Thorax

Question 1

At what breathing phase is the ideal picture taken?

Answer 1

At peak of inspiration
- Lungs are maximally inflated with air

Question 2

Why is end of expiration phase bad?

Answer 2

Opacity of lungs appears densier, which can be mistaken for pathology

Question 3

If only one lateral view is available, is left or right better?

Answer 3

Right preferable
- Lung field is less covered by diaphragm in caudodorsal part
- Cardiac silhouette less affected
- Enlarged thoracic lymph nodes seen better

Question 4

Positioning for radiograph

Answer 4

Neck slightly stretched
Front legs extended to avoid summation with muscles
Sternum and spine on same line
Thoracic inlet and both crus of diaphragm should be seen

Question 5

VD is the preferred view for lungs, but if animal comes with dyspnea, which view is better

Answer 5

DV

Question 6

Shadow of which organ is visible in young animals?

Answer 6

Shadow of thymus

Question 7

What happens with images if animal has excessive fat?

Answer 7

Cardiac silhouette appears larger
Cranial part of mediastinum looks wider
Lung field is more opaque
Separates edge of lung from thoracic wall
-> mimics pleural effusion

Question 8

What happens with images if animal is excessively thin?

Answer 8

Hyperlucent lung field
Seemingly microcardia
You might be able to see azygous vein

Question 9

Motion artefact

Answer 9

Edges of cardiac silhouette are slightly hazy

Question 10

What if there’s very clear smooth edge and larger cardiac silhouette

Answer 10

Suspect pericardial effusion

Question 11

Where is heart located?

Answer 11

At 3-6 intercostal space

Question 12

Can we see actual margins of heart?

Answer 12

No. Only cardiac silhouette

Question 13

Laying heart can be seen in

Answer 13

Older cats

Question 14

Pericardial fat stripe

Answer 14

In case of pleural effusion, there is a radiolucent stripe surrounding the cardial silhouette
- Not always visible

Question 15

When can we see azygous vein?

Answer 15

If there’s pneumomediastinum
In some deep chested breeds
in very thin cats

Question 16

Which margin of trachea is normally visible? Inner or outer?

Answer 16

Inner. Gas creates the background

Question 17

Pathologies of trachea

Answer 17

Change in size (narrowing, widening)
Change in location
Hypoplasia
- brachycephalic breeds
Foreign bodies
Mineralisation
Collapse

Question 18

When can we see esophagus?

Answer 18

If empty - we normally can’t
If there’s air or food - ye

Question 19

Tracheal strip line

Answer 19

Air in the lumen of esophagus, looks like a light strip between trachea and esophagus

Question 20

Bronchial pattern

Answer 20

Thickening of the wall of bronchi, bronchial structures are more prominent
- Peribronchial hazyness
- you see donuts and tram lines

Question 21

Types of bronchial pattern

Answer 21

Mineralisation
- Thin line (cushing, age, chondrodystrophic breeds)
Soft tissue thickening
- bronchitis, bronchopneumonia, bronchiectasis
Peribronchial cuffs
- Edema, bronchopneumonia

Question 22

When can we see pleural cavity?

Answer 22

If there’s free air -> Pneumothorax
or
Free fluid -> Pleural effusion

Question 23

Types of lung patterns

Answer 23

Interstitial
Bronchial (only appears with interstitial)
Alveolar (preceeded often by interstitial)

Question 24

Interstitial pattern

Answer 24

Increased soft tissue opacity (connective tissue)

Question 25

Variants of interstitial pattern

Answer 25

Nodular
Unstructured or reticular

Question 26

Interstitial pattern: Nodular

Answer 26

Nodular changes in connective tissue
Metastases
Granulomatous diseases
Primary miliary neoplasia

Question 27

Interstitial pattern; unstructured or reticular

Answer 27

Diffuse edema of connective tissue
Artefact: fat, underexposure
Pneumonia
Edema
Hemorrhagia
Neoplasia

Question 28

Alveolar pattern

Answer 28

Alveoles filled with fluid or cells (consolidation) or collapsed (atelectasis)
Margins of vessels, heart, diaphragm can disappear

May appear as
- Fluffy or cotton-like (infiltrate)
- Well marginated + “lobar sign” (consolidation

Air bronchogram
- Air filled bronchi seen inside inflated lung
- Always pathological!

Question 29

Alveolar pattern: Lobar sign

Answer 29

Clear margin seen when two lung parts with different opacities are overlapped

Question 30

Vascular pattern

Answer 30

Larger quantity of blood in vessels -> vessels become more prominent
Overall opacity increased
- Not a true pulmonary pattern

Question 31

How to differentiate all different patterns?

Answer 31

Are borders not seen? -> Yes: Alveolar
l No
Bronchial walls more opaque/thickened -> Yes: Bronchial
l No
Nodules or masses present? -> Yes: Structured interstitial
l No
Unstructured interstitial