ANATOMY OF CHEST& NECK,

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PATHOLOGY

PNEUMONIA

EMPHYSEMA Emphysema is defined as abnormal permanent enlargement of air spaces distal to the terminal bronchioles, accompanied by the destruction of the walls and without obvious fibrosis. The 3 described morphological types of emphysema are centriacinar, panacinar, and paraseptal

EMPHYSEMA

PULMONARY EDEMA

PNEUMOTHORAX A collapsed lung, or pneumothorax, occurs when all or part of a lung collapses or caves inward. This occurs when air gets in the area between the lung and chest wall. When this happens the lung cannot fill up with air, breathing becomes hard, and the body gets less oxygen. A collapsed lung can occur spontaneously in a healthy person or in someone who has lungs compromised by trauma, asthma, bronchitis, or emphysema. Update Date: 12/3/2004

PNEUMOTHORAX

HEMOTHORAX

TUBERCULOSIS Tuberculosis (TB) is a contagious bacterial disease that primarily involves the lungs. Like the common cold, it spreads through the air. Only people who are sick with TB in their lungs are infectious. When infectious people cough, sneeze, talk or spit, they propel TB germs, known as bacilli, into the air. A person needs only to inhale a small number of these to be infected. TB can also affect other parts of the body, such as the brain, the kidneys or the spine.

TUBERCULOSIS

SARCOIDOSIS What is sarcoidosis? Sarcoidosis is an inflammatory disease that affects multiple organs in the body, but mostly the lungs and lymph glands. In patients with sarcoidosis, abnormal masses or nodules (called granulomas) consisting of inflamed tissues form in certain organs of the body. These granulomas may alter the normal structure and possibly the function of the affected organ(s

SARCOIDOSIS

PULMONARY FIBROSIS Pulmonary fibrosis is a disease where scar tissue develops in the lungs following many infections and swelling. The scar tissue causes the lungs to become more stiff than normal. This means that the lungs cannot expand like normal, and therefore less air can get in and out of the lungs.

BRONCHOGENIC CARCINOMA

CALCIFIED B. C.

GRANULOMA The human immune system, which protects us from disease, is made up of a complex network of highly specialized cells and organs. When any part of this network is faulty, it interrupts the smooth functioning of the immune response and can result in an immulogic disorder. Chronic granulomatous disease (CGD) is actually a group of rare, inherited disorders of the immune system that are caused by defects in the immune system cells called phagocytes. These defects leave patients vulnerable to severe recurrent bacterial and fungal infections and chronic inflammatory conditions such as gingivitis (swollen inflamed gums), enlarged lymph glands, or tumor-like masses called granulomas. While not malignant, granulomas can cause serious problems by obstructing passage of food through the esophagus, stomach, and intestines as well as blocking urine flow from the kidneys and bladder

GRANULOMA

INTERSTITIAL LUNG DISEASE

What is interstitial lung disease (ILD) / pulmonary fibrosis? Interstitial lung disease (ILD) is a broad category of lung diseases that includes more than 130 disorders characterized by scarring (i.e. “fibrosis”) and / or inflammation of the lungs. Some of the disorders included under the heading of ILD are: Idiopathic pulmonary fibrosis Hypersensitivity pneumonitis Sarcoidosis Eosinophilic granuloma Chronic eosinophilic pneumonia Bronchiolitis obliterans Lymphangioleiomyomatosis

ASBESTOSIS

A chronic, progressive condition of scar tissue build-up in the lungs resulting from the inhalation of asbestos fibers. Shortness of breath, increased risk of lung infection and permanent lung damage are common symptoms of asbestosis. ASBESTOSIS

PAROTID GLAND TUMOR

THYROID CANCER

CAROTID ANEURYSM

NECK ABCESS

PROTOCOLS NECK CHEST

CT OF THE NECK

SPONGE CT OF THE CHEST

SCOUT: LATERAL SCANNING MODE: SPIRAL LANDMARK: OML SLICE PLANE: AXIAL I.V. CONTRAST: ml BREATH HOLD: BREATH HOLD: HOLD ON INSPIRATION SLICE THICKNESS: 5 MM START LOCATION: SUPERIOR TO BASE OF TONGUE END LOCATION: LUNG APICES FILMING: SOFT TISSUE NECK-STANDARD

