Cardiology Imaging kompres.ppt

8/11/2019 Cardiology Imaging kompres.ppt

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Subagia Santoso MD.

Medical FacultyPelita Harapan University

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Basic Conventional Imaging

We do conventional imaging s basic

Imaging : Black and white


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Contrast In Imaging

Black // white

Radio lucent // R Opaque

Hypo echoic // Hyper echoic

Hypo intens // Hyper intens

Lucent

Intermediate

Semi-Lucent

Semi-Opaque

Opaque


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Position photo processing

1. AP / PA

2. Right or Left lateral

2. Oblique , RAO , RPO , LAO and LPO

3. Tangensial : soft tissue4. Rekumben : prone or supine

5. Dekubitus : X ray horizontal direction

6. Semi erect : semi supine


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Photo position diagram


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Chest X Ray

The most important information in conventionalrespiratory imaging


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Ro Imaging Anatomi


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Mediastinum Borders of mediastinum:

Right : Right Lung

Left : Left Lung Anterior : Sternum

Posterior : Vertebrae

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Mediastinum structuresAnterior : Thymus, lymph node

Medial : Heart

Posterior : Oesophagus, Trachea

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Mediastinum abnormalities Pneumomediastinum

In patient with COPD, the air can out from alveolus intosurrounding broncovascular structures and finally entermediastinum through pulmonal hilum.

PA and lateral films show longitudinal lines andradioluscent bubles.

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Mediastinum abnormalities

Mediastinum mass Many variants of tumor origins from mediastinum.

To facilitate you in recognizing the possible mass arisesfrom mediastinum, so mediastinum is divided into 3

areas: Anterior : Upper level : tiromegaly, timoma, teratoma,

adenopathy, aneurysm.

Lower level : pericardium cyst, Morgagni hernia

Middle : bronchogenic cyst, hiatal hernia, esophageal

lesions, adenopathy and aneurysm. Posterior : neurogenic tumors, adenopathy, aneurysm

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Heart Normal anatomy of the heart;

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RA LA

RV LV


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Normal Cardiac Photo

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How to Measure Cardiac Size

Standard

method of

measuring CTRusing a

Posteroanterio

CXR.

CTR=(A+B)/C

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a b


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Normal Blood Pressure Increase Pulmonal Congestion

A. Pulmonal Hypertesion Post-Stenosis Pulmonal Blood Pressure Decrease


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Left Atrium Enlargement Left Ventricle Enlargement

Right Atrium Enlargement Right Ventricle Enlargement


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Pericardial effusion

Water bottle apperancein PA film is a spesificsign of pericardialeffusion.

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Coronary arterial disease Not so useful

But can help to detect the dilatation of heart andcongestion of the lung vessels.

We can see coronary heart disease w/ MSCT or heartcath.

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Left heart failure Left ventricular hyperthopy

Cardiomegaly sign

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Dilatation of superior lobes blood

vessels

Normally in erect position superior lobe vessels issmaller than inferior. And more peripher more sharp.

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vessels Increasing of flows

Etiology

Right to left shunt

Conditions that make Cardiac Outout increase eg anemia,tirotoksikosis

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vessels Congestion of Pulmonal Veins

Etiology

Mitral stenosis

Left heart failure

Atrial myxoma

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Interstitial oedema Pathopysiology

Interstitial oedema can occur due to consistent atrialpressure that make transudation. Transudate fluids flow

into interstitial space and interlobularis connectivetissue and make a line. The line that made is calledKerley line.

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Interstitial oedema

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Kerley lines

There are 3 types of Kerley lines

Type A : long, unbranched, and go to the hilum

Type B : short, tine, best showed at costophrenic angle Type C : soft, reticular form

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Kerley B Lines

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Interstitial oedema etiologies Pulmonal arterial hypertension

Etiology

COPD

Recurent pulmonal emboli

Post-stenosis dilatation

Reducing of flows

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Intra-alveolar oedema Is a continue from interstitial oedema. The fluids will

accumulate at alveolar space.

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Cardiology Imaging kompres.ppt