Pulmonary, or chest, imaging includes imaging of the lungs Lungs Lungs are the main organs of the respiratory system. Lungs are paired viscera located in the thoracic cavity and are composed of spongy tissue. The primary function of the lungs is to oxygenate blood and eliminate CO2. Lungs: Anatomy and surrounding structures in the thorax. Imaging of the chest represents a substantial portion of the imaging tests that are routinely performed. Common imaging methods include X-ray X-ray Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source. Pulmonary Function Tests, CT, MRI, and ultrasonography (US). Each imaging method has advantages and disadvantages. Radiology exams, once completed, are read and interpreted by board-certified, fellowship-trained radiologists; however, most physicians Physicians Individuals licensed to practice medicine. Clinician–Patient Relationship should know the basics of how to interpret these images.
Last updated: 14 Mar, 2022
Before interpreting any image, the physician should take certain preparatory steps. The same systematic approach should be followed every time.
Medical indications:
Nonmedical indications:
Advantages:
Disadvantages:
Positioning:
Positioning for specific views:
Penetration Penetration X-rays:
Penetration Penetration X-rays is the degree to which radiation Radiation Emission or propagation of acoustic waves (sound), electromagnetic energy waves (such as light; radio waves; gamma rays; or x-rays), or a stream of subatomic particles (such as electrons; neutrons; protons; or alpha particles). Osteosarcoma has passed through body, resulting in a darker or lighter image.
Different standard projections:
Chest X-rays can be taken from multiple directions, called “views.” Each view has benefits and drawbacks for different pathologies. Three common views are posteroanterior, anteroposterior, and lateral.
Posteroanterior (PA): The PA view is performed with the patient upright ( X-ray X-ray Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source. Pulmonary Function Tests beam perpendicular to cassette).
Image by Lecturio.Supine ( X-ray X-ray Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source. Pulmonary Function Tests beam perpendicular to cassette)
Image by Lecturio.Decubitus projection Projection A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. Defense Mechanisms
Image by Lecturio.Systematic approach:
Different views are used to evaluate different portions of the chest:
AP/PA view:
Normal posteroanterior (PA) view
chest X-ray
Chest X-ray
X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs.
Pulmonary Function Tests:
The standard
chest X-ray
Chest X-ray
X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs.
Pulmonary Function Tests is taken in the PA
orientation
Orientation
Awareness of oneself in relation to time, place and person.
Psychiatric Assessment. The
X-ray
X-ray
Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source.
Pulmonary Function Tests should be interpreted in a systematic and consistent way.
SVC:
superior vena cava
Superior vena cava
The venous trunk which returns blood from the head, neck, upper extremities and chest.
Mediastinum and Great Vessels: Anatomy
PA:
pulmonary artery
Pulmonary artery
The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs.
Lungs: Anatomy
Normal posteroanterior (PA) view
chest X-ray
Chest X-ray
X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs.
Pulmonary Function Tests:
The standard
chest X-ray
Chest X-ray
X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs.
Pulmonary Function Tests is taken in the PA
orientation
Orientation
Awareness of oneself in relation to time, place and person.
Psychiatric Assessment. The
X-ray
X-ray
Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source.
Pulmonary Function Tests should be interpreted in a systematic and consistent way.
SVC:
superior vena cava
Superior vena cava
The venous trunk which returns blood from the head, neck, upper extremities and chest.
Mediastinum and Great Vessels: Anatomy
PA:
pulmonary artery
Pulmonary artery
The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs.
Lungs: Anatomy
RUL: right upper lobe
LUL: left upper lobe
RLL: right lower lobe
LLL: left lower lobe
Normal posteroanterior (PA) view
chest X-ray
Chest X-ray
X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs.
Pulmonary Function Tests:
The standard
chest X-ray
Chest X-ray
X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs.
Pulmonary Function Tests is taken in the PA
orientation
Orientation
Awareness of oneself in relation to time, place and person.
Psychiatric Assessment. The
X-ray
X-ray
Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source.
Pulmonary Function Tests should be interpreted in a systematic and consistent way.
