Thoracic Radiology

Question 1

Signs of left sided cardiomegaly: left lateral

Answer 1

1) flattened caudodorsal margin
2) wide and tall
3) dorsal elevation of trachea

Question 2

Signs of left sided cardiomegaly: DV

Answer 2

1) left atrial enlargement at 6:00
2) left auricle enlargement at 2-3:00

Question 3

Signs of right sided cardiomegaly: left lateral

Answer 3

1) increased sternal contact
2) increased amount of heart cranial to carina (more than 1/2)
3) rounded cranial margin

Question 4

Signs of right-sided cardiomegaly: DV

Answer 4

1) reverse D
2) enlargement of MPA
3) enlargement of right atria

Question 5

veins are located…

Answer 5

ventrally and centrally

Question 6

what is a sign of artery enlargement and what does this indicate

Answer 6

tortuosity; indicates pulmonary hypertension

Question 7

Signs of feline cardiomegaly: left lateral

Answer 7

1) indented caudal margin
2) rounded caudodorsal margin
3) bean shape
4) venous enlargement

Question 8

Signs of feline cardiomegaly: DV

Answer 8

valentine shape

Question 9

Signs of a PDA

Answer 9

1) aortic enlargement
2) MPA enlargement
3) left-sided cardiomegaly

Question 10

what pulmonary vessels can we consistently see on:
a) left lateral
b) DV

Answer 10

a) pulmonary vessels to the cranial lung lobe
b) pulmonary vessels to the caudal lung lobe

Question 11

what causes an enlarged pulmonary artery

Answer 11

1) left to right shunts
2) heartworm
3) pulmonary hypertension

Question 12

what causes an enlarged pulmonary vein

Answer 12

left-sided heart failure

Question 13

if you take an expiratory radiograph what happens

Answer 13

lungs whiter than normal, get atelectasis (artifact due to incomplete inhalation)

Question 14

what does a caudodorsal lung distribution indicate

Answer 14

cardiogenic or non-cardiogenic pulmonary edema

Question 15

what does a cranioventral lung distribution indicate

Answer 15

pneumonia, hemorrhage, or neoplasia

Question 16

define an interstitial pattern

Answer 16

soft tissue opacity in the lungs that partially silhouettes with the pulmonary vessels

Question 17

define an alveolar pattern

Answer 17

soft tissue opacity in the lungs that totally obscures the pulmonary vessels

Question 18

what are two signs associated with an alveolar pattern

Answer 18

air bronchogram and lobar sign

Question 19

is interstitial or alveolar pattern more severe

Answer 19

alveolar

Question 20

what is a bronchial pattern

Answer 20

soft tissue opacity that follows the airways, creating parallel lines and rings

Question 21

what can cause a bronchial pattern

Answer 21

airway disease and lymphatic disease

Question 22

T/F pleural fluid can silhouette with lung pathologies, the heart and the diaphragm

Answer 22

T

Question 23

what are signs of pleural fluid

Answer 23

1) silhouetting with structures (heart, diaphragm)
2) pleural fissures
3) rounding of lung lobes

Question 24

how can you distinguish fat in the mediastinum from pleural fluid

Answer 24

1) apex of heart on a lateral view will not silhouette with fat, but will with fluid
2) pleural fluid will obscure the heart on a VD view

Question 25

signs of a pneumothorax

Answer 25

1) lungs retracted 2) air-filled space where lungs normally extend 3) blood vessels do not extend all the way to the body wall 4) dorsal deviation of the heart

Question 26

pulmonary masses make what angle with the body wall? what about non-pulmonary masses

Answer 26

pulmonary: acute angle non-pulmonary: obtuse angle

Question 27

what is the most common cause of a widened mediastinum

Answer 27

fat accumulation in the cranial mediastinum

Question 28

what is the normal width of the cranial mediastinum

Answer 28

no more than 2x the width of the thoracic vertebrae

Question 29

mediastinal masses result in (3):

Answer 29

1) dorsal displacement of the caudal trachea 2) widening of the mediastinum 3) displacement of the lungs

Question 30

what are the mediastinal lymph nodes (3)

Answer 30

1) sternal lymph nodes 2) cranial mediastinal lymph nodes 3) tracheobronchial lymph nodes

Question 31

T/F the normal thoracic lymph nodes are visible

Answer 31

F; only become visible if enlarged or if pneumomediastinum

Question 32

how can you distinguish between enlarged tracheobronchial lymph nodes and an enlarged left atria (as they are both at the same location)

Answer 32

enlarged tracheobronchial ln will cause VENTRAL displacement of the trachea whereas left atrial enlargement will cause DORSAL displacement of the trachea (as well as other signs associated with left-sided heart failure)

Question 33

where are the sternal ln located

Answer 33

dorsally to the 2nd to 3rd sternebrae

Question 34

what is a sign of esophageal enlargement, especially megaesophagus

Answer 34

tracheal stripe sign (prominent thickened dorsal margin of trachea due to superimposition of the tracheal and esophageal walls)

Question 35

what are the signs of an esophageal FB

Answer 35

soft tissue or mineralized opacity in the esophagus

Question 36

what are the signs of a persistent right aortic arch (PRAA)

Answer 36

1) focal megaesophagus cranially 2) left deviation of trachea

Question 37

what is a common sequelae of megaesophagus

Answer 37

aspiration pneumonia -> alveolar pattern present

Question 38

what type of hernia is present in brachycephalic breeds

Answer 38

hiatal

Question 39

signs of a hiatal hernia

Answer 39

1) cranially rounded soft tissue/gas opacity in plane with the esophagus 2) broad base to diaphgram

Question 40

signs of diaphragmatic hernia

Answer 40

abdominal contents in the thorax

Question 41

signs of peritoneal-pericardial diaphragmatic hernia (PPDH)

Answer 41

1) abdominal contents in pericardium 2) reduced cranial abdominal content 3) enlarged cardiac silhouette with non-uniform soft tissue opacity

Question 42

what great vessels can you normally see in a thoracic radiograph

Answer 42

aorta, caudal vena cava

Question 43

what lateral projection highlights the left lung lobes

Answer 43

right lateral

Question 44

what lateral projection highlights the right lung lobes

Answer 44

left lateral

Question 45

what is the caudal mediastinal reflection and where do we see it

Answer 45

on the VD view, thin soft tissue line extending from cardiac apex to diaphragm on the left side of the patient

Question 46

what is the word to describe multidimensional imaging and what is the most common

Answer 46

tomographic imaging; CT

Question 47

concentric vs eccentric hypertrophy

Answer 47

concentric: myocardium enlarged, volume decreases eccentric: myocardium same size, volume increases

Question 48

is right or left sided cardiomegaly more common

Answer 48

left

Question 49

what are signs of left sided congestive heart failure

Answer 49

- pulmonary venous enlargement - enlargement of the cardiac silhouette - interstitial and/or alveolar pattern

Question 50

what are signs of pericardial effusion

Answer 50

- globoid cardiomegaly - pulmonary arteries smaller - enlarged cardiac silhouette

Question 51

what are the signs of tension pneumothorax

Answer 51

- barrelling of ribs - may see normal structures deviated to one side - large volume of gas in affected pleural space - marked deviation of heart

Question 52

characteristics of thymoma

Answer 52

1) mass in the cranial mediastinum 2) megaesophagus 3) aspiration pneumonia (secondary to megaesophagus)