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Radiology Review

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					Radiology Review

  November 3, 2006
Case #1
                 Questions
•   Description?
•   Symptoms?
•   Diagnosis?
•   What to do for the patient?
        Answers to Case #1
• Cardiomegaly, prominent pulmonary
  vasculature bilaterally, cephalization of
  vessels
• Dyspnea, orthopnea
• Pulmonary edema
• Aggressive diuresis
Case #2
                Questions
•   Description?
•   Symptoms?
•   Diagnosis?
•   Most common risk factor?
        Answers to Case #2
• Intimal flap, differential contrast
  enhancement of true vs. false lumen,
  mediastinal widening
• Sharp, tearing chest/back pain
• Aortic dissection
• Hypertension
Case #3
                 Questions
•   Description?
•   Symptoms?
•   Diagnosis?
•   What to do for the patient?
        Answers to Case #3
• Focal area of consolidation obscuring the
  right heart border
• Fever, white count, productive cough
• RML pneumonia
• Antibiotics
         Tips for Pneumonia
• RML and lingular PNA obscure the heart
• Lower lobe infiltrates obscure the
  diaphragm
• Think aspiration if there is a rapid onset
  (and esp. if it is right lobe or bilateral)
• Look for air bronchograms!!
Case #4
                  Questions
•   Description?
•   Symptoms?
•   Diagnosis?
•   What to do for the patient?
•   Why is this not heart failure?
          Answers to Case #4
•   Diffuse bilateral alveolar infiltrates
•   Dyspnea, tachypnea
•   ARDS
•   Ventilatory support
•   Heart is normal, pay attention to history
Case #5
                   Questions
•   Description?
•   Symptoms?
•   Diagnosis?
•   Risk factor?
        Answers to Case #5
• Increased lung volume (hyperinflated),
  flattened diaphragms, long thin heart
• SOB
• Emphysema
• Smoking
Case #6
                 Questions
•   Description?
•   Symptoms?
•   Diagnosis?
•   What to do for the patient?
        Answers to Case #6
• Hyperlucent right hemithorax, no lung
  markings, ipsilateral lung edge seen
  parallel to chest wall
• Dyspnea
• Pneumothorax
• Chest tube
Case #7
                 Questions
•   Description?
•   Symptoms?
•   Diagnosis?
•   What to do for the patient?
        Answers to Case #7
• White out of lower 2/3 of left hemithorax
  with meniscus, deviation of airway and
  heart to contralateral side
• Dyspnea, may have fever and white count
  if infected, may have symptoms related to
  malignancy, may have CHF
• Left sided pleural effusion
• Thoracocentesis, chest tube for empyema
Case #8
                  Questions
•   Description?
•   Symptoms?
•   Diagnosis?
•   What is the likely progression of this
    disease?
        Answers to Case #8
• Focal lesion of soft tissue density in the
  left lung
• May have weight loss and other symptoms
  of malignancy or may be asymptomatic
• Lung cancer
• Metastases to adrenal glands, liver, brain,
  bone
Case #9
                 Questions
• Description?
• Symptoms?
• Diagnosis?
        Answers to Case #9
• Multiple bilateral round masses of soft
  tissue density and with sharp margins,
  also referred to as canon ball lesions
• Likely symptoms of malignancy such as
  weight loss, anorexia, fatigue
• Metastases to the lungs
                   Topics
•   Pulmonary edema
•   Aortic dissection
•   Pneumonia
•   ARDS
•   COPD
•   Pneumothorax
•   Pleural effusion
•   Primary lung cancer
•   Pulmonary metastases

				
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