Difference between revisions of "CT of the thorax"

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{{Authors
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|author1=[[User:Mikael Häggström|Mikael Häggström]]
 
|author1=[[User:Mikael Häggström|Mikael Häggström]]
 
|author2=
 
|author2=
 
}}
 
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==Normal anatomy==
 
==Normal anatomy==
[[File:High-resolution computed tomographs of a normal thorax (thumbnail).jpg|thumb|center|link=HRCT of a normal thorax|High-resolution computed tomographs of a normal thorax, taken in the axial, coronal and sagittal planes, respectively. {{noprint|[[HRCT of a normal thorax|Click here to scroll through the image stacks.]]}}]]
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[[File:High-resolution computed tomographs of a normal thorax (thumbnail).jpg|thumb|center|link=Commons:Scrollable high-resolution computed tomography images of a normal thorax|High-resolution computed tomographs of a normal thorax, taken in the axial, coronal and sagittal planes, respectively. {{noprint|[[Commons:Scrollable high-resolution computed tomography images of a normal thorax|Click here to scroll through the image stacks.]]}}]]
 +
 
 +
==Regions==
 +
<gallery>
 +
File:CT of the heart.jpg|link=CT of the heart|[[CT of the heart|CT of the '''heart''']]
 +
</gallery>
  
 
==Angiography==
 
==Angiography==
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*Pulmonary veins
 
*Pulmonary veins
 
:*[[CT of pulmonary embolism|CT of '''pulmonary embolism''']]
 
:*[[CT of pulmonary embolism|CT of '''pulmonary embolism''']]
 +
 +
==Basic screening==
 +
*'''Lung parenchyma''': Scan for opacities, preferably at a [[maximum intensity projection]] of about 8 mm in order to detect any lung nodules (if found, see '''[[CT of lung nodules]]''').<ref name="KawelSeifert2009">{{cite journal|last1=Kawel|first1=Nadine|last2=Seifert|first2=Burkhardt|last3=Luetolf|first3=Marcus|last4=Boehm|first4=Thomas|title=Effect of Slab Thickness on the CT Detection of Pulmonary Nodules: Use of Sliding Thin-Slab Maximum Intensity Projection and Volume Rendering|journal=American Journal of Roentgenology|volume=192|issue=5|year=2009|pages=1324–1329|issn=0361-803X|doi=10.2214/AJR.08.1689}}</ref>
 +
*'''Pleura''', for any fluid in the dorsal parts
 +
*'''Skeleton''': Any signs of damage.
 +
*'''Lymph''' nodes in mediastinal, hilar and axial areas. ''If possibly enlarged, see '''[[CT of thoracic lymphadenopathy]]'''
 +
*Visible '''abdominal''' volumes for any expansions or focal changes in the liver, adrenals or spleen.
 +
 +
===Report===
 +
Even absence of:
 +
*Opacities in the lung parenchyma.
 +
*Pleural fluid.
 +
 +
{{Reporting}}
  
 
==Diseases==
 
==Diseases==
*[[CT of pulmonary embolism]]
+
;Lungs
 +
*[[CT of lung nodules|CT of '''lung nodules''']]
 +
 
 +
;Vascular
 +
*[[CT of pulmonary embolism|CT of '''pulmonary embolism''']]
 +
*[[CT of superior vena cava syndrome|CT of '''superior vena cava syndrome''']]
  
===Lymphadenopathy===
+
;Lymph nodes
{|class="wikitable"
+
*[[CT of thoracic lymphadenopathy|CT of thoracic '''lymphadenopathy''']]
|+ Definition by size
 
|-
 
| Mediastinum, generally || 10 mm<ref name=Torabi2004>{{cite journal | vauthors = Torabi M, Aquino SL, Harisinghani MG | title = Current concepts in lymph node imaging | journal = Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine | volume = 45 | issue = 9 | pages = 1509–18 | date = September 2004 | pmid = 15347718 }}</ref><ref name=Saba2016>[https://books.google.com/books?id=q7v1CwAAQBAJ&pg=PA432 Page 432] in: {{cite book|title=Image Principles, Neck, and the Brain|author=Luca Saba|publisher=CRC Press|year=2016|isbn=9781482216202}}</ref>
 
|-
 
| Superior mediastinum and high paratracheal || 7mm<ref name="SharmaFidias2004"/>
 
