Thoracic Imaging (15) Flashcards by Heather Whalon

CT Chest: Indications (4)

Trauma
Cancer
Hilar Adenopathy
General Survey
Etc.
NOT Vascular imaging (need CTA)
NOT lung Ds (high res preferred)

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CT Chest: Scan Type

Helical

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CT Chest: Slice Parameters

5mm w matching interval

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CT Chest: Gantry Tilt

None

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CT Chest: Contrast
Volume
Rate
Timing

100 mL
3mL/sec
30 sec delay

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CT Chest: Algorithm

Standard: 400/40
Lung: 1800/-600

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CT Chest: Reformation

Coronal from thinnest data set

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CT Chest: FOV

Must include both adrenals

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CT Chest: NonCon Indications when contrast contraindicated

Effusion
Pneumothorax
Hemothorax
Etc.

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Atelectasis

Collapsed lung

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CT Chest: Smoothing Algorithms

Used for most soft tissues–including structures of mediastiunm: decreases spatial resolution, but also image noise

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CT Chest: Utility of 1800WW

decrease contrast of images
increase visibility of lung markings

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CT Chest: Utility of Contrast for COPD

Unnecessary: COPD blebs enhance readily under 1800/-600 algorithm

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CT Chest: Utility of Contrast for Tumor Borders (2)

Visibility of tumors greatly enhanced
Can aid in discerning borders tumor vs effusions

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HRCT Chest: Indications

Interstitial lung disease
COPD
Emphysema

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HRCT Chest: Scan Type

Axial for increased spatial resolution

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HRCT Chest: Slice Parameters

1.25mm thickness/10-20mm interval
(survey of lung tissue, so significant gaps in the image data is allowed)

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HRCT Chest: Gantry Tilt

None

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HRCT Chest: Contrast

None

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HRCT Chest: Algorithm

Lung 1800/-600
(or Bone)

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HRCT Chest: Required Series (3)

Supine-Inspiration
Supine-Expiration
Prone-Inspiration

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HRCT Chest: Purpose
(Not indicated for)

Provide high-res images of lungs (not heart/vasculature)

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CTA Chest-PE: Frequency

Among most commonly performed CTs

CTA Chest-PE: Indications (4)

(If MI already excluded)
Pain
SOB
+ D-dimer(blood clot test)
Recent Surgery

CTA Chest-PE: Scan Type

Helical

CTA Chest-PE: Slice Parameters

2.5mm w matching interval

CTA Chest-PE: Gantry Tilt

None

CTA Chest-PE: Contrast Volume Timing Rate

100-150 IV using bolus tracking @ 4+ mL/sec

CTA Chest-PE: Algorithm

Standart: 400/40 Lung: 1800/-600

CTA Chest-PE: Reformation

Coronal

CTA Chest-PE: FOV

To include both adrenals

CTA Chest-PE: Bolus Tracking ROI (2 options)

Pulmonary trunk (bifurcation occurs at the level of the carina) Left atrium (allows contrast to *fully* circulate through heart before scan initiated)

CTA Chest-PE: Common Outcomes of + CT (2)

Pneumonia Infarction (both d/t reduced circulation thru parenchyma)

Controls level of edge-enhancement (sharpness)

Reconstruction Algorithm

Controls the brightness/contrast of images

Windowing Technique

Special kind of Beam-Hardening that occurs at the interface of high-density contrast & low-density tissues (e.g., lungs)

Edge-Gradient Artifact

CTA CHEST-Thoracic Aorta: ROI

Descending Aorta (peak enhancement of aorta is generally a few sec after peak enhancement of pulmonary aa.)

CTA CHEST-Thoracic Aorta: Indications (4)

Aneurysm Sx of aneurysm: Pressure Changes SOB Chest/Back Pn

CTA CHEST-Thoracic Aorta: Scan Type

Helical

CTA CHEST-Thoracic Aorta: Slice Parameters

2.5mm w matching interval

CTA CHEST-Thoracic Aorta: Gantry Tilt

None

CTA CHEST-Thoracic Aorta: Contrast Volume Timing Rate Direction

100-150 mL IV Bolus tracking 4ml/sec Superior-->Inferior

CTA CHEST-Thoracic Aorta: Algorithm

Standard: 400/40 Lung: 1800/-600

CTA CHEST-Thoracic Aorta: Reformations

Coronal

CTA CHEST-Thoracic Aorta: FOV

Include both adrenals

Aneurysm

Abnormal enlargement of vessel

Dissection

Tear in arterial wall creating 2 channels through the vessel

thrombi that form and adhere on the inner wall of a large blood vessel or heart chamber

Mural Thrombosis

Build up of fluid between the layers of tissue that line the lungs and chest cavity

Effusion HU >15

Collection of air outside the lung but within the plural cavity

Pneumothorax

Collection of blood in the space between the chest wall and the lung

Hemothorax

Commonly precedes HRCT

Chest routine WO

Effusion HU

>15

Lung consolidation is when the

air in the small airways of the lungs is replaced with a fluid, solid, or other material such as pus, blood, water, stomach contents, or cells

CTA CHEST-Thoracic Aorta: Intimal Flap

In dissected aorta: separates true lumen from false lumen

HRCT Chest: Utility of Bone Algorithm

Offers highest level of edge-enhancement and therefore spatial resolution