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7/28/2019 CXR Presentation
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The Chest X-Ray
For: Nottingham SCRUBS 26th August 2006
Presented by: Matthew
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Aims:Basics
Best exam resultsAppreciate the role radiology plays
? Instil an interest in radiology
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Contents:
Densities
Techniques
Anatomy
CXR Interpretation
Common Pathologies
Questions
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DensitiesThe big two densities are:
(1) WHITE - Bone(2) BLACK - Air
The others are:
(3) DARK GREY- Fat
(4) GREY- Soft tissue/water
And if anything Man-made is on the film, it is:
(5) BRIGHT WHITE - Man-made
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Techniques - ProjectionP-A (relation of x-ray beam to patient)
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Techniques - Projection (continued)
A-P Supine/Erect
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Techniques - Projection (continued)Lateral
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Techniques - Projection (continued)
Lateral Decubitus
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Techniques - Projection (continued)
Oblique
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Orientation
Orientation
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Rotation
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Rotation (continued)
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Penetration
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Inspiration/Expiration
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Anatomy
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Anatomy
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Anatomy
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Lobes Right upper lobe:
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Lobes (continued) Right middle lobe:
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Lobes (continued) Right lower lobe:
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Lobes (continued) Left lower lobe:
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Lobes (continued) Left upper lobe with Lingula:
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Lobes (continued) Lingula:
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Lobes (continued) Left upper lobe - upper division:
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Pleura Layers:
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Heart
Right border: Edge of (r) Atrium
3. Left border: (l) Ventricle + Atrium
4. Posterior border: Reft Ventricle
5. Anterior border: Right Ventricle
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Heart (continued)
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Heart (continued)
H
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Heart (continued)
Valves
M di ti
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Mediastinum
Hil
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Hilum
Made of:
1. Pulmonary Art.+Veins
2. The Bronchi
Left Hilus higher (max 1-2,5 cm)
Identical: size, shape, density
Hilum
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Hilum
Ribs
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Ribs
Soft tissue & bones
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Soft tissue & bones
Lateral CXR
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Lateral CXR
Lateral CXR ( ti d)
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Lateral CXR (continued)
Lateral CXR ( ti d)
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Lateral CXR (continued)
Lateral CXR (continued)
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Lateral CXR (continued)
Lateral CXR (continued)
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Lateral CXR (continued)
CXR Interpretation
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CXR Interpretation
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Technical Details
Type
Orientation
RotationInspiration/expiration
Penetration
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Lungs:
Lungs Density
Symmetry
Lesions
Heart
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Heart
Size:
Heart
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HeartSize of heart
Size of individualchambers of heart
Size of pulmonary
vessels
Evidence of stents, clips,
wires and valves
Outline of aorta and IVC
and SVC
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Mediastinum: Width
Contour AP window
Hila: Size
Location
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Review areas:
Apices Behind the heart
CP angles
Below the diaphragm Soft tissues ( breast, surgical emphysema)
Ribs & clavicle
Vertebrae
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Identify the lesion localise the lesion describe the lesion give DD
Never stop looking, carry on with your
systematic approach!!
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Pathology
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RUL pneumonia
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RML pneumonia
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RLL pneumonia
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LUL pneumonia
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LLL pneumonia
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Consolidation on CT
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Hilar m l
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The Enlarged Hila
Causes:
1. Adenopathies (neoplasia, infection)
2. Primary Tumor
3. Vascular
4. Sarcoidosis
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Multiple Masses
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Hilar Lymphadenopathy - BL
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Pleural Effusion
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Pulmonary Fibrosis
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?
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Heart failure
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Pneumothorax
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RUL collapse
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LLL collapse
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Air under the diaphragm
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Emphysema
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Cervical Rib
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Cavitating lesion
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Hiatus hernia
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Miliary shadowing
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Chest Tube, NG Tube, Pulm. artery cath
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