07 intro to radiology

8/14/2019 07 Intro to Radiology

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RadiologyCardioPulmonary Module

Dr. Mary G. Cormier

Professor of RadiologyGeorgetown Medical School


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Outline

Historical perspective

Making images

Basic anatomy

CXRCT

Examples of disease

lung

pleuraheart/pericardium


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HISTORICAL PERSPECTIVE

Wilhelm Konrad Roentgen

Radiology

officially tracesits beginning toWilhelm KonradRoentgensdiscovery (andnaming) of x-rays, 1895


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HISTORICAL PERSPECTIVE

physics professor atUniversity of Wurzburg, inGermany

discovered a new kind of

ray accidentally whileexperimenting with Crookeelectrical tubes

x was the mathematicalsymbol for an unknown

WILHELM KONRAD ROENTGEN


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Making X-RAYS

Electrons from (-)anode areaccelerated to (+)cathodein vacuum tube

Electrons direction alteredby the (+)nucleus

X-RAYs are thereby emittedin all directions

X-RAYS escape through afiltered window

X-rays


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MAKING IMAGES


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X-RAYS

Electromagnetic radiation of a short

wavelength (high energy)

Penetrate materials to a certain degree

Conventional radiology is based on

irradiating the measured object

measuring the intensity of the X-rays

which have been attenuated by the object


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Making a chest radiograph


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Creating a PA CXR


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Creating a lateral CXR


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Making a CT image


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Making a CT image


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Multiplanar capability


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Multiplanar CT images

axial coronal sagittal


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Normal Anatomy

CXR

CT Chest


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Normal CXR

frontal view side view


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Normal frontal CXR

trachea

Pleura

langle

heart

Pulmonary arteries

diaphragm


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Normal bones

Spinous process

ribs

clavicle

Coracoidprocess

vertebrae


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Normal moguls

Aortic arch

Pulmonarytrunk

Left atrium/appendage

Left ventricle

Rightatrium


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Normal Lateral CXR

sternum

heart

diaphragm

Vertebrae

scapulae

trachea


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Axial slice


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Normal axial CT anatomy


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1 8

13

14

15169

10

1211

27

6

543


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1

12

13 145

6

7118

111

15

16

9

10141

1312


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Normal cardiac valves (axial

CT)

aortic valve with right (R), left (L), and

noncoronary (N) cuspspulmonary valve with right (R), left (L), and

anterior(A) cusps
http://radiographics.rsnajnls.org/content/vol23/issue90001/images/large/g03oc03g7a.jpeghttp://radiographics.rsnajnls.org/content/vol23/issue90001/images/large/g03oc03g7a.jpeg


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Normal coronary arteries

(axial CT)

Left main (LM) coronary artery at the level of the ostium, arises from the left

Valsalva sinus, courses posterior to the right ventricular outflow tract(RVOT),

and bifurcates into the left anterior descending (LAD) and the left circumflex

(LCX) branches

Middle segment of the right coronary artery (RCA) and distal segments of the

left anterior descending and left circumflex branches. The latter is seen in the

left atrioventricular groove, in close proximity to the great cardiac vein (GCV).
http://radiographics.rsnajnls.org/content/vol26/issue4/images/large/g06jl23g01a.jpeghttp://radiographics.rsnajnls.org/content/vol26/issue4/images/large/g06jl23g01b.jpeghttp://radiographics.rsnajnls.org/content/vol26/issue4/images/large/g06jl23g01a.jpeg


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Normal azygos vein

azygos vein arches

forward to join the

SVC (arrow)

right paratracheal

prominence caused by the

azygos vein (arrow)

widening is due to

the azygos vein

(arrow)

azygos vein (arrow)
http://radiographics.rsnajnls.org/cgi/content/full/21/5/1257/F5Dhttp://radiographics.rsnajnls.org/content/vol21/issue5/images/large/g01se02g5c.jpeghttp://radiographics.rsnajnls.org/content/vol21/issue5/images/large/g01se02g5a.jpeghttp://radiographics.rsnajnls.org/content/vol21/issue5/images/large/g01se02g5b.jpeg


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Examples of disease

Lungpneumonia

tumorpulmonary embolism


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pneumonia


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pneumonia


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baseline


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RUL pneumonia

baseline RUL pneumonia


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RUL pneumonia

baseline RUL pneumonia


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tuberculosis (cavitary)


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tumor


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lung carcinoma


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lung carcinoma

PET scan


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uterus cancer, spread tolungs

2007 2008


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colon cancer, spread tolungs

2006 2008


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possible early neoplasm


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pulmonary embolism


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Pulmonary embolism

Axial: clot in right and

left pulmonary arteries

(arrows)

Coronal: clot in right

pulmonary artery extending

into upper and lower

branches (arrow)
http://radiographics.rsnajnls.org/content/vol21/issue5/images/large/g01se02g11b.jpeghttp://radiographics.rsnajnls.org/content/vol21/issue5/images/large/g01se02g11a.jpeg


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Normal Pleura


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normal pleura


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Pleural outlines

Minor fissure

Major fissures


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Pleural fissures (LEFT)

LUL

LLL


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Pleural fissures (RIGHT)

RUL

RLLRML


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Normal pleura
http://radiographics.rsnajnls.org/cgi/content/full/21/4/861/F2http://radiographics.rsnajnls.org/content/vol21/issue4/images/large/g01jl24g4x.jpeghttp://radiographics.rsnajnls.org/content/vol21/issue4/images/large/g01jl24g5b.jpeghttp://radiographics.rsnajnls.org/content/vol21/issue4/images/large/g01jl24g5a.jpeg


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Examples of disease

Pleurapneumothorax

pleural effusionpleural infection (empyema)other


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pneumothorax


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pneumothorax


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Complete L pneumothorax


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L apical pneumothorax


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Pleural effusion

l l ff i


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Large pleural effusion

L i l l ff i


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Layering pleural effusion

L i l l ff i


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Layering pleural effusion


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Pleural infection

(empyema)


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empyema

empyema Chest tube drainage

Pl l i d l


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Pleural micronodules(sarcoidosis)

CT scan demonstrates small nodules in the

lungs and along the minor (arrowhead) and

major (arrow) fissures representing

sarcoidosis

Normal pleura

E l f di
http://radiographics.rsnajnls.org/content/vol21/issue4/images/large/g01jl24g16x.jpeghttp://radiographics.rsnajnls.org/content/vol21/issue4/images/large/g01jl24g5a.jpeghttp://radiographics.rsnajnls.org/content/vol21/issue4/images/large/g01jl24g5a.jpeghttp://radiographics.rsnajnls.org/content/vol21/issue4/images/large/g01jl24g16x.jpeg


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Examples of disease

Heart/PericardiumEnlarged cardiac silhouettePulmonary edemaPericardial effusion

l d di


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enlarged cardiacsilhouette

Normal heart size Enlarged cardiac


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pulmonary edema

l l d


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alveolar edema

l d


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pulmonary edema

baseline 1 day later

pulmonar edema


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pulmonary edema

0000 hrs 0800 hrs


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pericardial effusion



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Review


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Review

Historical perspective Making images

Basic anatomy

CXR

CT

Examples of disease

lung

pleuraheart/pericardium

The End


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The End

07 intro to radiology

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