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Anurag Agarwal, MD, Radiologist, NBE
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Diagnostic X-Ray Radiology
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- Title:
- X-ray (chest), PA, Pericardial Effusion, Adult Male, Answers
- 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.
- Keyword:
- Diagnostic X-Ray, Radiology, Diagnostic X-Ray, Diagnostic X-Ray Radiology, X-Ray, Diagnostic, Diagnosis, Hemopericardium, Chylopericardium, X-Ray Radiology, Diagnostic, Roentgenography, Radiography
- Subject:
- Diagnostic Techniques and Procedures, Multimodal Imaging, Pericardial Effusion, Cardiovascular Diseases, Heart Diseases, Diagnostic Imaging
- Creator:
- Anurag Agarwal, MD, Radiologist, NBE
- Contributor:
- Lars Ensign, MD (annotations)
- Publisher:
- NBE
- Language:
- English
- Copyright Holder:
- Anurag Agarwal, MD
- Rights:
- http://www.i-human.com/service-agreement-print
- Resource Type:
- Medical Imaging
- Identifier:
- 1452
- Title:
- X-ray (chest), PA, Pericardial Effusion, Adult Male
- 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.
- Keyword:
- Roentgenography, Diagnostic X-Ray, X-Ray Radiology, Diagnostic, Chylopericardium, Diagnosis, X-Ray, Diagnostic, Radiology, Diagnostic X-Ray, Radiography, Diagnostic X-Ray Radiology, Hemopericardium
- Subject:
- Multimodal Imaging, Heart Diseases, Pericardial Effusion, Cardiovascular Diseases, Diagnostic Imaging, Diagnostic Techniques and Procedures
- Creator:
- Anurag Agarwal, MD, Radiologist, NBE
- Contributor:
- Lars Ensign, MD (annotations)
- Publisher:
- NBE
- Language:
- English
- Copyright Holder:
- Anurag Agarwal, MD
- Rights:
- http://www.i-human.com/service-agreement-print
- Resource Type:
- Medical Imaging
- Identifier:
- 1452
- Title:
- X-ray (chest), PA, Pericardial Effusion, Adult Male, Numbered
- 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.
- Keyword:
- Radiography, Roentgenography, Diagnostic X-Ray, X-Ray, Diagnostic, Radiology, Diagnostic X-Ray, Chylopericardium, Hemopericardium, Diagnosis, Diagnostic X-Ray Radiology, X-Ray Radiology, Diagnostic
- Subject:
- Pericardial Effusion, Cardiovascular Diseases, Multimodal Imaging, Diagnostic Imaging, Heart Diseases, Diagnostic Techniques and Procedures
- Creator:
- Anurag Agarwal, MD, Radiologist, NBE
- Contributor:
- Lars Ensign, MD (annotations)
- Publisher:
- NBE
- Language:
- English
- Copyright Holder:
- Anurag Agarwal, MD
- Rights:
- http://www.i-human.com/service-agreement-print
- Resource Type:
- Medical Imaging
- Identifier:
- 1452
- Title:
- X-ray (chest), PA, With Annotations, Adult Male, Normal
- 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)
- Keyword:
- Radiography, Thoraces, Chest, Diagnostic X-Ray, Roentgenography, X-Ray, Diagnostic, Diagnosis, Radiology, Diagnostic X-Ray, Diagnostic X-Ray Radiology, X-Ray Radiology, Diagnostic
- Subject:
- Torso, Body Regions, Thorax, Diagnostic Imaging, Diagnostic Techniques and Procedures, Multimodal Imaging
- Creator:
- Anurag Agarwal, MD, Radiologist, NBE
- Publisher:
- NBE
- Language:
- English
- Copyright Holder:
- Anurag Agarwal, MD
- Rights:
- http://www.i-human.com/service-agreement-print
- Resource Type:
- Medical Imaging
- Identifier:
- 1455
- Title:
- X-ray (chest), PA, With Annotations, Adult Male, Normal
- 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)
- Keyword:
- X-Ray Radiology, Diagnostic, Diagnosis, Radiology, Diagnostic X-Ray, Thoraces, Radiography, Diagnostic X-Ray Radiology, Roentgenography, Diagnostic X-Ray, Chest, X-Ray, Diagnostic
- Subject:
- Torso, Diagnostic Techniques and Procedures, Thorax, Diagnostic Imaging, Multimodal Imaging, Body Regions
- Creator:
- Anurag Agarwal, MD, Radiologist, NBE
- Publisher:
- NBE
- Language:
- English
- Copyright Holder:
- Anurag Agarwal, MD
- Rights:
- http://www.i-human.com/service-agreement-print
- Resource Type:
- Medical Imaging
- Identifier:
- 1455
- Title:
- X-ray (chest), PA, Thymoma Invasive, Adult Male
- 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.
