HighResolution Chest CT Practical Clinical Applications Paul L
- Slides: 76
High-Resolution Chest CT: Practical Clinical Applications Paul L. Molina, M. D. Department of Radiology University of North Carolina at Chapel Hill
Disclosures None
Objectives • Identify current clinical indications for the use of HRCT • Review proper technique for performance of HRCT • Summarize the characteristic patterns of abnormality seen on HRCT and the most common diseases resulting in their formation
HRCT - Indication • Evaluation of patients with suspected infiltrative lung disease but normal or nonspecific findings on CXR
HRCT - Indication • Further characterization of known or suspected diffuse lung disease
HRCT - Indication • Evaluation of patients in whom radiographic findings are not in keeping with clinical findings or pulmonary function tests
HRCT - Indication • Delineation of disease prior to lung biopsy as a guide to the optimal type and site of biopsy
HRCT Technique • Thin collimation (1 mm) • High spatial frequency reconstruction • Windows -700/1000 -1500 HU • • Prone scans – differentiate atelectasis Expiratory scans – air trapping
HRCT Findings • Septal thickening • Reticular densities • Nodules • Increased lung opacity • Decreased lung opacity
Septal Thickening • Pulmonary edema • Lymphangitic carcinomatosis • Sarcoidosis • Asbestosis • Idiopathic pulmonary fibrosis
Reticular Densities • Idiopathic pulmonary fibrosis • Collagen vascular disease • Asbestosis • Chronic hypersensitivity pneumonitis • Sarcoidosis
UIP
Nodular Opacities • Sarcoidosis • Silicosis • Coal worker’s pneumoconiosis • Hypersensitivity pneumonitis • Tuberculosis • Metastatic disease
Nodular Opacities • Perilymphatic nodules • Random distribution • Centrilobular nodules
Perilymphatic Nodules • Sarcoidosis • Silicosis • Lymphangitic Ca
Silicosis
Random Nodules • Miliary TB • Hematogenous mets m
Metastatic adenoca
Centrilobular Nodules • Endobronchial spread of TB or other infection • Hypersensitivity pneumonitis • Endobronchial tumor spread
Nodular Opacities • Perilymphatic nodules • Random distribution • Centrilobular nodules
Increased Lung Opacity • Ground-glass opacity • Air-space consolidation
Ground-glass Opacity • Hypersensitivity pneumonitis (subacute) • Desquamative interstitial pneumonitis • Non-specific interstitial pneumonitis • Sarcoidosis • Alveolar proteinosis
DIP
Non-specific Interstitial Pneumonitis
Crazy-Paving Alveolar Proteinosis
Mosaic Pefusion
Consolidation • Obscures underlying vessels • Solid, opaque • Air bronchograms
Consolidation • Chronic eosinophilic pneumonia • BOOP / COP • Bronchoalveolar cell carcinoma • Lymphoma
Chronic Eosinophilic Pneumonia
BOOP / COP
Decreased Lung Opacity • Emphysema • Cystic airspaces • Mosaic perfusion
Cystic Airspaces • Lymphangioleiomyomatosis (LAM) • Langerhans Cell Histiocytosis (EG) • End-stage (honeycomb) lung
LAM
EG
HRCT - Indications • Suspected infiltrative disease but normal or nonspecific CXR • Further characterize diffuse disease • CXR findings not in keeping with clinical findings or PFT’s • Guide type and site of biopsy
HRCT Findings • Septal thickening • Reticular opacities • Nodular opacities • Increased lung opacity • Decreased lung opacity
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- Chest oblique view
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- Q wave in ecg
- Seekers quorum chest
- Septae
- Latrogenis
- Deadly dozen itls
- Chest tube chamber
- 5-lead ecg placement colors
- Chest tube parts
- Chest x-ray anatomy
- Pressure points of supine position
- 50 shades of chest pain
- Klinefelter syndrome in females
- Bones of the vertebral column
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- Hypogammaglobulenemia
- Chest ais
- Chest quadrants
- Audio compression test
- Body positioning nursing
- Lung assessment landmarks
- Helminthology notes
- Cpr tutorial
- Tactile fremitus increased
- Dullness percussion sound
- Ellis s curve pleural effusion
- Tactile fremitus
- Petmac chest pain
- Cardiothoracic
- Chest wiggle factor
- Rash on upper chest and back
- Regio thorax
- Angina care plan
- Costochondritis
- Posterior thorax
- Urticaria classification
- Vena cava syndrome
- Atheromatous thoracic aorta
- Head body head body gif
- Chest pain in pediatrics
- Subcostales
- How to read growth chart
- Kontusio paru radiologi
- Agnosist
- Barrel chest
- Juxtaductal position
- Chest tube suture
- Typical vs atypical chest pain
- Heart sounds on chest
- Michael r. jackson
- Bilateral chest tubes
- Tactile fremitus
- Narmer king of egypt
- Chest fy
- Fowler's position angle
- Deep chest muscles
- Fascia clavipectoralis
- Chapter 23 of the scarlet letter
- Flail chest symptoms
- Knee chest position
- Ellis curve on chest x ray
- Chemical pleurodesis
- Suprapleural membrane
- Chest pediatric pulmonary board review
- Chest pain location chart
- Typical chest pain
- Chest compressions
- Causes chest pain
- Infant cpr algorithm
- Trauma tumpul thorax