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Radiology of The Respiratory System: Dr. Dhanti Erma, Sprad

The document provides an overview of radiology of the respiratory system. It discusses the anatomy and radiological investigation methods of the lungs, pleura, diaphragm and mediastinum. It covers the radiological appearance of common lung diseases including pneumonia, tuberculosis, lung tumors and other conditions. Imaging views and findings related to the chest x-ray, CT, MRI and other modalities are presented. Key anatomical structures and pathological signs are illustrated through radiology images.

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Seri Maria Uruha
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91 views115 pages

Radiology of The Respiratory System: Dr. Dhanti Erma, Sprad

The document provides an overview of radiology of the respiratory system. It discusses the anatomy and radiological investigation methods of the lungs, pleura, diaphragm and mediastinum. It covers the radiological appearance of common lung diseases including pneumonia, tuberculosis, lung tumors and other conditions. Imaging views and findings related to the chest x-ray, CT, MRI and other modalities are presented. Key anatomical structures and pathological signs are illustrated through radiology images.

Uploaded by

Seri Maria Uruha
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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RADIOLOGY OF THE

RESPIRATORY SYSTEM

dr. Dhanti Erma, SpRad


THE LOWER RESPIRATORY
SYSTEM (= CHEST)

• RADIOLOGY OF THE :
• LUNG PARENCHYME
• PLEURA
• DIAPHRAGM
• MEDIASTINUM (TUMORS)
ANATOMY-1
LUNGS : LOBES & SEGMENS
ANATOMY-2
ANATOMY-3
ACINUS-PATCHIES

NORMAL INFLAMMATION
RADIOLOGICAL METHODS OF
INVESTIGATION

• PLAIN FILM/ CHEST X-RAYS


• CT SCAN
• MRI
• ULTRASONOGRAPHY (USG)
• NUCLEAR MEDICINE
RADIOLOGICAL METHODS OF
INVESTIGATION
• ARTERIOGRAPHY
• TOMOGRAPHY
• FLUOROSCOPHY
• BRONCHOGRAPHY
CHEST X-RAYS: VIEWS
• POSTEROANTERIOR (PA)ROUTINE
• LEFT LATERAL (LL/RL)
• RIGHT/LEFT ANTERIOR OBLIQUES
(RAO/LAO)
• RIGHT/LEFT LATERAL DECUBITUS
(RLD/LLD)
• TOP LORDOTIK
POSTERO-ANTERIOR (PA)
VIEW
LEFT LATERAL VIEW
RIGHT LATERAL VIEW
CHEST : LAO VIEW
CHEST: RAO VIEW
RIGHT/LEFT LATERAL
DECUBITUS
RLD LLD
L
L

DBD/DHF
D
TOP LORDOTIC VIEW

1
COMPUTED TOMOGRAPHYC
(CT) SCAN
MRI=MAGNETIC
RESONANCE IMAGING
NUCLEAR MEDICINE
TOMOGRAPHY

BASIC DEVOLOVEMENT OF CT
FLUOROSCOPHY
BRONCHOGRAPHY
NORMAL CHEST

NORMAL CHEST PARENCHYME : RADIOLUCENT


P

OLUSEN A1 PLEURA : INVISIBLE


P
P
A2 L
H
HE
T1
T2 HILAR
I
U : LEFT < RIGHT
L
R
DTI
A
LANCIP R
L
DIAPHRAGM : RIGHT > LEFT

SINUS PHRENICO COSTALIS <


NORMAL CHEST

PA=HILAR
RADIOLUCENT D=DIAPH
DISEASES OF THE LUNG
PARENCHYME (1)
• INFLAMMATORY
• LUNG ABSCESS
• ATELECTASIS
• LUNG EDEMA
DISEASES OF THE LUNG
PARENCHYME (2)
• EMPHYSEMA
• CHRONIC BRONCHITIS
• BRONCHIECTASIS
• RESPIRATORY DISTRESS OF
THE NEW BORN (RDN)
• LUNG TUMORS
INFLAMMATORY
• TUBERCULOSIS (TBC)
• PRIMARY TBC
• POST PRIMARY TBC
• NON TBC /ANON SPESIFIC
• PNEUMONIA
• BRONCHOPNEUMONIA
TERMINAL BRONCHIOLES
NORMAL-INFLAMMATORY

