Professional Documents
Culture Documents
Peter Santos
Radiologist and Nuclear Medicine Specialist
Aims
Structure : Anatomy
Systematic Approach to Reading a CXR=Search Pattern
Lines and tubes
Emergency and common pathologies : consolidation,
pleural effusion, pneumothorax, fluid overload, mass,
asthma
PACS Tips and Tricks
Questions
What are the lobes of the lungs?
Anatomy
Anatomy
Disclosures
Search Pattern
ETT
Tip 5 cm above carina
Just above the aortic
knuckle
2cm of movement
Neck flexion/extension
Pleural tubes
Thoracostomy, chest, tubes or
intercostal catheters
10-40Fr
Position
Pneumothorax
Anterosuperior
Pleural fluid
Posteroinferior
Malpositioned
Ptx or effusion still present
Fissures
Lung
Proximal side hole
Kinked
Tip mediastinum
Hunter T B et al. Radiographics 2004;24:1725-1746
Nasogastric
Tip below diaphragm
Venous catheters
Inferior SVC
Cavoatrial junction
1 VB below carina
SVC crosses the right
main bronchus
L brachiocephalic vein
Avoid tips at junctions
How to present
This is a frontal chest xray in a X year old man/woman
who presented with Y
Lets go
Warm Up
Warm Up
Warm Up - Tips
Warm Up - 2
Warm Up - 3
Warm Up - 3
Case 1
Case 2
Case 3
Case 4
Case 5
Case 6
Case 7
Cases
Case 8
Case 9
Case 10
Case 11
Radiation
Dose (background
equivalent)
Chest X ray
2 days
10 days
10 days
VQ scan
11 months,
if preg 4 months
sestaMIBI stress
1.3 years
Coronary CT
1.3 years
Bone Scan
1.8 years
CTPA
2 years
CT Brain
10 months
Coronary Angiogram
2 6.8 years
To Order or Request?
CONCLUSION
1) Reading chest radiographs is an important skill
2) Systematic approach
3) If in doubt, please contact radiology
References
ACKNOWLEDGEMENTS
Dr Phillip Tran (Radiologist)
Western Health Medical Imaging
THANK YOU
Email : peter.santos@wh.org.au