SCOUT: LATERAL SCANNING MODE: SPIRAL LANDMARK: OML SLICE PLANE: AXIAL I.V. CONTRAST: 1-2 ML/SEC. 125 ML BREATH HOLD: HOLD ON INSPIRATION SLICE THICKNESS: 5 MM, 1MM THROUGH VOCAL CORDS LETTER “E” PHONATION TO ASSESS MOBILITY OF VOCAL CORDS START LOCATION: SUPERIOR TO BASE OF TONGUE END LOCATION: BELOW CARINA ( T4-T5) FILMING: SOFT TISSUE NECK: VOCAL CORD PARALYSIS

AVOIDANCE OF METALLIC ARTIFACTS

SCOUT: LATERAL SCAN MODE: SPIRAL LANDMARK: OML SLICE PLANE: AXIAL- NECK HYPEREXTENDED I.V. CONTRAST: 100ml, 1MML/SEC. BREATH HOLD: QUIET RESPIRATION SLICE THICKNESS: 3-5 MM, 1MM THROUGH VOCAL CORDS START LOCATION: SUPERIOR NASOPHARYNX END LOCATION: CRICOID CARTILAGE FILMING: SOFT TISSUE NECK AND LARYNX+NASOPHARYNX

SCOUT: AP- AZIMUTH 0 DEG. LANDMARK: STERNAL NOTCH SLICE PLANE: AXIAL OR SPIRAL I.V. CONTRAST: ml, MML/SEC., DELAY 60 SEC BREATH HOLD: SUSPENDED INSPIRATION SLICE THICKNESS: 8-10 MM OR 5 MM THROUGH HILUM START LOCATION: STERNAL NOTCH END LOCATION: TOP OF KIDNEYS (THROUGH ADRENALS) FILMING: SOFT TISSUE + SHARP LUNG CHEST ROUTINE

CT OF CHEST END LOCATION KIDNEYS-THROUGH ADRENALS BRONCHOGENIC CARCINOMAADRENAL MASS

DISPLAY OF CHEST CT 400/401500/ -500

SCOUT: AP SCANNING MODE: SPIRAL LANDMARK: STERNAL NOTCH SLICE PLANE: AXIAL I.V. CONTRAST: ml, 3 ML-4 ML/SEC., DELAY SEC SCANNING IN CAUDOCRANIAL ORIENTATION – IF MOTION SUSPECTED- TO PASS DIPHRAGM FAST BREATH HOLD: SUSPENDED INSPIRATION SLICE THICKNESS: 3 MM START LOCATION: STERNAL NOTCH END LOCATION: LUNG BASES FILMING: SOFT TISSUE + SHARP LUNG 3D + MPR RECONSTRUCTION CHEST –PE

PE

SCOUT: AP SCANNING MODE: AXIAL/ SPIRAL LANDMARK: STERNAL NOTCH SLICE PLANE: AXIAL I.V. CONTRAST: NONE BREATH HOLD: SUSPENDED INSPIRATION SLICE THICKNESS: MM INDEX: 10 MM START LOCATION: STERNAL NOTCH END LOCATION: THROUGH LUNG BASES FILMING: SHARP LUNG CHEST –HIGH RESOLUTION

DISPLAY & FILMING 1500/ -500

SCOUT: AP PATIENT SCANNED IN SUPINE AND PRONE POSITION FOR INFLATION OF THE LUNG BASES SCANNING MODE: AXIAL/ SPIRAL LANDMARK: STERNAL NOTCH SLICE PLANE: AXIAL I.V. CONTRAST: NONE BREATH HOLD: SUSPENDED INSPIRATION SLICE THICKNESS: MM INDEX: 10 MM START LOCATION: STERNAL NOTCH END LOCATION: THROUGH LUNG BASES FILMING: SHARP LUNG CHEST –HIGH RESOLUTION- ASBESTOSIS

SCOUT: AP SCANNING MODE: AXIAL LANDMARK: STERNAL NOTCH SLICE PLANE: AXIAL I.V. CONTRAST: NONE BREATH HOLD: SUSPENDED INSPIRATION + EXPIRATION SLICE THICKNESS: MM INDEX: 10 MM START LOCATION: STERNAL NOTCH END LOCATION: THROUGH LUNG BASES FILMING: SHARP LUNG ONLY CHEST –HIGH RESOLUTION AIR TRAPPING

INSPIRATION AND EXPIRATION SCAN TO EVALUAATE AIR ENTRAPMENT DETECTION OF: EMPHYSEMA ASTHMA SARCOIDOSIS INHALATION OF FOREIGN PARTICLES