Week 2- Cardiac & Vascular imaging Flashcards
3 Main areas of CXR interpretation?
- Image details
- Image quality (RIPE)
- System/ structures (ABCDEFGHI)
Image details- what is included?
- Name
- DOB
- Image acquisition date & time
-
Type of study:
- Front/ lateral
- AP/PA
- Supine/ Erect
What should you look for in image quality?
- Rotation (clavicular heads in line w/ spinous processes)
- Inspiration (10 to 11 posterior ribs)
- Penetration (should see vertebrae)
- Entire field covered
What are you looking for with systems and strucutres?
- Airway
- Bones and tissue
- Cardia
- Diaphragm
- Edges of pleura
- Fields of lung
- Gastric bubble
- Hila
- Instruments & wires
What things are you looking at in airways?
- Trachea
- Carina
Is this in the midline? Can you see the split of the trachea?
What can you see?
- tracheal deviation to the patient’s right due to tension pneumothorax
What has happened here?
A: Pneumothorax
B: Posterior rib fracture
Cardia: what areas of the heart are the different colour blobs?
Oranage: Left atrium
Purple: Left atrial appendage
Green: Right atrium
Red: Left ventricle
Blue: Right ventricle
What do the arrows show?
In relation to heart
What is this showing?
Left hemi-diaphragm
Surgical clips which indicate it’s due to left phrenic nerve palsy asa surgical complicaiton
What is this showing
No lung markings on the patients left lung in the apical area thus pneumothorax
What is this showing in fields of lungs and is the gastric buble normal?
Cavitation/ abscess
Gastric buble is normal
What is this showing in the Hila region?
What is it suggetstive of?
Hila is more rounded and some areas of hyperdensity (calcification)
This is hilar lymphadenopathy suggestive of TB, Sarcodosis, or lymphoma
What tubes/ wires and lines can you see here?
Central line but an incorrectly sited site into the right subclavian. Should come down internal jugular vein into the SVC
What is this showing?
What are the symptoms?
What are the two catagories of causes?
Pleural effusion- not the concave shape of hemidiaphragm
Symptoms: SOB
Catagories of causes based on compotision of fluid:
- Trasudate (systemic complem): CCF, Low albumin state
- Exudate (local problem): Pneumonia, Empyema, Malignancy
What is this showing?
What are the common symptoms?
- Cardiomegaly,
- More prominent hilar vessels
- Generalised opacitiy
Thus could be pulmonary oedema or CCF
Symptoms: Fatigue, SOB especially on exertion
What is abnormal here?
What would you request next?
Enlarged aorta
Request CT and here you see that the Aortic dissection. Some renal cysts in the kidneys
What types of imaging could be done if someone presents with MI aside Xray?
What treatments?
- CT with contrast
- Fluroscopy
Tx:
- PCI (stent insertion)
What is going on here?
Patient presents with abdo pain
Perforated diverticultis
Look at the free air under the right hemidiaphragm
A lady presents with right leg pain and swelling. Also had some lower back pain for the last year so been off work. Which imaging modality would you use and why?
What do you think diagnosis is? And which symptoms would you expect
USS
Consider DVT
Symptoms: Painful, swollen, erythematous limb
On USS: normally on compression vein will compress but with DVT it isn’t really compressed (as shown on USS)
