Radiology Nuclear Medicine

Download Chest x-ray made easy by Jonathan Corne; Kate Pointon PDF

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By Jonathan Corne; Kate Pointon

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3. Look at the diaphragms. The right diaphragm is usually higher than the left. Collapse in the left lung may distort this. 4. Look for the horizontal fissure in the right lung (pp. 18, 19). The horizontal fissure on the right should run from the centre of the right hilum to the level of the 6th rib at the axillary line. If this is pulled up it suggests right upper lobe collapse or, if pulled down, right lower lobe collapse. 5. The heart should straddle the midline with one-third to the right and two-thirds to the left.

14). If the lesion is below the horizontal fissure it is in the middle lobe. If it is above it is in the upper lobe. If the lesion is in the left lung: 1. Identify the oblique fissure. If it is behind the oblique fissure it must be in the lower lobe. If it is anterior to the oblique fissure it is within the upper lobe – there is no middle lobe on the left! See Chapter 3, which describes localizing using CT scanning. 2 The heart In order to fully assess any abnormalities of the shape of the heart it is important to understand the composition of the heart shadow.

The numbers are explained in the text on page 21. 2 A M This film is of a patient with prosthetic aortic (A) and mitral (M) valves showing their position in the AP and lateral films. 2 A M 25 This page intentionally left blank CHAPTER 3 The CT scan The CT scan 3 Although the plain chest X-ray is one of the most useful imaging techniques, it is limited by the fact that it is a two-dimensional image and small or subtle abnormalities can be overlooked. In other circumstances the chest X-ray will identify an abnormality but will give limited information as to its extent or detailed appearance.

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