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ObjectivesTheBasicsApproachtointerpretationAnatomyInterstitaldiseaseAlveolardiseasePatternRecognitionPractice!1CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025InterpretationUseasystematicapproachUseordeveloponeyoulikeUsethesameapproacheverytimeDescribewhatyouseeFormadifferentialbasedonpatientpresentationandappearanceofx-rayIfyoufindanabnormality,don’tstopthereFinishyoursystematicreadingThesecondlesionisoftenmissed2CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025SystematicApproachABCDEAirway(trachea)Midlinev.deviatedorrotated,FBintrachea,ETtubepositionBones(clavices,ribs,humeri,etc)CardiomediastinalsilhoutteDiaphragms(andthecostophrenicangles)EverythingElse(lungfields,softtissues,tubes,lines,wires,devices,etc)3CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025NormalChestRadiograph4CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025TracheaRightmainstembronchusLeftmainstembronchusPulmonaryarteryPulmonaryarteryAorticknobLeftventricleRightatriumAnatomy5CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025LefthemidiaphragmRightcostophrenicangleStomachUpperlobesMiddlelobeLingulaLowerLobesAnatomy6CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025LowerlobesUpperlobesRightmiddlelobeLingula

7CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025CommonViewsPAAPLeftLateralRightanteriorobliqueAPsupineRightlateraldecubitusPortableCXRPA/LateralCXR8CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025ThesearefromtheSamePatient

Explainthedifference…..9CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025PAAPAlwaysgetaPAfilmtoavoidcardiacmagnificationExceptions:trauma,activecardiacchestpain,unstable,unabletocooperatewithprocedure10CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025SilhouetteSignTwosubstancesofthesamedensity,indirectcontact,cannotbedifferentiatedfromeachotheronx-rayCommonlocationsLowerlobes-diaphragmsRightheartborder–RMLLeftheartborder–LingulaLeftdiaphragm–Heart(onlateralview)11CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025AirBronchogramSignVisualizationofairintheintrapulmonarybronchiAbnormalDenotesapulmonarylesion/consolidation(excludesapleuralormediastinallesion)Seeninpneumonia,pulmonaryedemaorpulmonaryinfarctAnairbronchogramwithintheheartshadowsuggestsLLLconsolidationSilhouettesign12CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025InterstitialLungDiseaseThevessels(lungmarkings)appearmoreprominentAlveoliarestillaeratedDDx:Pulmonaryedema,inflammation,tumor,fibrosis13CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025AlveolarDiseaseVesselsarelessvisibleintheareaofdiseaseLungisnotaeratedMayhaveairbronchogramsorsilhouettesignDDx:Bacterialpneumonia,pulmonaryedema14CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025Let’sPracticeWhattypeoffilmDescribewhatyouseeConsolidation,infiltrate,nodular,diffuse,streaky,opacificationLookforSilhouettesignandairbronchogramsIsitaninterstitialoralveolarpatternOtherfindings…Givedifferentialordiagnosis15CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/202575yoFwithhxofMInowpresentingwithSOB,hypoxia16CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025Pulmonaryedema17CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/202518CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025Opacificationofrighthemithorax,obscuredlefthemidiaphramDDx:Massivepleuraleffusion,rightpneumonectomy19CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/202520CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025MultipleRsidedribfractures–flailchest21CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025

22CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025

Opacificationoflefthemithorax,air-fluidlevelinleftupperlobe,leftclavicularfractureDiagnosis:LeftempyemaaftertraumaAir-fluid(cavitary)lesion23CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025SamepatientLateralview

Air-fluidlevel24CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/202548yoMwithhxofPUDpresentingwithabdominalpain25CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025pneumoperitoneum26CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/202567yosmokerwithoneweekofcough,sob,fevers27CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025Leftlowerlobepneumonia28CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025“SpineSign”/imgresimgurl=/content/RSP/2006/07/img/Case_pneum_1.jpg&imgrefurl=/issues/articles/2006-07_02.asp&h=572&w=580&sz=72&hl=en&start=23&um=1&tbnid=wBsgta58mO7XPM:&tbnh=132&tbnw=134&prev=/images%3Fq%3Dleft%2Blower%2Blobe%2Batelectasis%26start%3D21%26ndsp%3D21%26um%3D1%26hl%3Den%26sa%3DN29CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/202530CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025Dx:Subcutaneousairinneckandshoulderandpneumomediastinum(leftheartborder)31CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/202532CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025Lackoflungmarkingsonright,collapsedlungDx:CompleterightpneumothoraxCollapsedlungIsitatensionpneumothorax33CXRInterpretation胸部醫(yī)學(xué)影像解讀1/22/2025NO!TensionPneumothoraxMediastinumisshiftedtooppositesiteofpneumothoraxLookattracheaandbronchiLookatheartYourpatientis

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