Lydia Kuntjoro

ANATOMY

SIGN AND PATTERN OF LUNG DISEASE

PULMONARY EMBOLI

HUMPTON HUMP EMBOLUS

AIR BRONCHOGRAM

SIGN AND PATTERN OF LUNG DISEASE

AIR BRONCHOGRAM

INTERSTITIAL LUNG DISEASE

LINIER

NODULER

histoplasmosis and reticulonodular

Reticuler , honeycomb/ bronchiectasis

ALVEOLAR LUNG DISEASE

focal airspace opacity

MEDIASTINAL MASS
thymoma

lymphoma

MEDIASTINAL MASS.

PULMONARY NODUL
Primary adenocarcinoma

Benign lymph node

PULMONARY NODUL.

Cervical carcinoma metastases

Descending aortic laceration Pulmonary laceration pneumothorax (P)

RIB FRACTURE

PLEURA,CHEST WALL, DIAPHRAGMA

PLEURA

Subpleural squamous cell bronchogenic carcinoma mass is contiguous with the pleural surface

PLEURA.

Pleural & pericardiac effusion

empyema

Pleural calcification due to old TB empyema

mesothelioma

CHEST WALL

consists of skin, subcutaneous tissues, muscles, clavicles, scapulae, ribs, sternum, and spine

Sternal metastasis

Osteochondroma

ATELECTASIS

Right upper lobe segmental atelectasis

LUNG TUMOR
TNM STAGGING FOR BRONCHOGENIC CA Liver Adrenal COMMON EXTRATHORACIC SITES Bone FOR METASTASES Brain

TYPE OF BRONCHOGENIC CA

A: PA chest radiograph of a 48-year-old man shows an irregular mass in the right upper lobe abutting the mediastinum. B: CT shows the mass extending into the mediastinum. The center of the mass is of low attenuation, secondary to tumor necrosis. C: CT at a more inferior level shows tumor along the posterior wall of the right upper lobe bronchus. D: CT with lung windowing shows the spiculated mass and a background of paraseptal and centrilobular emphysema.

TNM STAGGING FOR BRONCHOGENIC CA

TNM STAGGING FOR BRONCHOGENIC CA

High Resolution CT (HRCT)

very thin (1-2 mm) axial sections of the chest. The sections are spaced 10-15 mm ( 20-25 percent of the lung is sampled) The images are viewed on suitable lung windows (Level -500 to -750, width 1000 to 1500). volume imaging allowing contiguous slices

High Resolution CT (HRCT)

Indication : diffuse lung disease , investigate resoiratory symptom when the chest x-rays are normal Exp : idiopatic interstitial pneumonia, emphysema, idiopathic pulmonary fibrosis, lymphangitis carcinomatosis, sarcoidosis, Langerhans cell histiocytosis, lymphangiomyomatosis, sub-acute hypersensitivity pneumonitis

High Resolution CT (HRCT)

HRCT is not suitable for focal diseases such as lung cancer. sensitivity of HRCT to detect interstitial lung disease is approximately 94%

HIGH RESOLUTION CT (HRCT)

FOR DIFFUSE LUNG DISEASE MOST IMPORTANT : BREATH HOLD

POOR

GOOD

FULL INSPIRATION

EXPIRATION IMAGES ( SOME CASES)

EMPHYESEMA

1mm OR SMALLER SLICE THICKNESS

Centrilobular emphysema

Cystic lung disease In lymphangioleiomyomatosis

patchy ground-glass opacity In interstitial pneumonitis lymphangitic carcinomatosis metastasis