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You searched for: Creator Anurag Agarwal, MD, Radiologist, NBE Remove constraint Creator: Anurag Agarwal, MD, Radiologist, NBE File Format png (Portable Network Graphics) Remove constraint File Format: png (Portable Network Graphics) Subject Diagnostic Techniques and Procedures Remove constraint Subject: Diagnostic Techniques and Procedures
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  1. X-ray (chest), PA, Pericardial Effusion, Adult Male, Answers

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    Description: 1. Cardiomegaly with water bottle sign. The widest diameter of the heart (A) is compared with the width of half the thorax at its widest point (B). This is known as the cardiothoracic ratio. The normal heart should be less than the diameter of the hemithorax (see the normal comparison study). This should be measured on an upright PA radiograph with adequate inspiration (Right cardiophrenic junction overlies 10th and 11th ribs posteriorly). AP portable studies, poor inspiration, patient rotation, and the patient not in an upright position can cause falsely elevated estimation of heart size. This example study does not have technically adequate inspiration as it shows only to the 9th rib. 2. Note also the pericardium has sagged like a water balloon that has been set on a table. Note the distortion of the normal contours of the heart visible on the comparison study. This is described as a “water bottle” shaped heart. This finding is associated with very large, slowly accumulating pericardial effusions. It is not sensitive for small, rapidly developing hemodynamically significant pericardial effusion. An acute, rapidly developing pericardial effusion that is causing cardiac tamponade frequently presents with a normal size heart on the chest radiograph.
    Keywords: Diagnostic X-Ray, Radiology, Diagnostic X-Ray, Diagnostic X-Ray Radiology, X-Ray, Diagnostic, Diagnosis, Hemopericardium, Chylopericardium, X-Ray Radiology, Diagnostic, Roentgenography, Radiography

  2. X-ray (chest), PA, Pericardial Effusion, Adult Male

    show more
    Description: 1. Cardiomegaly with water bottle sign. The widest diameter of the heart (A) is compared with the width of half the thorax at its widest point (B). This is known as the cardiothoracic ratio. The normal heart should be less than the diameter of the hemithorax (see the normal comparison study). This should be measured on an upright PA radiograph with adequate inspiration (Right cardiophrenic junction overlies 10th and 11th ribs posteriorly). AP portable studies, poor inspiration, patient rotation, and the patient not in an upright position can cause falsely elevated estimation of heart size. This example study does not have technically adequate inspiration as it shows only to the 9th rib. 2. Note also the pericardium has sagged like a water balloon that has been set on a table. Note the distortion of the normal contours of the heart visible on the comparison study. This is described as a “water bottle” shaped heart. This finding is associated with very large, slowly accumulating pericardial effusions. It is not sensitive for small, rapidly developing hemodynamically significant pericardial effusion. An acute, rapidly developing pericardial effusion that is causing cardiac tamponade frequently presents with a normal size heart on the chest radiograph.
    Keywords: Roentgenography, Diagnostic X-Ray, X-Ray Radiology, Diagnostic, Chylopericardium, Diagnosis, X-Ray, Diagnostic, Radiology, Diagnostic X-Ray, Radiography, Diagnostic X-Ray Radiology, Hemopericardium

  3. X-ray (chest), PA, Pericardial Effusion, Adult Male, Numbered

    show more
    Description: 1. Cardiomegaly with water bottle sign. The widest diameter of the heart (A) is compared with the width of half the thorax at its widest point (B). This is known as the cardiothoracic ratio. The normal heart should be less than the diameter of the hemithorax (see the normal comparison study). This should be measured on an upright PA radiograph with adequate inspiration (Right cardiophrenic junction overlies 10th and 11th ribs posteriorly). AP portable studies, poor inspiration, patient rotation, and the patient not in an upright position can cause falsely elevated estimation of heart size. This example study does not have technically adequate inspiration as it shows only to the 9th rib. 2. Note also the pericardium has sagged like a water balloon that has been set on a table. Note the distortion of the normal contours of the heart visible on the comparison study. This is described as a “water bottle” shaped heart. This finding is associated with very large, slowly accumulating pericardial effusions. It is not sensitive for small, rapidly developing hemodynamically significant pericardial effusion. An acute, rapidly developing pericardial effusion that is causing cardiac tamponade frequently presents with a normal size heart on the chest radiograph.
    Keywords: Radiography, Roentgenography, Diagnostic X-Ray, X-Ray, Diagnostic, Radiology, Diagnostic X-Ray, Chylopericardium, Hemopericardium, Diagnosis, Diagnostic X-Ray Radiology, X-Ray Radiology, Diagnostic

  4. X-ray (chest), PA, With Annotations, Adult Male, Normal

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    Description: (A) right clavicle (B) right scapula (C) right fourth anterior rib (D) right costophrenic angle (E) left lung apex (F) aortic arch (G) hilum (H) heart (I) left lung base (J) right hemidiaphragm (white arrow)
    Keywords: Radiography, Thoraces, Chest, Diagnostic X-Ray, Roentgenography, X-Ray, Diagnostic, Diagnosis, Radiology, Diagnostic X-Ray, Diagnostic X-Ray Radiology, X-Ray Radiology, Diagnostic

  5. X-ray (chest), PA, With Annotations, Adult Male, Normal

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    Description: (A) right clavicle (B) right scapula (C) right fourth anterior rib (D) right costophrenic angle (E) left lung apex (F) aortic arch (G) hilum (H) heart (I) left lung base (J) right hemidiaphragm (white arrow)
    Keywords: X-Ray Radiology, Diagnostic, Diagnosis, Radiology, Diagnostic X-Ray, Thoraces, Radiography, Diagnostic X-Ray Radiology, Roentgenography, Diagnostic X-Ray, Chest, X-Ray, Diagnostic