SVC:
superior vena cava
Superior vena cava
The venous trunk which returns blood from the head, neck, upper extremities and chest.
Mediastinum and Great Vessels: Anatomy
PA:
pulmonary artery
Pulmonary artery
The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs.
Lungs: Anatomy
RUL: right upper lobe
LUL: left upper lobe
RLL: right lower lobe
LLL: left lower lobe
Lateral view:
Normal findings on a lateral chest X-ray Chest X-ray X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs. Pulmonary Function Tests
Image by Hetal Verma.Normal findings on a lateral chest X-ray Chest X-ray X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs. Pulmonary Function Tests
Image by Hetal Verma.Normal findings on a lateral chest X-ray Chest X-ray X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs. Pulmonary Function Tests
Image by Hetal Verma.Right lower lobe
pneumonia
Pneumonia
Pneumonia or pulmonary inflammation is an acute or chronic inflammation of lung tissue. Causes include infection with bacteria, viruses, or fungi. In more rare cases, pneumonia can also be caused through toxic triggers through inhalation of toxic substances, immunological processes, or in the course of radiotherapy.
Pneumonia:
Wedge-shaped area of increased opacity representing
consolidation
Consolidation
Pulmonary Function Tests in the right lung seen commonly with bacterial
pneumonia
Pneumonia
Pneumonia or pulmonary inflammation is an acute or chronic inflammation of lung tissue. Causes include infection with bacteria, viruses, or fungi. In more rare cases, pneumonia can also be caused through toxic triggers through inhalation of toxic substances, immunological processes, or in the course of radiotherapy.
Pneumonia
Heart enlargement on
chest X-ray
Chest X-ray
X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs.
Pulmonary Function Tests:
The cardiothoracic ratio (width of the heart/width of the
diaphragm
Diaphragm
The diaphragm is a large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm consists of muscle fibers and a large central tendon, which is divided into right and left parts. As the primary muscle of inspiration, the diaphragm contributes 75% of the total inspiratory muscle force.
Diaphragm: Anatomy) can be used to evaluate for enlargement of the heart. A normal heart is roughly ½ the width of the
diaphragm
Diaphragm
The diaphragm is a large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm consists of muscle fibers and a large central tendon, which is divided into right and left parts. As the primary muscle of inspiration, the diaphragm contributes 75% of the total inspiratory muscle force.
Diaphragm: Anatomy (left image). If the heart is greater than ½ the width of the
diaphragm
Diaphragm
The diaphragm is a large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm consists of muscle fibers and a large central tendon, which is divided into right and left parts. As the primary muscle of inspiration, the diaphragm contributes 75% of the total inspiratory muscle force.
Diaphragm: Anatomy (right image), there is likely an ongoing pathologic process causing
cardiac
Cardiac
Total Anomalous Pulmonary Venous Return (TAPVR) dilatation.
Boot-shaped heart: Chest X-ray Chest X-ray X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs. Pulmonary Function Tests of a 16-month-old boy with tetralogy of Fallot Tetralogy of Fallot Tetralogy of Fallot is the most common cyanotic congenital heart disease. The disease is the confluence of 4 pathologic cardiac features: overriding aorta, ventricular septal defect, right ventricular outflow obstruction, and right ventricular hypertrophy. Tetralogy of Fallot
Image: “Typical preoperative chest X‐ray of a 16‐month‐old boy with tetralogy of Fallot Tetralogy of Fallot Tetralogy of Fallot is the most common cyanotic congenital heart disease. The disease is the confluence of 4 pathologic cardiac features: overriding aorta, ventricular septal defect, right ventricular outflow obstruction, and right ventricular hypertrophy. Tetralogy of Fallot” by Andrew C. Chatzis et al AL Amyloidosis. License: CC BY 4.0Chest radiograph showing left diaphragmatic hernia Hernia Protrusion of tissue, structure, or part of an organ through the bone, muscular tissue, or the membrane by which it is normally contained. Hernia may involve tissues such as the abdominal wall or the respiratory diaphragm. Hernias may be internal, external, congenital, or acquired. Abdominal Hernias and contralateral shift of the heart and mediastinum Mediastinum The mediastinum is the thoracic area between the 2 pleural cavities. The mediastinum contains vital structures of the circulatory, respiratory, digestive, and nervous systems including the heart and esophagus, and major thoracic vessels. Mediastinum and Great Vessels: Anatomy
Image: “Chest radiograph showing left diaphragmatic hernia Hernia Protrusion of tissue, structure, or part of an organ through the bone, muscular tissue, or the membrane by which it is normally contained. Hernia may involve tissues such as the abdominal wall or the respiratory diaphragm. Hernias may be internal, external, congenital, or acquired. Abdominal Hernias” by Alberta Children’s Hospital, Calgary, AB, Canada T3B 6A8. License: CC BY 4.0Medical indications:
Advantages:
Disadvantages:
Photograph of CT scanner:
The
motorized table
Motorized Table
Computed Tomography (CT) moves the patient through the scanner, which contains the
X-ray tube
X-Ray Tube
X-rays and detectors.
