Questions
T1 relaxation VS T2 Relaxation (Video)
T1 relaxation VS T2 Relaxation
T1 relaxation
T1 relaxation time is a measure of the rate of transfer of energy from the nuclear spin system
to the neighboring molecules (the lattice). It is the time when 63% of the longitudinal
magnetization has recovered. It occurs in the z-direction (z-axis is often depicted as a vertical
line).
T1 relaxation VS T2 Relaxation
T2 relaxation
T2 relaxation time is a measure of the rate of the decay of transverse
magnetization within the xy-plane. It is the time when 63% of the transverse
magnetization has decayed.
They can be generally defined
T1 relaxation VS T2 Relaxation as two intrinsic coefficients
under specific magnetic field
• T1-weighted imaging is used to differentiate anatomical structures mainly on the basis
of T1 values. This is good for demonstrating anatomy.
• T2-weighted imaging is used to differentiate anatomical structures mainly on the basis
of T2 values. This is good for demonstrating pathology since most (not all) lesions are
associated with an increase in water content.
Window setting(video)
Question: WL:50, WW:300
the range?
Medical Imaging Report
• CLINICAL HISTORY: Gender, age
Cough, fever, headache…
Lab tests…
For Medical Imaging report:
• Technique/modality:
Fluoroscopy, Radiography, CT, MRI, Ultrasound, PET scanning….
With/without contrast
Scan area: Head, chest, abdomen, sinus, spine, pelvis……
• Imaging findings
Location, Density/Signal, Size, Number, Shape, Surrounding,
Enhancement mode…..
• Diagnosis and differential diagnosis
• Suggestions for further examinations
Chest One
Respiratory System
Yuanyuan Ma: MD, PhD, Associated Research Fellow
Radiology Department, Zhongda Hospital
Mobile:15850671908
Email:yuany_ma@[Link]
Imaging Techniques
The Plain Chest Radiography (PA and Lateral view)
CT (High resolution CT)
MRI
PET Scanning (positron emission tomography)
Ultrasound
……
The Plain Chest Radiography
Posteranterior (PA) View Lateral View
Chest x-ray anatomy
The Plain Chest Radiography
Upper field
Outer zone
Middle zone Middle field
Inner zone
Lower field
Vertical direction:
Horizontal direction: zone field
Describe a normal chest x-ray
• This is a PA view of the chest with normal
exposure, proper centering and without any
apparent bony abnormality.
• The lung fields are clea r with normal
bronchovascular markings; cardiovascular
silhouette is within normal limit with normal
cardiothoracic ratio.
• Mediastinum, costophrenic and cardiophrenic
angles, domes of the diaphragm and soft tissue
shows no abnormality.
The lung markings are a reflection of other structures
within the lungs that show-up as white on the X-ray.
How to read a chest radiograph
To Trace the diaphragm
Check the size and shape of the heart
Check the position of the heart and mediastinum
Look at the mediastinum
Examine the hilar structures
Examine the lungs
Check the integrity of the ribs, clavicles and spine and examine the soft tissues
Assess the technical quality of the film
ABCDEFG(video)
The Plain Chest Radiography
Lung lobes and fissures
Trachea, bronchi and broncho-pulmonary segments
The right lung is five centimeters shorter
than the left lung to accommodate the
diaphragm, which rises higher on the
right side over the liver; it is also broader.
The volume, the total capacity, and the
weight of the right lung is greater than
that of the left.
Right lung: three lobes
ten segments
Left lung: two lobes
eight/nine segments
(lingula in left upper lobe)
Trachea, bronchi and broncho-pulmonary segments
Computer Tomography Lung Window
Right mainstem bronchus
trachea Right upper lobe bronchus
Bronchus intermedius Right middle lobe bronchus（8）
Right lower lobe bronchus（9）
Left mainstem bronchus- left upper lobe brunchus
Left lower lobe bronchus（10）
[Link] apical segmental bronchus of the right upper lobe
2. the apical posterior segmental bronchus
3. anterior segment bronchus of the right upper lobe
4. posterior segment bronchus of the right upper lobe
5. the apical posterior segmental bronchus 6. intermediate bronchus
7. lingula segmental bronchus [Link] middle lobe bronchus
[Link] lower lobe bronchus [Link] lower lobe bronchus
11. apical segment of left lower lobe
Computer Tomography Mediastinum Window
Plain CT scanning Enhanced CT scanning
Images are taken both with and without radiocontrast. CT images are called pre-contrast or
native-phase images before any radiocontrast has been administrated, and postcontrast after
radiocontrast administration. Hyperdensity in blood vessels.
