INTRODUCTION TO CHEST RADIOLOGY CHI S ZEE M D Professor OF Radiology Director of international education KECK SCHOOL OF MEDICINE
INTRODUCTION TO CHEST RADIOLOGY CHI S. ZEE, M.D. Professor OF Radiology Director of International Education KECK SCHOOL OF MEDICINE
Know your limitations Evaluate film for Techniqu ue 1. Inspiratory Vs. Expiratory a good inspiration is completely through the 5th anterior ribs Expiratory films often have bibasilar compressive changes and crowding of vasculature which may simulate disease
Know Your Limitations - Evaluate Film for Technique 1. Inspiratory vs. Expiratory - A good inspiration is completely through the 5th Anterior ribs. - Expiratory films often have bibasilar compressive changes and crowding of vasculature which may simulate disease
ExPISATION INSPIRATION Same patient taken in forced expiration and inspiration demonstrating compressive changes that mimic disease
Same patient taken in forced expiration and inspiration demonstrating compressive changes that mimic disease
2. Rotation/ Position Clavicles Symmetric- equidistant from spinous process. A-P Vs, P-A chest films Describes direction of x-ray beam and which surface is closest to film. I.e. AP film -x-ray from Anterior to posterior with film behind patients back, Will magnify cardiac couette Lordotic vs. Apical view-techniques to visualize the apices Move the patient VS, angling the x-ray beam
2. Rotation/Position - Clavicles Symmetric - equidistant from spinous process. - - A-P vs. P-A chest films Describes direction of x-ray beam and which surface is closest to film. I.e. AP film - x-ray from Anterior to Posterior with film behind patient’s back. Will magnify cardiac silhouette. - Lordotic vs. Apical view- techniques to visualize the apices. - Move the patient vs. angling the x-ray beam
same patient rotated, distorting cardiac silhouette. Note appearance of clavicles
same patient rotated, distorting cardiac silhouette. Note appearance of clavicles
Expiratory vs Inspiratory images, distorts cardiac silhouette and mimics enlargement
Expiratory vs Inspiratory images, distorts cardiac silhouette and mimics enlargement
Lordotic positioning, Xray beam angled towards patient's head, projecting clavicles off chest, paralleling ribs, obscuring lul nodule
Lordotic positioning, Xray beam angled towards patient’s head, projecting clavicles off chest, paralleling ribs, obscuring lul nodule
3 Penetration Should be able to see the thoracic spine through the cardiac silhouette Technique for viewing bones different for technique to visualize lung Copyright 2006 by Randy Glasbergen, "More and more patients are going to the Internet I changed my name to Dr. Google, oing, for medical advice. To keep my practice g
3. Penetration - Should be able to see the thoracic spine through the cardiac silhouette. - Technique for viewing bones different for technique to visualize lung