5 MM

5 5
5
N NORMAL INFLAMMATORY
N N P
ALVEOLI-PATCHIES

NORMAL PATHOLOGIS
ACINAR SHADOWS
NORMAL & INFLAMMATION

NORMAL
N PATCHIES
P
PRIMARY PULMONARY TBC
 GHON FOCUS & RANKE
COMPLEX
PERIFERAL AIRWAYS &
ACINUS

22,2 CM22
2
PRIMARY TBC & PNEUMONIA
ACTIVE SIGNS:
TBC
• CHEST X-RAYS
• PATCHIES
• CONFLUENSOPACITIES
• CLOUDY HAZINESS
• CAVITY CAVITIES
TERMINAL BR.RESPIR BR.
ACINUS-CONFLUENS
PNEUMONIA
POST PRIMARY TBC(ADULT)

CAVITY INHOMOGENEOUS OPACITY


I
TBC : CAVITY AT LUL
POST PRIMARY TBC :
inaktif

• FIBROSISRETRACTION
• CALCIFICATIONS
INACTIVE (OLD) TBC:
FIBROSIS & CALCIFICATION
OLD / INACTIVE TBC
TBC COMPLICATION :
MILIAR TBC
SPONDYLITIS TBC & PARA
VERTEBRAL ABSCESS
PNEUMONIA ( NON TB)
• RELATIVELY HOMOGENOUS
CONSOLIDAZATION 
• CLOUDY HAZINESS LOBAR
SEGMENTALS .
• SHARP BORDER
• AIR BRONCHOGRAM SIGN (ABS+/-)
• SILHOUETE SIGN (+/- )
CONSOLIDATION OF THE
LUNG PARENCHYME
PNEUMONIALOBAR/SEGMENS
OBSTRUCTIVE-PNEUMONITIS
CHEST X-RAYS : RML
PNEUMONIA (S SIGN +)

TENDENCY TO  THE LOWER/ MIDDLE LOBES


AIR BRONCHOGRAM SIGN
(ABS)

PNEUMONIA/HMD
P
P P
PNEUMONIC ASPIRATION
RML PNEUMONIA
BRONCHOPNEUMONIA
(NON TB)
CHEST X-RAYS DENSITIES
D D
D DDD
D
• PATCHIES
• POORLY DEFINED
• INHOMOGENOUS
• IRREGULAR SCATTERED

C
TENDENCY TO THE LOWER LOBE
ACINUS-CONSOLIDATION
BRONCHOPNEUMONIA
ACINUS

NORMAL
N
BP
BRONCHOPNEUMONIA
RLLL
BILATERAL
BRONCHOPNEUMONIA

PATCHIES
P

IRREGULAR SCATTERED
I
BRONCHOPNEUMONIA
RIGHT PLEUROPNEUMONIA

PNEUMONIA

++ +
P+

PLEURAL EFFUSION
LUNG ABSCESS
• CAVITY WITH ONE CHAMBER
• OR NODUL WITH
• FLUID LEVEL,
• THICK WALL
• IRREGULAR BORDER
LUNG ABSCESS:
AIR FLUID LEVEL
LUL NODUL& ABSCESS

NODUL 33DAYS LATER


3
LUNG ABSCESS
ABSCESS : THICK &
IRREGULAR WALL
ATELECTASIS
• ALVEOLAR COLLAPS
• CAUSED BY :
• MECHANISMS:
• OBSTRUCTION / RESOR PTION
• COMPRESSION/PASSIVE/RELAXATION
• CONSTRICTION / CICATRIZATION
• ADEHESIVE /MICROATELECTASIS
MECHANISME OF
ATELECTASIS
DIRECT SIGN : ATELECTASIS
 CHEST X-RAYS
 DISPLACED SEPTA
 LOSS OF AERATION / RADIOPACITY
OR LOCAL INCREASE IN DENSITY
 VASCULAR & BRONCHIAL SIGNS :
CROWDING BRONCHIAL OR
VASCULAR MARKING
RUL ATELECTASIS
RML ATELECTASIS
INDIRECT SIGN :
ATELECTASIS
• HEMIDIAPHRAGM ELEVATION
• MEDIASTINUM DISPLACEMENT
• HILAR DISPLACEMENT
• COMPENSATORY OVERAERATION
• NARROWING OF THE RIB CAGE
RIGHT & LEFT MASSIVE
ATELECTASIS
AGENESIS OF THE RIGHT &
LEFT LUNG
LUNG EDEMA
• CHEST X-RAYS :
• EDEMA
• INTERSTITIAL
• ALVEOLAR
EDEMA:
RIGHT PERIHILAR HAZE
RADIOLOGY OF THE
ALVEOLAR EDEMA
• CHEST X-RAYS
• BATWING APPEARANCE
• BUTTERFLY APPEARANCE
• HAZINESS
EDEM :BATWING / UREMIC
LUNG
RADIOLOGY OF EDEMA:
BUTTERFLY APPEARANCE
CHEST X-RAYS EDEMA :
NODULES/HAZINESS
CPOD: LUNG EMPHYSEMA

