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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