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 IMAGING IN PUL INFECTIONS

• INTRODUCTION
• ROLE OF IMAGING IN PUL INFECTION
• THE CHEST RADIOGRAPH

• Technique
• Systemic interpretation
• Anatomy
• RADIGRAPHIC FEATURES OF PNEUMONIA
 INTRODUCTION

• Most common cause of morbidity and mortality

• Major component of diagnostic rad
• CXR AND CT –most useful
• CXR most commonly performed
• CXR—images heart/lung/air ways/blood vessels and
bones
 ROLE OF IMAGING

• CXR -remains an important component for

pt with pneumonia
 Confirm or exclude the dx
 Look for complications
 Narrows ddx
 monitor the course of the disease
 Assist in selection of additional dx
measures
 ROLE OF IMAGING

• CAP—is usually readily diagnosed by CXR

• CXR –finding sometimes difficult to differentiate from
other diseases
• 1/3 of pt admitted with clinical dx pneumonia have other
dx -CHF
• -ATELECTASIS
• -EMBOLIZIM
• -COPD
 COMPLICATIONS

• Lung abscess
• Pneumatocele
• Gangrene
• Septic emboli
• Empyema
 MONITER

• Regression of opacity
• 1-2wks to 2mon
• Factors
• age
• comorbidity
• organism type
 TECHNIQUE

• Position
• Projection
• State of respiration
 TEC
• Lateral
• AP
• Inspiration and expiration
 PNEUMONIA
• DEFINTION
• CLASSIFICATIONS
 RAD CASSIFICATION
• LOBAR
• BRONCHOPNEUMONIA
• INTERSTITISL
 CXR FINDING OF LOBAR PNEUMONIA

• Uniform homogenous of partial and complete

lung lobe consolidation( opacity)
• Silhouette sign
• Air bronchogram-frequent
• Do not cross inter lobar fissures
• Is typical of Pneumococcal pneumonia
• Volume loss unusual
 KLEBSIELLA PNEUMONIA

• GM neg bacilli
• 0.5-5% of all causes pne
• CXR=Dense consolidation
• =UL
• =Fissure buldge
• =Early abscess formation
 BRONCHO PNEUMONIA

• Initially patchy multi focal opacities progress to lobular

and segmental consolidation

• air bronchogram not common

• S aurous is the commonest cause

 RADIOGRAPHIC TEATURES OF PUL TB

• Two types
• primary and post primary
 PRIMARY TB

• Childern
• CXR mainstay
• 15% normal
 CXR FINDING

• Parenchymal
• LAP
• Plural effusion
• Miliary opacity
 Parenchymal
• Dense and homogenous parenchymal consolidation
•
• Predominately LL AND ML

• Often indistinguishable from bacterial pneumonia

•
• LAP AND LACK OF RESPONSE TO ANTIBIOTICS
 LAP
• Most common finding with or without opacity

• 96% in children and 46%adults

• Unilateral but 15% bilateral

• RT hilar and paratracheal

 PLURAL EFFUSION
• Often large and unilateral
• 25%
• Often the sole manifestation
• Residual change is unusual