  6. X-ray (chest), PA, Thymoma Invasive, Adult Male

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    Description: 1. Mediastinal mass with compression of trachea. Note that the mass silhouettes the superior aspect of the right heart border and superior vena cava suggesting it abuts or is anterior to these structures. Also note the roughly "sail-sign" like triangular shape with the inferior margin terminating at the inferior base of the hilum, a configuration similar to that seen when the thymus is visible on a pediatric radiograph. 2. Elevation of the right hemidiaphragm likely due to bronchogenic obstruction and associated volume loss given the increased opacity and plate-like atelectasis changes of the right lung parenchyma. Also could be due to injury to the right phrenic nerve. Note the marked overall lung volume loss and increased density of lung markings suggestive of bronchogenic obstruction. 3. Oblique fissure right lung. 4. Blunting of the right costophrenic angle consistent with a pleural effusion. In general it takes about 200-300 ml of fluid to cause blunting of the costophrenic angle. 5. Thickened, distorted horizontal fissure vs. plate-like atelectasis due to obstructed bronchus.
    Keywords: X-Ray Radiology, Diagnostic, Roentgenography, Diagnostic X-Ray Radiology, Diagnostic X-Ray, Radiology, Diagnostic X-Ray, X-Ray, Diagnostic, Diagnosis, Carcinoma, Thymic, Neoplasms, Neoplasms by Histologic Type, Radiography

  7. X-ray (chest), PA, Thymoma Invasive, Adult Male

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    Description: 1. Mediastinal mass with compression of trachea. Note that the mass silhouettes the superior aspect of the right heart border and superior vena cava suggesting it abuts or is anterior to these structures. Also note the roughly "sail-sign" like triangular shape with the inferior margin terminating at the inferior base of the hilum, a configuration similar to that seen when the thymus is visible on a pediatric radiograph. 2. Elevation of the right hemidiaphragm likely due to bronchogenic obstruction and associated volume loss given the increased opacity and plate-like atelectasis changes of the right lung parenchyma. Also could be due to injury to the right phrenic nerve. Note the marked overall lung volume loss and increased density of lung markings suggestive of bronchogenic obstruction. 3. Oblique fissure right lung. 4. Blunting of the right costophrenic angle consistent with a pleural effusion. In general it takes about 200-300 ml of fluid to cause blunting of the costophrenic angle. 5. Thickened, distorted horizontal fissure vs. plate-like atelectasis due to obstructed bronchus.
    Keywords: Radiography, Diagnostic X-Ray Radiology, Neoplasms by Histologic Type, Radiology, Diagnostic X-Ray, Roentgenography, Neoplasms, Diagnostic X-Ray, Carcinoma, Thymic, X-Ray, Diagnostic, X-Ray Radiology, Diagnostic, Diagnosis

  8. X-ray (chest), PA, Thymoma, Adult Male

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    Description: 1. Mediastinal mass. CT is required to differentiate this mass as a thymoma vs. sarcoidosis or carcinoma other than location. 2. Deviation of the trachea to the right of the vertebral processes from mass effect. 3. Silhouette of aorta showing common age-related ectasia or unfolding of the aorta. The fact that the border of the aorta can be sharply differentiated from the mediastinal mass argues strongly that the mass is not due to aortic aneurysm or dissection. 4. Age-related calcification of costal cartilage.
    Keywords: Neoplasms by Histologic Type, Carcinoma, Thymic, Radiology, Diagnostic X-Ray, Roentgenography, Diagnostic X-Ray, Diagnosis, X-Ray, Diagnostic, Radiography, Neoplasms, X-Ray Radiology, Diagnostic, Diagnostic X-Ray Radiology

  9. X-ray (chest), PA, Thymoma, Adult Male

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    Description: 1. Mediastinal mass. CT is required to differentiate this mass as a thymoma vs. sarcoidosis or carcinoma other than location. 2. Deviation of the trachea to the right of the vertebral processes from mass effect. 3. Silhouette of aorta showing common age-related ectasia or unfolding of the aorta. The fact that the border of the aorta can be sharply differentiated from the mediastinal mass argues strongly that the mass is not due to aortic aneurysm or dissection. 4. Age-related calcification of costal cartilage.
    Keywords: Diagnostic X-Ray, X-Ray Radiology, Diagnostic, Radiology, Diagnostic X-Ray, Roentgenography, Carcinoma, Thymic, Neoplasms, Radiography, Neoplasms by Histologic Type, Diagnosis, X-Ray, Diagnostic, Diagnostic X-Ray Radiology

  10. X-ray (chest), PA, Thymoma, Adult Male

    show more
    Description: 1. Mediastinal mass. CT is required to differentiate this mass as a thymoma vs. sarcoidosis or carcinoma other than location. 2. Deviation of the trachea to the right of the vertebral processes from mass effect. 3. Silhouette of aorta showing common age-related “ectasia” or unfolding of the aorta. The fact that the border of the aorta can be sharply differentiated from the mediastinal mass argues strongly that the mass is not due to aortic aneurysm or dissection. 4. Age-related calcification of costal cartilage.
    Keywords: Diagnosis, Neoplasms, X-Ray Radiology, Diagnostic, X-Ray, Diagnostic, Carcinoma, Thymic, Diagnostic X-Ray Radiology, Diagnostic X-Ray, Roentgenography, Neoplasms by Histologic Type, Radiology, Diagnostic X-Ray, Radiography