實戰課題Medical Internship Topic 7: CXR案例判讀
* All pictures from https://radiopaedia.org, just for learning purpose1. Atelectesia
- Displacement of fissure
- Bronchovascular crowding
- Increase opacity
https://openi.nlm.nih.gov/detailedresult.php?img=PMC2823759_1752-1947-4-17-1&req=4
* Juxtaphrenic peak sign(peaked or tented appearance of a hemidiaphragm which can occur in the setting of lobar collapse): mostly upper lobe atelectasia
* Reverse S sign=Golden S sign: upper lobe atelectasia
* Luftsichel sign: LUL lung collapse
* Flat waist sign: LLL lung collapse
http://posterng.netkey.at/esr/viewing/index.php?module=viewing_poster&task=viewsection&pi=28734&ti=86331&searchkey=
* Paraesophageal line deviation, azygoesophagus recess
2. Hilar obstruction: DDx
- Sputum
- Tumor
- TB
- LN
3 Lung lobules
http://slideplayer.com/slide/9428451/29/images/2/Lung+Unit+Acinus+:+That+
part+of+the+lung+supplied+by+a+terminal+bronchiolus.+This+includes+
respiratory+bronchioli,+alveolar+ducts,+and..jpg
4. Descriping lung lesions:
- Fluffy margin
- Early coalescence
- Alveologram
- Rapid timing(?)
5. Cryptococcus pneumonia
- Lower lungs, nodules, air bronchogram
6. Slow in progress nodules
- BAC( a kind of adenocarcinoma)
- Lymphoma
- Autoimmune related, inflammation
7. Describing lung nodules
- 2S: size, shape
- 3C: calcification, cavitation, contrast
- DOA: doubling time, density, other, area, age
- scalloped(lobulated), corona radiata, rabbit ears, rat tail sign, pleural tag sign, eccentric cavitation, thick wall(>16mm? ex: SCC with cavitation)
8. DDx of lung nodules/masses
- H: hema(spread by blood)
- I: infection
- I: inhalation
- N: neoplasm
9. Fungus ball: aspergiilus
10. Bronchogenic cyst: homogenous, smooth
11. Calcifications:
good signs- popcron(harmatoma), diffuse, laminated, central nidus
bad signs- eccentric, strippled
Ring- teratoma, thymogenic cyst
12. Congenital pulmonary airway malformations (multicystic, bronchial proliferation)
13. Lung sequestration
- Often triangular
14. Varicella pneumonia
- Fast
- Skin rashes, vesicles
- Calcification(+)
DDx: miliary TB
15. GGO
- Viral
- Clamydia
- Legionella
- Cryptococcus
- PJP
16. Proteinosis, PJP in AIDS
- Long term
- Crazy paving
- Reticular
DDx: PAS(+), milky BAL in proteinosis
17. LAM(lymphangioleiomyomatosis)
- Penumothorax
- Chylothorax
- Young people
18. Thymoma
- Anterior mediastinum
- Calcification(-)
19. EMH (extramedullary hematopoiesis)
- Bilateral
- Paraspinal rib widening
20. Hilum overlay
21. Asbestosis (associated with mesothelioma)
22. Diaphragm hernia
Morgagni hernia: right, anterior
Bochdalek hernia: left, posterior