|-
 
| Low paratracheal and subcarinal || 11 mm<ref name="SharmaFidias2004">{{cite journal|last1=Sharma|first1=Amita|last2=Fidias|first2=Panos|last3=Hayman|first3=L. Anne|last4=Loomis|first4=Susanne L.|last5=Taber|first5=Katherine H.|last6=Aquino|first6=Suzanne L.|title=Patterns of Lymphadenopathy in Thoracic Malignancies|journal=RadioGraphics|volume=24|issue=2|year=2004|pages=419–434|issn=0271-5333|doi=10.1148/rg.242035075}}</ref>
 
|-
 
|}
 
  
 
===Pulmonary hypertension===
 
===Pulmonary hypertension===
 
The presence of a dilated main pulmonary artery of 29 mm or more in combination with an artery–to-bronchus diameter ratio of 1:1 or more at segmental level in three or four lobes, confers a specificity of 100% for the presence of pulmonary hypertension.<ref name="PeñaDennie2012">{{cite journal|last1=Peña|first1=Elena|last2=Dennie|first2=Carole|last3=Veinot|first3=John|last4=Muñiz|first4=Susana Hernández|title=Pulmonary Hypertension: How the Radiologist Can Help|journal=RadioGraphics|volume=32|issue=1|year=2012|pages=9–32|issn=0271-5333|doi=10.1148/rg.321105232}}</ref>
 
The presence of a dilated main pulmonary artery of 29 mm or more in combination with an artery–to-bronchus diameter ratio of 1:1 or more at segmental level in three or four lobes, confers a specificity of 100% for the presence of pulmonary hypertension.<ref name="PeñaDennie2012">{{cite journal|last1=Peña|first1=Elena|last2=Dennie|first2=Carole|last3=Veinot|first3=John|last4=Muñiz|first4=Susana Hernández|title=Pulmonary Hypertension: How the Radiologist Can Help|journal=RadioGraphics|volume=32|issue=1|year=2012|pages=9–32|issn=0271-5333|doi=10.1148/rg.321105232}}</ref>
  
==References==
+
{{Bottom}}
{{reflist}}
 

Latest revision as of 09:06, 17 September 2019

Author: Mikael Häggström [notes 1]

Normal anatomy

High-resolution computed tomographs of a normal thorax, taken in the axial, coronal and sagittal planes, respectively.

Regions

Angiography

CT angiography of the thorax is a contrast CT exam, tailored to the proper contrast phase depending on the level of the suspected condition by the referring clinician:

  • Veins from contrast infusion
  • Pulmonary veins

Basic screening

  • Lung parenchyma: Scan for opacities, preferably at a maximum intensity projection of about 8 mm in order to detect any lung nodules (if found, see CT of lung nodules).[1]
  • Pleura, for any fluid in the dorsal parts
  • Skeleton: Any signs of damage.
  • Lymph nodes in mediastinal, hilar and axial areas. If possibly enlarged, see CT of thoracic lymphadenopathy
  • Visible abdominal volumes for any expansions or focal changes in the liver, adrenals or spleen.

Report

Even absence of:

  • Opacities in the lung parenchyma.
  • Pleural fluid.
See also: General notes on reporting

Diseases

Lungs
Vascular
Lymph nodes

Pulmonary hypertension

The presence of a dilated main pulmonary artery of 29 mm or more in combination with an artery–to-bronchus diameter ratio of 1:1 or more at segmental level in three or four lobes, confers a specificity of 100% for the presence of pulmonary hypertension.[2]

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.

References

  1. Kawel, Nadine; Seifert, Burkhardt; Luetolf, Marcus; Boehm, Thomas (2009). "Effect of Slab Thickness on the CT Detection of Pulmonary Nodules: Use of Sliding Thin-Slab Maximum Intensity Projection and Volume Rendering ". American Journal of Roentgenology 192 (5): 1324–1329. doi:10.2214/AJR.08.1689. ISSN 0361-803X. 
  2. Peña, Elena; Dennie, Carole; Veinot, John; Muñiz, Susana Hernández (2012). "Pulmonary Hypertension: How the Radiologist Can Help ". RadioGraphics 32 (1): 9–32. doi:10.1148/rg.321105232. ISSN 0271-5333.