Lung Patterns

Question 1

What are the 3 most important pulmonary diseases?

Answer 1

Pulmonary edema, pneumonia, hemorrhage/contusions.

Question 2

What starts out as an interstitial pattern and moves into an alveolar pattern?

Answer 2

Pulmonary edema

Question 3

Is an interstitial pattern or alveolar pattern more severe?

Answer 3

Alveolar pattern

Question 4

What disease have ventral distribution?

Answer 4

Aspiration pneumonia

Question 5

What disease have diffuse distribution with tiny little dots?

Answer 5

Fungal

Question 6

What disease has a caudal dorsal distribution?

Answer 6

Edema

Question 7

What cause will make the artery bigger than the vein?

Answer 7

Heart worm disease

Question 8

What causes the vein to be bigger than the artery leading to venous congestion?

Answer 8

Left sided heart congestive failure

Question 9

If both sides of the veins and arteries big, what is the disease is it?

Answer 9

PDA or VSD

Question 10

If both the veins and arteries are small?

Answer 10

Hypovolemia or shock

Question 11

What are rib fractures caused by?

Answer 11

Pulmonary contusions

Question 12

What can coughing indicate?

Answer 12

Asthma or bronchial disease

Question 13

What can dikepnic mean?

Answer 13

Pneumonia or metastatic disease

Question 14

What is an alveolar pattern?

Answer 14

Air is removed from the alveoli and replaced with fluid which causes increase lung space

Question 15

What are signs of an alveolar pattern?

Answer 15

1) Homogeneous, uniform fluid opacity (varies from solid and opaque to faint and wipsy)
2) Lobar sign
3) Silhouette effect
4) Air bronchograms

wont see every sign on radiographs

Question 16

What is the gold standard for an alveolar pattern?

Answer 16

Air bronchograms

Question 17

What is a lobar sign?

Answer 17

Line of demarcation of a lung lobe where two lungs are next to each other with different opacities

Question 18

Which lung is a common place for aspiration pneumonia?

Answer 18

Right middle lung lobe

Question 19

What is the silhouette effect?

Answer 19

Two soft tissue structures in close contact where borders merge (blend together) such as border effacement

Question 20

Which pattern is the only one that will have a silhouette effect?

Answer 20

Alveolar pattern

Question 21

Which air pattern causes more loss of air space than any other pattern?

Answer 21

Alveolar

Question 22

What are causes of alveolar pattern?

Answer 22

1) Pneumonia
-Aspiration
-Bronchopneumonia
-Hematogenous (foals, rare in dogs/cats)

2) Edema
-Cardiogenic
-Non-cardiogenic

3) Hemorrhage
-Trauma
-Coagulopathy

Question 23

What are the two types of pulmonary edema?

Answer 23

Cardiogenic and non-cardiogenic

Question 24

What is cardiogenic pulmonary edema?

Answer 24

High pressure edema with left sides congestive heart failure die to large left atrium

Question 25

What is non-cardiogenic pulmonary edema?

Answer 25

Increased permeability edema and/or high pressure with a normal left atrium

Question 26

What are causes of non-cardiogenic edema?

Answer 26

Electrocution Smoke inhalation Acute hypoxia Head trauma Submersion injury

Question 27

How does cardiogenic edema look like in cats?

Answer 27

No typical distribution

Question 28

What are pulmonary contusions?

Answer 28

Alveolar infiltrate, can be anywhere Associated radiographic changes include rib fractures, pneumothorax, pleural effusion

Question 29

What are less common causes of alveolar pattern?

Answer 29

Lung lobe torsion Pulmonary thromboembolism Neoplasia Bronchial foreign body (with focal pneumonia)

Question 30

Atelectasis

Answer 30

In alveolar pattern Loss of volume, removing air and not replacing it (collapsed lung), mediastinal shift

Question 31

What is a linear (unstructured) interstitial pattern?

Answer 31

Thickening of infrastructure Overall increase in hazy pulmonary opacity More lines Vessels appear smudged/hazy, not as defined No air bronchograms, silhouette effect or lobar signs Often the "default" pattern

Question 32

What can cause a linear interstitial pattern?

Answer 32

Artifact (radiograph taken on expiration) Geriatric change Pulmonary edema Viral pneumonia Hemorrhage Neoplasia Pulmonary fibrosis

Question 33

How do you know your interstital pattern is from taking a radiograph during expiration?

Answer 33

Lateral view will have an unstructured interstitial pattern but your VD/DV view will be normal

Question 34

What is a nodular/structured interstitial pattern?

Answer 34

Relatively circumscribed nodule/mass Single/multiple Varying sizes: mililary (tiny), nodule (<2 cm), mass (>2 cm)

Question 35

What are causes of a interstitial nodular pattern?

Answer 35

Artifact of chest wall Primary neoplasia Metastatic neoplasia Fungal granulomas Abscess (common in horses) Hematoma Fluid filled bulla Parasitic cyst

Question 36

What disease is commonly seen with a miliary pattern in dogs?

Answer 36

Fungal infection, likely blasto