tailieunhanh - Radiology for Anaesthesia and Intensive Care - Part 2

Bao gồm các yêu cầu cốt lõi phóng xạ cho kiểm tra FRCA, nhưng nó cũng là lý tưởng chuẩn bị cho các bác sĩ Văn bằng trong y học chăm sóc chuyên sâu. Nó không phải là chỉ nhằm mục đích như là một kiểm tra sửa đổi viện trợ, mà còn là một phóng xạ nói chung hoặc sửa đổi văn bản gây mê X quang. | Imaging the chest Fig. Aspirated and swallowed teeth following facial trauma. Right upper lobe collapse and partial collapse of left lower lobe. Opacities in the stomach. Fig. The penetrated film demonstrates tooth fragments in the right upper lobe bronchus and also the left lower lobe bronchus. 16 Case illustrations plain films and CT Question 5 Fig. Quiz case. 72-year-old smoker. Haemoptysis and cough. What does the chest X-ray Fig. show 1 Answer Left lower lobe collapse Lobar or segmental collapse occurs in large airway obstruction and subsequent absorbtion of air from the affected lung. Causes are listed below. Bronchogenic malignancy is one of the commonest causes and the case study illustrates the subtle signs on plain X-ray. Subsequent CT imaging of this patient demonstrated a malignant neoplasm originating in the left lower lobe bronchus. Table Causes of lobar collapse Luminal mass Neoplasm carcinoma carcinoid Foreign body peanut see Figs and Mucus plug inflammatory exudate Endoluminal metastasis Misplaced endotracheal tube ITU ventilated patients Bronchial wall Inflammation TB sarcoid Extrinsic compression Lymph nodes aneurysm 17 Imaging the chest 1 In children bronchial malignancy is rare and the causes of lobar collapse differ from those in adults. Inflammatory exudate in pneumonia or mucus plugging in patients with cystic fibrosis and asthma are much more common causes Table . The five lobes collapse in different directions to produce different patterns although there are some common features see below . If the vessels within the collapsed lobe remain perfused then a wedge-shaped opacity is more clearly identified. In lower lobe collapse both right and left lower lobe the lung collapses posteriorly and medially. This is well illustrated by the CT scan see Fig. . In left lower lobe collapse the silhouette of the medial aspect of the hemidiaphragm and the descending Fig. CT left lower lobe collapse. Note how