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Transcript
ANATOMY
OF
CHEST& NECK,
Bifurcation of carotid
arteries
C3-C4
B.A.
I.C.
E.C.
V.A.
C.C.
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PATHOLOGY
PNEUMONIA
PNEUMONIA
EMPHYSEMA
Emphysema is defined as abnormal permanent enlargement of air
spaces distal to the terminal bronchioles, accompanied by the
destruction of the walls and without obvious fibrosis. The 3
described morphological types of emphysema are centriacinar,
panacinar, and paraseptal
EMPHYSEMA
PULMONARY EDEMA
PNEUMOTHORAX
A collapsed lung, or pneumothorax, occurs when all or part of a lung collapses or caves inward.
This occurs when air gets in the area between the lung and chest wall. When this happens the lung
cannot fill up with air, breathing becomes hard, and the body gets less oxygen. A collapsed lung can
occur spontaneously in a healthy person or in someone who has lungs compromised by trauma,
asthma, bronchitis, or emphysema.
PNEUMOTHORAX
HEMOTHORAX
TUBERCULOSIS
Tuberculosis (TB) is a contagious bacterial disease that
primarily involves the lungs. Like the common cold, it
spreads through the air. Only people who are sick with TB in
their lungs are infectious. When infectious people cough,
sneeze, talk or spit, they propel TB germs, known as bacilli,
into the air. A person needs only to inhale a small number of
these to be infected. TB can also affect other parts of the
body, such as the brain, the kidneys or the spine.
TUBERCULOSIS
SARCOIDOSIS
What is sarcoidosis?
Sarcoidosis is an inflammatory disease that affects
multiple organs in the body, but mostly the lungs
and lymph glands. In patients with sarcoidosis,
abnormal masses or nodules (called granulomas)
consisting of inflamed tissues form in certain
organs of the body. These granulomas may alter
the normal structure and possibly the function of
the affected organ(s).
SARCOIDOSIS
PULMONARY FIBROSIS
Pulmonary fibrosis is a disease where scar tissue develops in the
lungs following many infections and swelling. The scar tissue
causes the lungs to become more stiff than normal. This means that
the lungs cannot expand like normal, and therefore less air can get
in and out of the lungs.
BRONCHOGENIC
CARCINOMA
CALCIFIED B. C.
GRANULOMA
The human immune system, which protects us from disease, is made up
of a complex network of highly specialized cells and organs. When any
part of this network is faulty, it interrupts the smooth functioning of the
immune response and can result in an immulogic disorder. Chronic
granulomatous disease (CGD) is actually a group of rare, inherited
disorders of the immune system that are caused by defects in the immune
system cells called phagocytes. These defects leave patients vulnerable to
severe recurrent bacterial and fungal infections and chronic inflammatory
conditions such as gingivitis (swollen inflamed gums), enlarged lymph
glands, or tumor-like masses called granulomas. While not malignant,
granulomas can cause serious problems by obstructing passage of food
through the esophagus, stomach, and intestines as well as blocking urine
flow from the kidneys and bladder
GRANULOMA
INTERSTITIAL LUNG
DISEASE
What is interstitial lung disease (ILD) / pulmonary fibrosis?
Interstitial lung disease (ILD) is a broad category of lung diseases that
includes more than 130 disorders characterized by scarring (i.e. “fibrosis”)
and / or inflammation of the lungs. Some of the disorders included under
the heading of ILD are:
Idiopathic pulmonary fibrosis
Hypersensitivity pneumonitis
Sarcoidosis
Eosinophilic granuloma
Chronic eosinophilic pneumonia
Bronchiolitis obliterans
Lymphangioleiomyomatosis
ASBESTOSIS
ASBESTOSIS
•A chronic, progressive condition of scar tissue
build-up in the lungs resulting from the inhalation
of asbestos fibers. Shortness of breath, increased
risk of lung infection and permanent lung damage
are common symptoms of asbestosis.
PAROTID GLAND TUMOR
THYROID CANCER
CAROTID ANEURYSM
NECK ABCESS
PROTOCOLS
• NECK
• CHEST
NECK-STANDARD
SCOUT: LATERAL
SCANNING MODE: SPIRAL
LANDMARK: OML
SLICE PLANE: AXIAL
I.V. CONTRAST: 100-150 ml
BREATH HOLD: BREATH HOLD: HOLD ON INSPIRATION
SLICE THICKNESS: 5 MM
START LOCATION: SUPERIOR TO BASE OF TONGUE
END LOCATION: LUNG APICES
FILMING: SOFT TISSUE
NECK:
VOCAL CORD PARALYSIS
SCOUT: LATERAL
SCANNING MODE: SPIRAL
LANDMARK: OML
SLICE PLANE: AXIAL
I.V. CONTRAST: 1-2 ML/SEC. 125 ML
BREATH HOLD: HOLD ON INSPIRATION
SLICE THICKNESS: 5 MM, 1MM THROUGH VOCAL CORDS
LETTER “E” PHONATION TO ASSESS MOBILITY OF VOCAL CORDS
START LOCATION: SUPERIOR TO BASE OF TONGUE
END LOCATION: BELOW CARINA ( T4-T5)
FILMING: SOFT TISSUE
AVOIDANCE OF METALLIC
ARTIFACTS
NECK AND
LARYNX+NASOPHARYNX
SCOUT: LATERAL
SCAN MODE: SPIRAL
LANDMARK: OML
SLICE PLANE: AXIAL- NECK HYPEREXTENDED
I.V. CONTRAST: 100ml, 1MML/SEC.