Standard CT scanning Standard CT scanning Imaging of the Liver and Biliary Tract:
CT scanning:
Patient is advanced into the CT machine and the scanner revolves around the patient. The procedure lasts as long as 30 minutes.
CT image viewing planes:
CT scans use multiple X-rays to create a 2- or 3-dimensional image. The X-ray “slices” are taken in the
sagittal
Sagittal
Computed Tomography (CT),
coronal
Coronal
Computed Tomography (CT), or
axial
Axial
Computed Tomography (CT) plane and reconstructed by a computer to produce the final image.
Special forms:
Coronal
Coronal
Computed Tomography (CT) chest
CT with contrast
CT with Contrast
Imaging of the Head and Brain (
lung window
Lung Window
Computed Tomography (CT)) showing normal lung anatomy and appearance
RUL: right upper lobe
RML: right middle lobe
RLL: right lower lobe
LUL: left upper lobe
LLL: left lower lobe
Axial
Axial
Computed Tomography (CT) chest
CT with contrast
CT with Contrast
Imaging of the Head and Brain (
lung window
Lung Window
Computed Tomography (CT)) showing normal lung anatomy and appearance
RUL: right upper lobe
RLL: right lower lobe
LUL: left upper lobe
LLL: left lower lobe
Anatomy of the great vessels on CT:
On CT, blood vessels appear as circles when viewed head on and like tubes when sliced lengthwise. The blood vessels can be distinguished from airways by their content (blood), which appears bright. This image represents an
axial
Axial
Computed Tomography (CT) view of the chest, just above the heart. The ascending and
descending aorta
Descending aorta
Mediastinum and Great Vessels: Anatomy can be seen (A) and the pulmonary
arteries
Arteries
Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles.
Arteries: Histology (PA) can also be appreciated coming off the left ventricle.
Anatomy of the heart
Anatomy of the heart
The heart is a 4-chambered muscular pump made primarily of cardiac muscle tissue. The heart is divided into 4 chambers: 2 upper chambers for receiving blood from the great vessels, known as the right and left atria, and 2 stronger lower chambers, known as the right and left ventricles, which pump blood throughout the body.
Heart: Anatomy on chest CT
axial
Axial
Computed Tomography (CT) view:
A 4-chamber view of the heart can be obtained with chest CT. The left atrium (LA) can be recognized with 2 pulmonary
veins
Veins
Veins are tubular collections of cells, which transport deoxygenated blood and waste from the capillary beds back to the heart. Veins are classified into 3 types: small veins/venules, medium veins, and large veins. Each type contains 3 primary layers: tunica intima, tunica media, and tunica adventitia.
Veins: Histology returning blood to it. The left ventricle (LV), with its thicker walls, is seen in continuity with the left atrium. The right atrium (RA) and right ventricle (RV) are more difficult to see in this image. The ascending and
descending aorta
Descending aorta
Mediastinum and Great Vessels: Anatomy (A) are also visible.
Anatomy of the heart
Anatomy of the heart
The heart is a 4-chambered muscular pump made primarily of cardiac muscle tissue. The heart is divided into 4 chambers: 2 upper chambers for receiving blood from the great vessels, known as the right and left atria, and 2 stronger lower chambers, known as the right and left ventricles, which pump blood throughout the body.
