Basic Radiology for Non Radiologist

Dr. Muhammad Bin Zulfiqar

PGR II SIMS/SHL

AIMS

• Introduction and basics of

– Plain Radiography (Chest X-Rays)

– CT Scan

– MR Imaging

Chest X-Rays

• Patent ID and date

• Projection----PA/AP/LAT

• Centering----Rotated /Non-rotated

• Exposure----Adequate /Poor

• Inspiratory effort

A The cardiomediastinal contour is significantly magnified on this AP film. This needs to be appreciated and not overcalled.

B On the PA film, taken only an hour later, the mediastinum appears normal.

Lateral View

• A well centred x-ray. Medial ends of clavicles are equidistant from the spinous process.

• This patient is rotated to the left. Note the spinous process is close to the right clavicle and the left lung is ‘blacker’ than the right, due to the rotation.

Exposure

• The cardiothoracic ratio should be less than 0.5.• i.e. A/B<0.5.• A cardiothoracic ratio of greater than 0.5 (in a good quality

film) suggests cardiomegaly.

Hilar Contour

Normal chestx-ray

Lobes and Fissures

RUL

LUL

RLL

RML

LLL

Left Lateral View Right Lateral View

LUL

LLL

RUL

RML

RLL

http://www.wikiradiography.com/page/Chest+Radiographic+Anatomy

Cervical Rib

Pleural Effusion

Lobulated pleural effusion

Subpulmonic pleural effusion

• Bronchiectasis. There is widespread bronchial wall abnormality in both lungs, but particularly in the right lung. In the right lower zone, there is marked bronchial wall thickening (remember that the normal bronchial wall should be ‘pencil line’ thin) with ‘tram lines’ visible.

• Carcinoma with rib destruction. Dense opacification of the left upper lobe with associated destruction of the left second and third anterior ribs.

• Left Hilar Mass

• Chronic obstructive pulmonary disease. The lungs are hyperinflated with flattening of both hemidiaphragms. On the lateral view, the chest appears ‘barrel-shaped’ due to an increase in the retro-sternalair space.

Emphysema

Bulla

Asthma

Post traumatic DH Congenital

• Flail chest – case 2. Double fractures of the left posterior fifth and sixth ribs.

• Simple pneumothorax. The right lung edge is faintly visible on the inspiratory film. However, the pneumothorax becomes clearly evident on the expiratory film.

Tension pneumothorax

TB

Miliary TB

Retrosternal Goiter

Adult Respiratory Distress Syndrome

CT Brain

ICH

Subarachnoid Hemorrhage

Subdural Hematoma

Extradural Hematoma

Infarction

Pneumocephalous

SOL

Disc Prolapse

Disc Herniation

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