NORMAL CHEST
LOCAL EMPHYSEMA :BULLAE
ALVEOLAR EMPHYSEMA

ALVEOLAR EMPHYSEMA
GIANT BULLAE 
PNEUMATOCELE
LOBAR EMPHYSEMA

PREOPERATIVE POST OPERATIVE


BRONCHIECTASIS-ANATOMY
BROCHIECTASIS : HONEY
COMB APPEARANCE
BRONCHIECTASES
BRONCHOGRAPHY
BRONCHIECTASIS
CHRONIC BRONCHITIS
RESPIRATORY DISTRESS
OF THE NEW BORN (RDN)
• HMD :HYALINE MEMBRANE DISEASES
• LACK OF SURFACTAN PRODUCTION
ALVEOLI COLLAPS
• PREMATUREHIPOXIA CAPILARY
BROKEN HBMEMBRANE
HYALINE MUCOSE OF TBDUCTUS
ALVEOLAR
RDN : HMD / IRDN

HIPOAERATION FINE GRANULARS


H
TUMORS / NEOPLASMS
CHEST X-RAYS
TUMORS
PRIMER
T SECUNDARY/
METASTASE
BENIGN MALIGNANT
BENIGN TUMOR
• CHEST X-RAYS
• SOLITER NODUL ( COIN LESION)
• CALCIFICATIONS
• SMOOTH CONTOUR / MARGIN
BENIGN TUMOR :
CALCIFICATION FORM
NODUL SOLITER
NN
/COIN LESION
MALIGNANT TUMOR
• CHEST X-RAYS :
• SOLITER NODUL
• NO (VERY RARE) CALCIFICATION
• IRREGULAR CONROUR/ MARGIN
• SPECIAL SIGN :
• GOLDEN SIGN
• RIGLER NOTCH SIGN
• EXCENTRIC CAVITY ECT
CT: ADENOCARCINOMA
BRONCHUS
LUNG CARC : VERTEBRAL
DESTRUCTION
 TUMOR METASTASES:
HEMATOGENEOUSLY

• CHEST X-RAYS/CT
• MULTIPLE NODULS
CHEST TUMOR
METASTASE
CT : METASTASEMULTIPLE
NODULS
MEDIASTINAL TUMORS

2.THYMIC TU- 1
MORS 20% 1.NEUROGENIC
TUMORS 20%
22

3.BENIGN 4. LIMPHONO-
CYST 20% NODUS 15%

2
2
MEDIASTINAL TUMORS
5.TERATODERMOID
1
TUMORS 10%

33
6.THYROID TUMORS 5%

7.MESENCHYMAL 5%

8.MISCELLANEOUS MASSES 5%
RADIOLOGY OF THE
MEDIASTINAL TUMORS
• CHEST X-RAYS
• SHARP BORDER
• INCOMPLETE TUMOR BORDER
• TAPERING MARGINS
• COVEXITY TOWARD LUNG
• NOT AFFECT ONPLEURA &RIBS
RADIOLOGY OF MEDIASTINAL
TUMORS
MEDIASTINAL POSTERIOR
TUMOR : NEUROFIBROMA
PLEURAL SPACE

• PLEURAL EFFUSION
• HAEMOTHORAX
• PYOTHORAX / EMPHYEMA
• PNEUMOTHORAX
• HYDROPNEUMOTHORAX
MILD & LAMELLAR PLEURAL
EFFUSION

BLUNT SINUS LAMELLAR EFFUSION


LEFT SUBPULMONARY
EFFUSIONLLD
RO: MODERATE PLEURAL
EFFUSION
• CHEST X-RAYS: ERECT VIEW
• WATER DENSITY
• MENISCUS SIGN
• SINUS & DIAPHRAGM INVISIBLE
MODERATE & MASSIVE
PLEURAL EFFUSION
PNEUMOTHORAX
• AIR IN THE PLEURAL SPACE
• CHEST X-RAYS
• HYPERLUSENHYPERAERATION
• AVASCULER
• MEDIAL LUNG COLLAPS
• WHITE LINE OF THE VISCERAL
PLEURA
LEFT TENSION
PNEUMOTHORAX
TBC &
HYDROPNEUMOTHORAX
RADIOLOGY OF THE
DIAPHRAGMA
• PHRENIC PALSY
• MORGAGNI DIAPHRAMATIC HERNIA
• BOCHDALEK DIAPHRAGMATIC
HERNIA
• TRAUMATIC HERNIA
• CONGENITAL/AGENESIS DIAPHRAGM
HERNIA
PHRENIC PALSY / PARALYSE
CONGENITAL DIAPH HERNIA
T
MERCY BEAUCOUX
M H
A
N
K
TERIMA KASIH

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