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Introduction to Thoracic Radiology

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Presentation on theme: "Introduction to Thoracic Radiology"— Presentation transcript:

1 Introduction to Thoracic Radiology
Dr. LeeAnn Pack Dipl. ACVR

2 Indications Coughing Dyspnea/ Tachypnea Heart Murmur, Collapse
Primary or Secondary Neoplasia Check for metastasis Thoracic Trauma Chest Wall Mass Exercise Intolerance, Weight Loss

3 Technical Factors Potential for Movement High inherent contrast area
Decrease mAs High inherent contrast area High kVp Collimation Centering – caudal scapula Thoracic inlet to diaphragm Pull forelimbs forward

4 Determining the Phase of Respiration
Always expose at peak inspiration Maximizes lung contrast Inspiratory lateral view Caudodorsal aspect of lung caudal to T12 Increased aeration of accessory lung lobe Separation of heart silhouette and diaphragm Inspiratory VD/DV view Diaphragmatic cupola caudal to mid T8 Lung tips caudal to T10

5 Inspiratory vs. Expiratory Lateral
Note the space inside the triangle

6 Inspiratory vs. Expiratory VD
Easy to see the difference in well visualized lung

7 DV vs. VD DV VD Less stressful, better for heart Diaphragm rounded
Caudal pulmonary vessels better visualized Better to see small amount of pleural air VD Better for lungs Hear appears elongated Flat diaphragm – Mickey Mouse ears Better to see small amount of pleural fluid

8 DV vs. VD

9 Right vs. Left Lateral etal.
Right Lateral Better cardiac detail R crus forward See Cava go into it Left Lateral Heart appears round L crus forward See Cava go past Anesthesia Breed Differences

10 The Effects of Lateral Recumbency
Lung lesions (mass, nodule, infiltrate) may only be seen on 1 view!!! Only the non-dependent (up) lung can be critically evaluated Dependent lung loses aeration (atelectasis) Increases in opacity Silhouettes with lesions

11 Interpretation of Thoracic Radiographs
Heart Lungs Mediastinum Pleural space Chest wall Bones, Abdomen,Neck

12 Normal Cardiac Silhouette
Subjective Dog = 2 ½ - 3 ½ intercostal spaces Cat = 2 – 2 ½ intercostal spaces 65% or less on VD/DV view Objective Buchanan method

13 Clock Face 11-1 Aortic Arch 1-2 Main Pulmonary Trunk 2-3 Left Auricle
2-5 Left Ventricle 5-9 Right Ventricle 9-11 Right Atrium Centrally – Left Atrium

14 Lateral View Make a Plus sign Bermuda triangle Left atrium
Left Ventricle Right Ventricle

15 Thoracic and Pulmonary Vessels
Aorta Caudal Vena Cava Cranial pulmonary vessels Proximal third rib Caudal pulmonary vessels 9th rib where crosses Veins are ventral and central

16 Trachea, Bronchial Tree
Carina – then splits to the main stem bronchi then lobar bronchi Tracheal rings can mineralize Decreased tracheal diameter Tracheal narrowing (stenosis, extramural compression), Tracheal hypoplasia, Tracheal collapse

17 Lungs Normal anatomy Left Right Cranial (cranial subsegment)
Cranial (caudal subsegment) Caudal Right Cranial Middle Accessory

18 The Mediastinum Cranial, middle, caudal compartments
Routinely visible structures: Heart, trachea, cvc, aorta, +/- thymus, +/- esophagus Cranioventral mediastinal reflection Caudoventral mediastinal reflection Aka phrenopericardiac ligament

19 Mediastinal reflections

20 Extrathoracic Structures
Sternum Vertebrae Ribs Adjacent soft tissues Diaphragm

21 The Diaphragm Cupola Right and left crura
Cranioventral convex portion Right and left crura Attach to cranioventral border of L3 and body of L4 May cause irregularity on these surfaces Appearance depends on centering of X-ray beam

22 The Diaphragm

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