Heart: Anatomy on chest CT on
coronal
Coronal
Computed Tomography (CT) view:
Coronal
Coronal
Computed Tomography (CT) view of the heart on chest CT provides more readily recognizable anatomic landmarks, with the
aorta
Aorta
The main trunk of the systemic arteries.
Mediastinum and Great Vessels: Anatomy (A) arising from the left ventricle (LV) and the
superior vena cava
Superior vena cava
The venous trunk which returns blood from the head, neck, upper extremities and chest.
Mediastinum and Great Vessels: Anatomy (SVC) feeding into the right atrium (RA). The left
pulmonary artery
Pulmonary artery
The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs.
Lungs: Anatomy (PA) can be seen head on, but its source (the right ventricle) is hidden in this image.
Airspace opacities on chest CT:
Consolidations on chest CT appear as brighter (denser) areas on the uniform background of dark gray lung parenchyma. These brighter areas represent areas of
consolidation
Consolidation
Pulmonary Function Tests and infection, and although areas of
consolidation
Consolidation
Pulmonary Function Tests are visible on
X-ray
X-ray
Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source.
Pulmonary Function Tests, chest CT has the advantage of allowing for more precise localization. In this image, the location of the
pneumonia
Pneumonia
Pneumonia or pulmonary inflammation is an acute or chronic inflammation of lung tissue. Causes include infection with bacteria, viruses, or fungi. In more rare cases, pneumonia can also be caused through toxic triggers through inhalation of toxic substances, immunological processes, or in the course of radiotherapy.
Pneumonia in the right middle lobe suggests that this is a
pneumonia
Pneumonia
Pneumonia or pulmonary inflammation is an acute or chronic inflammation of lung tissue. Causes include infection with bacteria, viruses, or fungi. In more rare cases, pneumonia can also be caused through toxic triggers through inhalation of toxic substances, immunological processes, or in the course of radiotherapy.
Pneumonia caused by aspiration.
Interstitial disease on chest CT:
Interstitial disease can be seen on
chest X-ray
Chest X-ray
X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs.
Pulmonary Function Tests but is better qualified on chest CT. The chest CT can have a fine reticular pattern that is diffuse or more localized but also shows some nodules. The image represents a diffuse fine reticular pattern due to
pneumonitis
Pneumonitis
Human Herpesvirus 6 and 7 that developed from complications of
chemotherapy
Chemotherapy
Osteosarcoma.
Atelectasis
Atelectasis
Atelectasis is the partial or complete collapse of a part of the lung. Atelectasis is almost always a secondary phenomenon from conditions causing bronchial obstruction, external compression, surfactant deficiency, or scarring.
Atelectasis on chest CT:
Loss of volume in the parenchyma of the
lungs
Lungs
Lungs are the main organs of the respiratory system. Lungs are paired viscera located in the thoracic cavity and are composed of spongy tissue. The primary function of the lungs is to oxygenate blood and eliminate CO2.
Lungs: Anatomy (
atelectasis
Atelectasis
Atelectasis is the partial or complete collapse of a part of the lung. Atelectasis is almost always a secondary phenomenon from conditions causing bronchial obstruction, external compression, surfactant deficiency, or scarring.
Atelectasis) can be due to multiple causes. Chest CT can help qualify what is provoking the loss of volume. In this image, a
pleural effusion
Pleural Effusion
Pleural effusion refers to the accumulation of fluid between the layers of the parietal and visceral pleura. Common causes of this condition include infection, malignancy, autoimmune disorders, or volume overload. Clinical manifestations include chest pain, cough, and dyspnea.
Pleural Effusion (green arrow) is compressing a lobe of the lung (black arrow), causing loss of volume.
Hyperinflation:
Destruction of terminal
bronchioles
Bronchioles
The small airways branching off the tertiary bronchi. Terminal bronchioles lead into several orders of respiratory bronchioles which in turn lead into alveolar ducts and then into pulmonary alveoli.
