- •Chest Imaging
- •Foreword
- •Preface
- •Educational Support and Funding
- •Acknowledgments
- •Contents
- •Fundamentals > Chest Primer Presentation
- •Chest X-Ray Interpretation Self-Study Instructions
- •Using the RoboChest Website
- •Decision Tree Algorithms to Help Solidify Concepts
- •References
- •Comprehensive Review of Search Patterns
- •Search Pattern Mnemonic
- •Interpretive Approach to CXR
- •Applying the Mnemonic to the Search Pattern
- •Chest Primer Presentation
- •References
- •Introduction and Terminology
- •Chest Imaging Terminology
- •Mach Effect on CXR
- •Trachea and Lungs on CXR
- •Mediastinal Anatomy on CXR
- •The Hilum (Plural: Hila)
- •Pulmonary Arteries and Veins
- •Normal Lung Markings
- •Vessel Size
- •Quiz Yourself: Mediastinum Lines, Edges
- •Shoulder Anatomy
- •Reference
- •Abnormal Lung Parenchyma
- •Mass
- •Mass Considerations
- •Size
- •Mass Characteristics
- •Malignancy
- •Case 4.1
- •Metastatic
- •Case 4.2
- •Bronchial Carcinoid
- •Radiological Signs
- •Case 4.3
- •Granulomatous Disease
- •Infectious Granulomatous Disease
- •Case 4.4
- •Non-infectious Granulomatous Disease
- •Benign Neoplasm
- •Hamartoma
- •Case 4.6
- •Congenital Abnormality
- •Pulmonary Arteriovenous Malformations
- •Case 4.7
- •Consolidation
- •Consolidative Radiological Findings/Distribution
- •Consolidative Model
- •Blood (Hemorrhage)
- •Case 4.8
- •Pus (Exudate)
- •Case 4.9
- •Case 4.10
- •Water (Transudate)
- •Pulmonary Edema
- •Case 4.11
- •Case 4.12
- •Protein (Secretions)
- •Case 4.13 (see Figs. 4.38 and 4.39)
- •Cells (Malignancy)
- •Interstitial
- •Radiological Signs
- •Linear Form: Lines
- •Case 4.14
- •Nodular Form: Dots
- •Case 4.15
- •Reticulo-Nodular Form
- •Pneumoconiosis
- •Case 4.16
- •Case 4.17
- •Destructive Fibrotic Lung
- •Case 4.18
- •Langerhans Cell Histiocytosis
- •Case 4.19
- •Vascular Pattern
- •Normal Pulmonary Vascular Anatomic Review
- •Radiological Signs in the Vascular Pattern
- •Mechanism
- •Vascular Examples
- •Pulmonary Arterial Hypertension (PAH)
- •Case 4.20
- •Pulmonary Venous Congestion
- •Pulmonary Venous Congestion: Edema
- •Emphysema
- •Airway (Bronchial) Patterns
- •Complete Obstruction
- •Lobar Atelectasis (Collapse)
- •Signs
- •Lobar Atelectasis Patterns
- •Complete Obstruction: Case Study
- •Partial Obstruction
- •Radiological Signs
- •Bronchial Wall Thickening
- •Bronchial Wall Thickening Causes
- •Bronchial Wall Thickening Model
- •Bronchiolar
- •Case 4.21
- •References
- •Pleural Effusion
- •Case 5.1
- •Technique and Positioning Revisited
- •Case 5.2
- •Comparison of Effusions over Time
- •Loculated Fluid/Pseudotumor
- •Case 5.3
- •Case 5.4
- •Thickening
- •Pneumothorax
- •Fluid and Air
- •Analogous Model
- •References
- •Anterior Mediastinal Mass
- •Case 6.1
- •Middle Mediastinal Mass
- •Posterior Mediastinal Mass
- •Case 6.2
- •Mediastinal Enlargement
- •Case 6.3
- •Reference
- •Case 7.1
- •Lines and Tubes
- •References
- •Appendix
- •Appendix 1: Glossary and Abbreviations
- •Appendix 2: Sources and Additional References
- •Text Sources
- •Image Sources
- •Additional References
- •Chest Imaging References
- •Chest Imaging Online References
- •Index
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1 Introduction, Development of the Algorithm, RoboChest Introduction, Additional Tools |
master effective Chest X-Ray (CXR) interpretation, and provide a launching platform for chest imaging in general. I hope you enjoy this book and the algorithmic format for learning chest imaging.
References
1. “Squire’s Fundamentals of Radiology” 6th edition. Novelline RA. 1964-2004. President and Fellows of Havard College.
2. Feigin DS. A revised system for analysis of abnormal pulmonary images. Chest. 1993;103(2):594–600.
3. Folio L, Feigin DS, Singleton B, Arner D. Algorithmic approach of abnormal patterns in chest imaging: a framework for web-assisted diagnosis. Poster presented at Association of University Radiologists, Knoxville, 2006. p. 82. http://www.aur.org/Annual_Meeting/upload/AUR-2006- Abstracts.pdf. Accessed Sept 2011.
Chapter 2
Search Pattern, Interpretive Approach,
Basic Anatomy and Fundamentals
Comprehensive Review of Search Patterns
The following is a concise yet comprehensive review of the Chest X-Ray (CXR) Search Pattern and normal anatomy that should be identiÞed while interpreting the CXR. Based on my teaching experiences and feedback from the Þrst two versions of RoboChest; this chapter is based around the search pattern mnemonic ABCDS × 2.
Before starting with the actual searchÉ
¥Verify that the patient information and date are complete and accurate on both frontal (PA, Posterior-Anterior, or AP, Anterior-Posterior) and lateral projections (when lateral is available).
¥Note position of left or right marker on frontal. Note any inclination markers or secondary indicators of patient positioning. Ask yourself if the patient is upright (do not trust up arrow markers) for example. Be sure you are comparing similar conditions given variable positioning. An effusion one day can look like a consolidation the next, just due to degree of inclination of the patient.
¥Note patient position relative to the cassette such as rotation or tilt. The vertebral spinous process should be midway between medial heads of both clavicles. If not, take this into consideration as relative densities may change.
¥Note adequacy of penetration or other potential technical defects. For example, you should be able to see intervertebral disk space through the heart shadow.
¥Look brießy at the entirety of both projections for obvious abnormalities.
L.R. Folio, Chest Imaging, DOI 10.1007/978-1-4614-1317-2_2, |
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© Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. 2012 |
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