复旦大学上海医学院：《医学影像学》PPT教学课件_胸部影像概论 Introduction to chest radiologyr

INTRODUCTION TO CHEST RADIOLOGY CHI S ZEE M D Professor OF Radiology Director of international education KECK SCHOOL OF MEDICINE

INTRODUCTION TO CHEST RADIOLOGY CHI S. ZEE, M.D. Professor OF Radiology Director of International Education KECK SCHOOL OF MEDICINE

Know your limitations Evaluate film for Techniqu ue 1. Inspiratory Vs. Expiratory a good inspiration is completely through the 5th anterior ribs Expiratory films often have bibasilar compressive changes and crowding of vasculature which may simulate disease

Know Your Limitations - Evaluate Film for Technique 1. Inspiratory vs. Expiratory - A good inspiration is completely through the 5th Anterior ribs. - Expiratory films often have bibasilar compressive changes and crowding of vasculature which may simulate disease

ExPISATION INSPIRATION Same patient taken in forced expiration and inspiration demonstrating compressive changes that mimic disease

Same patient taken in forced expiration and inspiration demonstrating compressive changes that mimic disease

2. Rotation/ Position Clavicles Symmetric- equidistant from spinous process. A-P Vs, P-A chest films Describes direction of x-ray beam and which surface is closest to film. I.e. AP film -x-ray from Anterior to posterior with film behind patients back, Will magnify cardiac couette Lordotic vs. Apical view-techniques to visualize the apices Move the patient VS, angling the x-ray beam

2. Rotation/Position - Clavicles Symmetric - equidistant from spinous process. - - A-P vs. P-A chest films Describes direction of x-ray beam and which surface is closest to film. I.e. AP film - x-ray from Anterior to Posterior with film behind patient’s back. Will magnify cardiac silhouette. - Lordotic vs. Apical view- techniques to visualize the apices. - Move the patient vs. angling the x-ray beam

same patient rotated, distorting cardiac silhouette. Note appearance of clavicles

same patient rotated, distorting cardiac silhouette. Note appearance of clavicles

Expiratory vs Inspiratory images, distorts cardiac silhouette and mimics enlargement

Expiratory vs Inspiratory images, distorts cardiac silhouette and mimics enlargement

Lordotic positioning, Xray beam angled towards patient's head, projecting clavicles off chest, paralleling ribs, obscuring lul nodule

Lordotic positioning, Xray beam angled towards patient’s head, projecting clavicles off chest, paralleling ribs, obscuring lul nodule

3 Penetration Should be able to see the thoracic spine through the cardiac silhouette Technique for viewing bones different for technique to visualize lung Copyright 2006 by Randy Glasbergen, "More and more patients are going to the Internet I changed my name to Dr. Google, oing, for medical advice. To keep my practice g

3. Penetration - Should be able to see the thoracic spine through the cardiac silhouette. - Technique for viewing bones different for technique to visualize lung