Bronchial Tree: Anatomy and
alveoli
Alveoli
Small polyhedral outpouchings along the walls of the alveolar sacs, alveolar ducts and terminal bronchioles through the walls of which gas exchange between alveolar air and pulmonary capillary blood takes place.
Acute Respiratory Distress Syndrome (ARDS) leads to increased pockets of air, which on CT look like dark spaces. CT allows better determination of the arrangement and size of the air pockets, helping to determine the etiology of hyperinflation.
Pneumothorax
Pneumothorax
A pneumothorax is a life-threatening condition in which air collects in the pleural space, causing partial or full collapse of the lung. A pneumothorax can be traumatic or spontaneous. Patients present with a sudden onset of sharp chest pain, dyspnea, and diminished breath sounds on exam.
Pneumothorax on chest CT:
Free air appears dark on CT set to the
lung window
Lung Window
Computed Tomography (CT), which allows for clear visualization of pockets of air in the
pleural space
Pleural space
The thin serous membrane enveloping the lungs (lung) and lining the thoracic cavity. Pleura consist of two layers, the inner visceral pleura lying next to the pulmonary parenchyma and the outer parietal pleura. Between the two layers is the pleural cavity which contains a thin film of liquid.
Pleuritis. In this image, a dark rim of air (B) can be seen around the lung after a needle
biopsy
Biopsy
Removal and pathologic examination of specimens from the living body.
Ewing Sarcoma of a
mass
Mass
Three-dimensional lesion that occupies a space within the breast
Imaging of the Breast is performed (A).
Pulmonary emboli:
Contrast chest CT is the gold standard for diagnosis of pulmonary emboli.
Filling defects
Filling Defects
Imaging of the Intestines (white arrows) are visible in the pulmonary
veins
Veins
Veins are tubular collections of cells, which transport deoxygenated blood and waste from the capillary beds back to the heart. Veins are classified into 3 types: small veins/venules, medium veins, and large veins. Each type contains 3 primary layers: tunica intima, tunica media, and tunica adventitia.
Veins: Histology.
CT demonstrating a pericardial effusion Pericardial effusion Fluid accumulation within the pericardium. Serous effusions are associated with pericardial diseases. Hemopericardium is associated with trauma. Lipid-containing effusion (chylopericardium) results from leakage of thoracic duct. Severe cases can lead to cardiac tamponade. Pericardial Effusion and Cardiac Tamponade, measuring 19.27 mm MM Multiple myeloma (MM) is a malignant condition of plasma cells (activated B lymphocytes) primarily seen in the elderly. Monoclonal proliferation of plasma cells results in cytokine-driven osteoclastic activity and excessive secretion of IgG antibodies. Multiple Myeloma
Image: “CT pulmonary embolus” by Stanford Hospital and Clinics, Stanford, California. License: CC BY 2.0Dissection of the aortic wall chest CT:
Contrast chest CT is the gold standard for diagnosis of
aortic dissection
Aortic dissection
Aortic dissection occurs due to shearing stress from pulsatile pressure causing a tear in the tunica intima of the aortic wall. This tear allows blood to flow into the media, creating a “false lumen.” Aortic dissection is most commonly caused by uncontrolled hypertension.
Aortic Dissection. A “double lumen” (red arrow) can be seen in the
aorta
Aorta
The main trunk of the systemic arteries.
Mediastinum and Great Vessels: Anatomy.
Medical indications:
Advantages:
Disadvantages:
Positioning:
MRA MRA Imaging of the Heart and Great Vessels:
Views:
Examples of T1-weighted, T2-weighted, and proton density Proton Density Magnetic Resonance Imaging (MRI) ( PD PD Parkinson’s disease (PD) is a chronic, progressive neurodegenerative disorder. Although the cause is unknown, several genetic and environmental risk factors are currently being studied. Individuals present clinically with resting tremor, bradykinesia, rigidity, and postural instability. Parkinson’s Disease)–weighted MRI scans
Image: “MRI sequence” by KieranMaher. License: Public DomainEvaluation of
myocardium
Myocardium
The muscle tissue of the heart. It is composed of striated, involuntary muscle cells connected to form the contractile pump to generate blood flow.
