Professional Documents
Culture Documents
Index
AA
SVC PA
PA
RA
LV
CoPhS
Index
Pneumothorax
5 © Vascular 2007
Index
Lt. side pneumothorax
6 © Vascular 2008
Index
Rt. side pneumothorax
•Marked difference in X-ray transparency (density) between the left and right thoracic cavities.
•Complete radio-translucency (manifest as greater film density or darker lung field on the image) of the
7 © Vascular 2007
Rt. thorax with absence of vascular markings Index
Note:
Lt. tension pneumothorax •The marked density
difference between the left
and right thoracic cavities.
•The complete translucency
on the left with absence of
vascular markings
•Shifting of the mediastinum
8 © Vascular 2007
Index Normal
Lt. Tension
pneumothorax
Index
Lt. side tension
pneumothorax
Basis of Diagnosis:
•Hyperresonance of
affected hemithorax
•Decreased or
absence of breath
sounds
•Tracheal deviation to
the other side of
pneumothorax
•Respiratory distress
•Hypotension
•Tachypnea
•Hypoxia
•Distended neck
veins (unless the
patient is hypovolemic)
Index
Rt. side tension
pneumothorax
in an infant
Index
Tension Pneumothorax
12 © Vascular 2007
Index
Emergency treatment of tension pneumothorax
14 © Vascular 2007
Index After treatment
Pleural Effusion
15 © Vascular 2007
Index
Rt. pleural effusion
oFlat opacified line
at the right
hemidiaphragm
with obliteration of
the costo-phrenic
angle
oThat curvature
is characteristic
of a pleural
effusion
17 © Vascular 2007
Index
Lt. pleural effusion
18 © Vascular 2007
Index
Lt. massive
pleural effusion
Normal
Index
Massive Lt. pleural effusion
20 © Vascular 2007
Index
Massive Right Pleural Effusion
The right
hemithorax is
opaque
There is a shift of
the heart and
trachea away from
the side of
opacification
Index
Rt. lung
effusion
If an effusion (whatever
the fluid is) fills the entire
hemithorax
It acts like a mass
Pushing the heart and
trachea away from the
side of opacification
Index
Hydro-
pneumothorax
23 © Vascular 2007
Index
Rt. hydro-
pneumothorax
Hydropneumothorax
in three different
views:
PA Lateral
The PA, lateral, and
right decubetus
reveal a horizontal
air and fluid level.
Rt. decubetus
24 © Vascular 2007
Index
Lt. Massive hydro-pneumothorax
25 © Vascular 2007
Index
Lung Collapse
26 © Vascular 2007
Index
Index
Normal
For comparison
oChest radiograph
shows complete
collapse of left lung and
deviation (arrows) of
trachea to left lung
28 © Vascular 2007
Index
Lt. Lung
Collapse
There is a shift of
heart and
hemidiaphragm
toward side of
opacification
(toward side of volume loss)
Normal Index
Compare
31 © Vascular 2007
Index
Compare
32 © Vascular 2007
Index
Massive
Pneumonia
33 © Vascular 2007
Index
Lt. lung
pneumonia
The hemithorax is
opaque and there is
no shift of the heart
or trachea
Index
Pneumonia of the
Left upper lobe
There is no shift of
the heart or trachea
The opacified
hemithorax contains
air bronchograms
Index
Lt. lung collapse Rt. lung effusion
Causes of
an
Opacified
Hemithorax
No
Index
Which is this?
Atelectasis
Pneumonia
Effusion
Index
Bronchogenic
Carcinoma
38 © Vascular 2007
Index
Bronchogenic
Carcinoma
Fungating, hard solid white
mass arising from the
bronchial lining invading into
the left bronchus and
surrounding tissues.
This is the lung of a 74-year-old man
who first presents with cough, chest
pain, wheezing, hemoptysis and
progressive dyspnea
40 © Vascular 2007
Index
72-year-old man with bronchogenic carcinoma : Bone scintigraphy study shows multiple sites of
increased uptake in left tibia, fibula and foot (metastasis)
41 © Vascular 2007
Index
Lung
Carcinoma
42 © Vascular 2007
Index
Lung Carcinoma
oA large, well-
defined mass in
the right upper
lobe
oExtensive
emphysematous
change
43 © Vascular 2007
Index
Squamous cell carcinoma
A portion of the tumor
demonstrates central
cavitation, probably because the
tumor outgrew its blood supply
44 © Vascular 2007
Index
Cavitary Lung Lesion
oThe air-fluid level
indicates
communication with
the airway - hence
sputum is likely to be
helpful in diagnosis.
oThe appearance of
the lesion could be a
carcinoma or an
abscess.
o Sputum cytology was
squamous cell
bronchogenic
carcinoma.
oCavitation is a typical
morphologic feature of
this form of lung cancer.
45 © Vascular 2007
Index
Cavitary Lung Lesions
46 © Vascular 2007
Index
Lung Abscess
47 © Vascular 2008
Index
Fibro-caseous
Pulmonary TB
48 © Vascular 2007
Index
Fibro-caseous TB of both superior
lobes with cavitations on the Rt. side
49 © Vascular 2007
Index
Pulmonary
Metastasis
50 © Vascular 2007
Index
Multiple
Pulmonary
secondaries
Index
Renal adenocarcinoma with multiple pulmonary metastasis
52 © Vascular 2007
Index
Lung metastasis
from CA colon
53 © Vascular 2007
Index
Can you identify the pulmonary metastasis?
54 © Vascular 2007
Index
Aortic Arch
Aneurysm
55 © Vascular 2007
Index
The mediastinal shadow is dominated by the dilation of the aorta.
Better definition of the aortic anatomy is achieved with the CT scan Index
Pulmonary Thoracic
T.B. aortic
aneurysm
Index