BREATH HOLD: QUIET RESPIRATION
SLICE THICKNESS: 3-5 MM, 1MM THROUGH VOCAL CORDS
START LOCATION: SUPERIOR NASOPHARYNX
END LOCATION: CRICOID CARTILAGE
FILMING: SOFT TISSUE
CHEST ROUTINE
SCOUT: AP- AZIMUTH 0 DEG.
LANDMARK: STERNAL NOTCH
SLICE PLANE: AXIAL OR SPIRAL
I.V. CONTRAST: 80-150 ml, 1.5-2 MML/SEC., DELAY 60 SEC
BREATH HOLD: SUSPENDED INSPIRATION
SLICE THICKNESS: 8-10 MM OR 5 MM THROUGH HILUM
START LOCATION: STERNAL NOTCH
END LOCATION: TOP OF KIDNEYS (THROUGH ADRENALS)
FILMING: SOFT TISSUE + SHARP LUNG
CT OF CHEST
END LOCATION
KIDNEYS-THROUGH ADRENALS
BRONCHOGENIC CARCINOMA
ADRENAL MASS
DISPLAY OF CHEST CT
400/40
1500/ -500
CHEST –PE
SCOUT: AP
SCANNING MODE: SPIRAL
LANDMARK: STERNAL NOTCH
SLICE PLANE: AXIAL
I.V. CONTRAST: 100-150 ml, 3 ML-4 ML/SEC., DELAY 15-20 SEC
SCANNING IN CAUDOCRANIAL ORIENTATION –
IF MOTION SUSPECTED- TO PASS DIPHRAGM FAST
BREATH HOLD: SUSPENDED INSPIRATION
SLICE THICKNESS: 3 MM
START LOCATION: STERNAL NOTCH
END LOCATION: LUNG BASES
FILMING: SOFT TISSUE + SHARP LUNG
3D + MPR RECONSTRUCTION
PE
CHEST –HIGH RESOLUTION
SCOUT: AP
SCANNING MODE: AXIAL/ SPIRAL
LANDMARK: STERNAL NOTCH
SLICE PLANE: AXIAL
I.V. CONTRAST: NONE
BREATH HOLD: SUSPENDED INSPIRATION
SLICE THICKNESS: 1-1.5 MM
INDEX: 10 MM
START LOCATION: STERNAL NOTCH
END LOCATION: THROUGH LUNG BASES
FILMING: SHARP LUNG
DISPLAY & FILMING
1500/ -500
CHEST –HIGH RESOLUTIONASBESTOSIS (MESOTHELIOMA)
SCOUT: AP
PATIENT SCANNED IN SUPINE AND PRONE POSITION
FOR INFLATION OF THE LUNG BASES
(POSTERIOR ASPECT)
SCANNING MODE: AXIAL/ SPIRAL
LANDMARK: STERNAL NOTCH
SLICE PLANE: AXIAL
I.V. CONTRAST: NONE
BREATH HOLD: SUSPENDED INSPIRATION
SLICE THICKNESS: 1-1.5 MM
INDEX: 10 MM
START LOCATION: STERNAL NOTCH
END LOCATION: THROUGH LUNG BASES
FILMING: SHARP LUNG + MEDIASTINUM
CHEST –HIGH RESOLUTION
AIR TRAPPING
SCOUT: AP
SCANNING MODE:
AXIAL
LANDMARK: STERNAL NOTCH
SLICE PLANE: AXIAL
I.V. CONTRAST: NONE
BREATH HOLD: SUSPENDED INSPIRATION + EXPIRATION
SLICE THICKNESS: 1-1.5 MM
INDEX: 10 MM
START LOCATION: STERNAL NOTCH
END LOCATION: THROUGH LUNG BASES
FILMING: SHARP LUNG ONLY
INSPIRATION AND EXPIRATION
SCAN TO EVALUATE AIR
ENTRAPMENT
DETECTION OF:
•
•
•
•
EMPHYSEMA
ASTHMA
SARCOIDOSIS
INHALATION OF FOREIGN PARTICLES