Heart: Anatomy by MRI:
MRI is advantageous for the evaluation of
soft tissue
Soft Tissue
Soft Tissue Abscess structures, such as the
myocardium
Myocardium
The muscle tissue of the heart. It is composed of striated, involuntary muscle cells connected to form the contractile pump to generate blood flow.
Heart: Anatomy.
Cardiac
Cardiac
Total Anomalous Pulmonary Venous Return (TAPVR) muscle size, wall thickness, and function can be evaluated using this imaging method. This MRI shows
dilated cardiomyopathy
Dilated Cardiomyopathy
Dilated cardiomyopathy (DCM) is the most common type of non-ischemic cardiomyopathy and a common cause of heart failure (HF). The cause may be idiopathic, familial, or secondary to a variety of underlying conditions. The disease is characterized by the enlargement of 1 or both ventricles and reduced systolic function.
Dilated Cardiomyopathy with evidence of
cardiac
Cardiac
Total Anomalous Pulmonary Venous Return (TAPVR) muscle remodeling (arrows).
Abnormal
thymus
Thymus
A single, unpaired primary lymphoid organ situated in the mediastinum, extending superiorly into the neck to the lower edge of the thyroid gland and inferiorly to the fourth costal cartilage. It is necessary for normal development of immunologic function early in life. By puberty, it begins to involute and much of the tissue is replaced by fat.
Lymphatic Drainage System: Anatomy MRI:
Chest MRI is useful to evaluate
soft tissue
Soft Tissue
Soft Tissue Abscess lesions. In this image, a thymic
mass
Mass
Three-dimensional lesion that occupies a space within the breast
Imaging of the Breast (arrows) is shown to be abnormal. In this context, MRI is superior to CT because of the resolution and detail it can provide.
MRI T2 = H20 is white
Medical indications:
Advantages:
Disadvantages:
Normal lung ultrasound:
(A): The pleural lines (arrows): The A-lines, or horizontal lines arising from the pleural line, are separated by
regular
Regular
Insulin intervals that are equal to the distance between the
skin
Skin
The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue.
Skin: Structure and Functions and the pleural line.
(B):
M-mode
M-Mode
Imaging of the Heart and Great Vessels shows the pleural line. Under the pleural line is the seashore sign (sandy pattern) due to the lung dynamics and pleural sliding. The horizontal lines are A-lines, separated by
regular
Regular
Insulin intervals (arrows).
Echocardiogram
Echocardiogram
Transposition of the Great Vessels showing anatomy and
flow
Flow
Blood flows through the heart, arteries, capillaries, and veins in a closed, continuous circuit. Flow is the movement of volume per unit of time. Flow is affected by the pressure gradient and the resistance fluid encounters between 2 points. Vascular resistance is the opposition to flow, which is caused primarily by blood friction against vessel walls.
Vascular Resistance, Flow, and Mean Arterial Pressure in mitral
regurgitation
Regurgitation
Gastroesophageal Reflux Disease (GERD):
Echocardiography
Echocardiography
Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic.
Tricuspid Valve Atresia (TVA) can show the
anatomy of the heart
Anatomy of the heart
The heart is a 4-chambered muscular pump made primarily of cardiac muscle tissue. The heart is divided into 4 chambers: 2 upper chambers for receiving blood from the great vessels, known as the right and left atria, and 2 stronger lower chambers, known as the right and left ventricles, which pump blood throughout the body.
Heart: Anatomy chambers,
myocardium
Myocardium
The muscle tissue of the heart. It is composed of striated, involuntary muscle cells connected to form the contractile pump to generate blood flow.
Heart: Anatomy, and valves. In this image, the
mitral valve
Mitral valve
The valve between the left atrium and left ventricle of the heart.
Heart: Anatomy has a defect (arrow labeled MV
perforation
Perforation
A pathological hole in an organ, blood vessel or other soft part of the body, occurring in the absence of external force.
Esophagitis). Using the
Doppler
Doppler
Ultrasonography applying the doppler effect, with frequency-shifted ultrasound reflections produced by moving targets (usually red blood cells) in the bloodstream along the ultrasound axis in direct proportion to the velocity of movement of the targets, to determine both direction and velocity of blood flow.