Specific Lung Diseases
Pneumonia
Lung abscess
Pulmonary tuberculosis
Chronic obstructive pulmonary disease
Carcinoma of the bronchus
Pulmonary metastases
Specific Lung Diseases
Case 1
Male,13-year-old, fever, cough for a week
Case 1
Case 1
• Technique: PA and Lateral Chest radiography
• Location: in the middle and low field of right lung
• High density: ill-defined consolidation (air bronchogram sign?)
• Other lung fields? The hilar? Heart shape? Mediastinum?
Case 1
Diagnosis:
Pneumonia (the whole right middle lobe)
Specific Lung Diseases
Case 2
Male, 22-year-old, fever, cough, white sputum
Case 2
Case 2
• Technique: Contrast Chest CT
• Location: the right upper lobe and both lower lobes
• High density: Multiple patchy ill-defined consolidation
(air bronchogram sign)
• Pleural effusion
• Mediastinum?
Case 2
Diagnosis:
Pneumonia (multi-lobes of bilateral lungs)
Specific Lung Diseases
Case 3
• Male, 58-year-old, fever, cough for 2 weeks,
yellow sputum
• Labs: WBC: 14.85×109/L (3.5-9.5×109/L )
Case 3
Case 3
• Technique: Noncontrast Chest CT
• Location: the right upper lobe
• A spherical shadow containing a central lucency due
to air within the cavity and an air-fluid level
• The lesion is surrounded by ill-defined consolidation
Case 3
Diagnosis:
Lung abscess (right upper lobe)
Cavity
A pulmonary cavity is a collection of gas and/or fluid enclosed by a thick and
often irregular wall which usually occurs when central necrotic tissue is expelled
via a bronchial connection. Cavities may be single or multiple and can be isolated
or associated with lung disease
Single cavity in pulmonary can often be seen in:
Cancer( sometimes, metastases)
Pulmonary abscess
Pulmonary tuberculosis
Pulmonary aspergillosis
…….
Specific Lung Diseases
Case 4
• Male, 48-year-old, cough for 2 weeks,
hemoptysis
Case 4
Case 4
• Technique: PA Chest radiography
• Location: the both upper lobes
• Density: multiple small areas of consolidation
and cavitation
• Bilateral
• Pleural effusion?
Case 4
Diagnosis:
Secondary tuberculosis (both upper lobes)
The apical and posterior segments of the upper lobes and apical segments
of the lower lobes
Specific Lung Diseases
Case 5
• Male, 63-year-old, cough, hemoptysis,
recurrent respiratory infection
Case 5
Case 5
• Technique: Chest CT, Lung window
• Location: the right lower lobe
• thick-walled, dilated bronchi crowd together
Case 5
Diagnosis:
Bronchiectasis (the right lower lobe)
Specific Lung Diseases
Case 6
• Male, 67-year-old, cough and sputum for 5
years
Case 6
Case 6
• PA radiography and Chest CT
• Increased lung volume: The diaphragm is pushed down and become
low and flat; The heart is elongated and narrowed; The intercostal
space are widen and more lung lies in front of the heart and
mediastinum.
• Attenuation of vessels: the reduction in size and number of the
pulmonary blood vessels can be generalized or localized and it is
accompanied by extensive bullae.
• CT：innumerable bullae
Case 6
Diagnosis:
Emphysema companied by bulla
Pulmonary emphysema is defined anatomically as destruction , break down of
lung parenchyma. Very dark field on CT
Specific Lung Diseases
Case 7
• Male, 48-year-old, cough for 2 months, body
weight loss, chest pain
Case 7
Case 7
• Technique: PA and lateral radiography
• Location: the right hilar mass
• Density: well-defined spherical shadow, with narrowing of the
right middle bronchus and the collapse of the right middle lobe
(atelectasis)
• The elevation of the right diaphragm
Case 7
Diagnosis:
Central type lung carcinoma (right lung)
Specific Lung Diseases
Case 8
• Female, 78-year-old, cough and difficulty
breathing
Case 8
Case 8
• Technique: Contrast-enhanced chest CT scan
• Location: the right middle lobe
• A lobulated mass with extensive enhancement
• Left pleural effusion
Case 8
Diagnosis:
Peripheral lung carcinoma (right middle lobe)
Specific Lung Diseases
Case 9
Female, 59-year-old, 4 years after breast cancer
surgery
Case 9
Case 9
• Technique: Chest CT scan
• Location: the both lung
• Numerous well-defined regular rounded
shadows of varying sizes
Case 9
Diagnosis:
Pulmonary metastases (both lung)
Home work
Male, 64-year-old, left chest pain, hemoptysis
Home work
Male, 57-year-old, sputum with blood streak, dyspnea
• TECHNIQUE:
• FINDINGS
• DIAGNOSIS/DDX:
• SUGGESTION:
