral infection presents a site for oppotunistic infection. This superimposition can distract from the primary diagnosis (viral disease)