- Keyword:
- 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
- Subject:
- Diagnostic Imaging, Diagnostic Techniques and Procedures, Thymoma, Neoplasms, Complex and Mixed, Multimodal Imaging, Neoplasms by Site, Hemic and Lymphatic Diseases, Thymus Neoplasms, Thoracic Neoplasms
- Creator:
- Anurag Agarwal, MD, Radiologist, NBE
- Contributor:
- Lars Ensign, MD (annotations)
- Publisher:
- NBE
- Language:
- English
- Copyright Holder:
- Anurag Agarwal, MD
- Rights:
- http://www.i-human.com/service-agreement-print
- Resource Type:
- Medical Imaging
- Identifier:
- 1449
- Title:
- X-ray (chest), PA, Thymoma Invasive, Adult Male
- 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.
- Keyword:
- 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
- Subject:
- Diagnostic Imaging, Thymus Neoplasms, Multimodal Imaging, Diagnostic Techniques and Procedures, Thoracic Neoplasms, Hemic and Lymphatic Diseases, Neoplasms by Site, Neoplasms, Complex and Mixed, Thymoma
- Creator:
- Anurag Agarwal, MD, Radiologist, NBE
- Contributor:
- Lars Ensign, MD (annotations)
- Publisher:
- NBE
- Language:
- English
- Copyright Holder:
- Anurag Agarwal, MD
- Rights:
- http://www.i-human.com/service-agreement-print
- Resource Type:
- Medical Imaging
- Identifier:
- 1449
- Title:
- X-ray (chest), PA, Thymoma, Adult Male
- 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.
- Keyword:
- 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
- Subject:
- Neoplasms, Complex and Mixed, Neoplasms by Site, Diagnostic Techniques and Procedures, Multimodal Imaging, Hemic and Lymphatic Diseases, Thymus Neoplasms, Thymoma, Thoracic Neoplasms, Diagnostic Imaging
- Creator:
- Anurag Agarwal, MD, Radiologist, NBE
- Contributor:
- Lars Ensign, MD (annotations)
- Publisher:
- NBE
- Language:
- English
- Copyright Holder:
- Anurag Agarwal, MD
- Rights:
- http://www.i-human.com/service-agreement-print
- Resource Type:
- Medical Imaging
- Identifier:
- 1448
- Title:
- X-ray (chest), PA, Thymoma, Adult Male
- 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.
- Keyword:
- 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
- Subject:
- Diagnostic Imaging, Neoplasms by Site, Multimodal Imaging, Hemic and Lymphatic Diseases, Thoracic Neoplasms, Thymoma, Neoplasms, Complex and Mixed, Diagnostic Techniques and Procedures, Thymus Neoplasms
- Creator:
- Anurag Agarwal, MD, Radiologist, NBE
- Contributor:
- Lars Ensign, MD (annotations)
- Publisher:
- NBE
- Language:
- English
- Copyright Holder:
- Anurag Agarwal, MD
- Rights:
- http://www.i-human.com/service-agreement-print
- Resource Type:
- Medical Imaging
- Identifier:
- 1448
- Title:
- X-ray (chest), PA, Thymoma, Adult Male
- 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.
- Keyword:
- 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
- Subject:
- Thymoma, Thoracic Neoplasms, Neoplasms, Complex and Mixed, Thymus Neoplasms, Neoplasms by Site, Diagnostic Techniques and Procedures, Multimodal Imaging, Diagnostic Imaging, Hemic and Lymphatic Diseases
- Creator:
- Anurag Agarwal, MD, Radiologist, NBE
- Contributor:
- Lars Ensign, MD (annotations)
- Publisher:
- NBE
- Language:
- English
- Copyright Holder:
- Anurag Agarwal, MD
- Rights:
- http://www.i-human.com/service-agreement-print
- Resource Type:
- Medical Imaging
- Identifier:
- 1448