Ultrasound (Sonography) function, a
retrograde flow
Retrograde flow
Veins: Histology of blood into the left atrium (LA) can be seen during contraction of the left ventricle, suggesting
mitral valve
Mitral valve
The valve between the left atrium and left ventricle of the heart.
Heart: Anatomy
regurgitation
Regurgitation
Gastroesophageal Reflux Disease (GERD).
RIPV: right inferior
pulmonary vein
Pulmonary Vein
Total Anomalous Pulmonary Venous Return (TAPVR)
Pleural effusion
Pleural Effusion
Pleural effusion refers to the accumulation of fluid between the layers of the parietal and visceral pleura. Common causes of this condition include infection, malignancy, autoimmune disorders, or volume overload. Clinical manifestations include chest pain, cough, and dyspnea.
Pleural Effusion visualized through
X-ray
X-ray
Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source.
Pulmonary Function Tests and
echocardiography
Echocardiography
Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic.
Tricuspid Valve Atresia (TVA):
Fluid in the
pleural space
Pleural space
The thin serous membrane enveloping the lungs (lung) and lining the thoracic cavity. Pleura consist of two layers, the inner visceral pleura lying next to the pulmonary parenchyma and the outer parietal pleura. Between the two layers is the pleural cavity which contains a thin film of liquid.
Pleuritis can be difficult to distinguish from pathologic processes affecting the lung parenchyma on
X-ray
X-ray
Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source.
Pulmonary Function Tests (left). On an ultrasound,
hypoechoic
Hypoechoic
A structure that produces a low-amplitude echo (darker grays)
Ultrasound (Sonography) areas (PF) can be sharply contrasted with lung tissue (A) and identified as fluid.
RIPV: right inferior
pulmonary vein
Pulmonary Vein
Total Anomalous Pulmonary Venous Return (TAPVR)
Chest X-ray Chest X-ray X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs. Pulmonary Function Tests showing right upper lobe consolidation Consolidation Pulmonary Function Tests
Image by Hetal Verma.CT with consolidations on air bronchogram
Image: “CT with consolidations” by Mikael Häggström, M.D. License: Public DomainChest radiograph and CT scan at diagnosis of lung adenocarcinoma:
A: Chest radiograph showing a mass shadow in the right middle zone (arrow)
B and C: Selected sections of a conventional CT scan of the chest showing a 30-mm solitary mass in S5 of the right lung (arrow), and mediastinal lymphadenopathy (arrowhead)
Atypical radiologic findings of excavated pulmonary metastases:
A:
Chest X-ray
Chest X-ray
X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs.
Pulmonary Function Tests showing a left
tension pneumothorax
Tension Pneumothorax
Pneumothorax with midline structures deviating to the right
B: Postprocedure
chest X-ray
Chest X-ray
X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs.
Pulmonary Function Tests showing nearly immediate reexpansion of the left lung with new infiltrates in the whole lung.
Chest CT scans of 2 bilateral pneumothorax Pneumothorax A pneumothorax is a life-threatening condition in which air collects in the pleural space, causing partial or full collapse of the lung. A pneumothorax can be traumatic or spontaneous. Patients present with a sudden onset of sharp chest pain, dyspnea, and diminished breath sounds on exam. Pneumothorax events
Image: “Radiographs of two bilateral pneumothorax Pneumothorax A pneumothorax is a life-threatening condition in which air collects in the pleural space, causing partial or full collapse of the lung. A pneumothorax can be traumatic or spontaneous. Patients present with a sudden onset of sharp chest pain, dyspnea, and diminished breath sounds on exam. Pneumothorax events” by Kenji Nakano et al AL Amyloidosis. License: CC BY 4.0Chest X-ray Chest X-ray X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs. Pulmonary Function Tests of emphysema Emphysema Enlargement of air spaces distal to the terminal bronchioles where gas-exchange normally takes place. This is usually due to destruction of the alveolar wall. Pulmonary emphysema can be classified by the location and distribution of the lesions. Chronic Obstructive Pulmonary Disease (COPD) showing hyperinflated lung fields with a large bullous lesion on the right side
Image: “Skiagram chest showing hyperinflated lung fields” by Department of Pulmonary Medicine, J. L. N. Medical College, Ajmer, India. License: CC BY 2.0
Pleural effusion
Pleural Effusion
Pleural effusion refers to the accumulation of fluid between the layers of the parietal and visceral pleura. Common causes of this condition include infection, malignancy, autoimmune disorders, or volume overload. Clinical manifestations include chest pain, cough, and dyspnea.
