VSUR65 VETERINARY DIAGNOSTIC IMAGING LABORATORY

RADIOGRAPHY OF THE THORAX

INDICATIONS FOR THORACIC

RADIOGRAPHY
• Coughing, gagging & retching
• Dyspnea
• Persistent sneezing
• Inspiratory or expiratory noise
• Regurgitation
• Assessment of neoplasia

Lateral View of Thorax

• Neutral head position
o Not: False airway narrowing
• Extend forelimbs cranially
• Hindlimbs pulled caudally
Ventrodorsal View of Thorax
• view taken on inspiration
• dorsal recumbency
• Vertical Line: caudal border of the scapula
• keep the patient’s spine and sternum
dorsally
aligned (V-trough)
• Horizontal Line: imaginary plane bisecting
• thoracic limbs are taped together evenly,
the thoracic cavity evenly between dorsal
pulled forward with the patient’s muzzle
and ventral
placed between the limbs
• vertical line: caudal border of the scapula
• horizontal Line: Tdirectly over the sternum
to bisect the thoracic cavity from left and
right lateral

Dorsoventral View of Thorax

• sternal recumbency
• legs extended forward
• head down on the tabletop
• the sternum and spine should be
superimposed
• view taken on inspiration
• vertical line: caudal border of the scapula.
• horizontal Line: directly over the spine to
bisect the thoracic cavity from left and right
lateral
 VSUR65 VETERINARY DIAGNOSTIC IMAGING LABORATORY

THORACIC RADIOGRAPHY: DIAPHRAGM

Left Lateral Vs Right Lateral

• LEFT LATERAL
o Heart appears round
▪ Indian mango-shaped
o L crus forward (seen as Y-shaped
diaphragmatic silhouette)
• RIGHT LATERAL
o Better cardiac detail
▪ Native mango-shaped
o R crus forward (seen as parallel
diaphragmatic silhouette)
o See CdVC go into it

• Cupula
• Cranioventral convex portion
• Right crus and left crus
Dorsoventral Vs Ventrodorsal
o Attached to cranioventral border of L3
and body of L4 • DORSOVENTRAL VIEW
o Less stressful, better for heart
Inspiratory Vs Expiratory o Diaphragm rounded
o Caudal pulmonary vessels better
• Always expose at peak inspiration
visualized
o Maximizes lung contrast
o Better to see small amount of pleural air
• Inspiratory lateral view
• VENTRODORSAL VIEW
o Caudodorsal aspect of lung caudal to
o Better for lung assessment
T12
o Heart appears elongated
o Increased aeration of accessory lung
o Flat diaphragm
lobe
▪ Mickey Mouse ears
o Separation of heart silhouette and
o Better to see small amount of pleural
diaphragm
fluid
• Inspiratory VD/DV view
o Diaphragmatic cupola caudal to mid T8
o Lung tips caudal to T10
 VSUR65 VETERINARY DIAGNOSTIC IMAGING LABORATORY

THORACIC RADIOGRAPHY: TRACHEA

• TD:TI
o tracheal lumen diameter to thoracic inlet
distance ratio
o 2:1

Bulldogs <0.127 (hypoplastic)

Brachycephalic <0.14 (hypoplastic)
Non-Bulldog
Non-brachycephalic <0.20 (hypoplastic)
Cats >0.18-0.20 (non-
hypoplastic)
• Alveolar
• TT/3R o Air bronchograms
o Thoracic tracheal lumen diameter to the o Lobar sign
width of the proximal third of the third rib o Area of relatively intense opacity that does
not have the sharp margins that
characterize a lung mass

THORACIC RADIOGRAPHY: LUNGS

Pulmonary Patterns
• Bronchial
o Ring shadows
▪ increased circular opacity with lucent • Interstitial
center o multiple nodules
o Tram lines o homogeneous haziness (unstructured
▪ parallel lines of increased opacity pattern)
o range of finely structured opacities (fine
structured pattern)
o very small nodular structures
 VSUR65 VETERINARY DIAGNOSTIC IMAGING LABORATORY

THORACIC RADIOGRAPHY: HEART

• Vascular
o change in the size and shape of the
pulmonary arteries or veins
o artery and vein nearly same size (right
fourth rib (L) and ninth rib (DV/VD)
o Cranial vessels
▪ Compared with 4th rib
o Caudal vessels
▪ Compared with 9th rib
o Artery and vein should be:
▪ Same size or smaller than rib
▪ similar size to each other
o Pulmonary hypertension – BIG
ARTERIES, normal veins Cardiac Silhouette
o Left heart failure – Normal arteries, BIG • Buchanan Method
VEINS • Vertebral heart score
o Overcirculation – Big veins, big arteries o CANINE: 9.7 +/- 0.5V
o FELINE: 7.5 +/- 0.3

Right lateral radiograph

• Long axis: ventral margin of the carina to apex
• Short axis: width of the heart perpendicular to
the length measurement; @ widest portion
• Scale them against the length of the vertebrae
beginning with T4