Pleural Effusion:
Pleural effusion
Pleural Effusion
Pleural effusion refers to the accumulation of fluid between the layers of the parietal and visceral pleura. Common causes of this condition include infection, malignancy, autoimmune disorders, or volume overload. Clinical manifestations include chest pain, cough, and dyspnea.
Pleural Effusion (asterisk) permits the ultrasound beam to penetrate deeply to reveal the vertebral stripe (arrow). The vertebral stripe will not be visible above the
diaphragm
Diaphragm
The diaphragm is a large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm consists of muscle fibers and a large central tendon, which is divided into right and left parts. As the primary muscle of inspiration, the diaphragm contributes 75% of the total inspiratory muscle force.
Diaphragm: Anatomy if the lung is aerated.
Chest CT image showing bilateral pleural effusion Pleural Effusion Pleural effusion refers to the accumulation of fluid between the layers of the parietal and visceral pleura. Common causes of this condition include infection, malignancy, autoimmune disorders, or volume overload. Clinical manifestations include chest pain, cough, and dyspnea. Pleural Effusion (arrows) and pulmonary edema Pulmonary edema Pulmonary edema is a condition caused by excess fluid within the lung parenchyma and alveoli as a consequence of a disease process. Based on etiology, pulmonary edema is classified as cardiogenic or noncardiogenic. Patients may present with progressive dyspnea, orthopnea, cough, or respiratory failure. Pulmonary Edema
Image: “Chest high-resolution computed tomography image” by Department of Clinical Microbiology, Umeå University, SE – 901 85 Umeå, Sweden. License: CC BY 2.0, edited by Lecturio.Chest radiograph showing bilateral pleural effusion Pleural Effusion Pleural effusion refers to the accumulation of fluid between the layers of the parietal and visceral pleura. Common causes of this condition include infection, malignancy, autoimmune disorders, or volume overload. Clinical manifestations include chest pain, cough, and dyspnea. Pleural Effusion, massive on the left side
Image: “Chest radiograph showing bilateral pleural effusion Pleural Effusion Pleural effusion refers to the accumulation of fluid between the layers of the parietal and visceral pleura. Common causes of this condition include infection, malignancy, autoimmune disorders, or volume overload. Clinical manifestations include chest pain, cough, and dyspnea. Pleural Effusion” by Department of Pulmonary Medicine, Kasturba Medical College, Manipal, Karnataka, India. License: CC BY 2.0Chest X-ray Chest X-ray X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs. Pulmonary Function Tests reveals pulmonary edema Pulmonary edema Pulmonary edema is a condition caused by excess fluid within the lung parenchyma and alveoli as a consequence of a disease process. Based on etiology, pulmonary edema is classified as cardiogenic or noncardiogenic. Patients may present with progressive dyspnea, orthopnea, cough, or respiratory failure. Pulmonary Edema
Image: “The chest X-ray Chest X-ray X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs. Pulmonary Function Tests on ICU ICU Hospital units providing continuous surveillance and care to acutely ill patients. West Nile Virus admission reveals pulmonary edema Pulmonary edema Pulmonary edema is a condition caused by excess fluid within the lung parenchyma and alveoli as a consequence of a disease process. Based on etiology, pulmonary edema is classified as cardiogenic or noncardiogenic. Patients may present with progressive dyspnea, orthopnea, cough, or respiratory failure. Pulmonary Edema” by Medical Intensive Care Unit, University Hospital Zurich, Raemistraße 100, 8091 Zurich, Switzerland. License: CC BY 3.0