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CHEST Normal CT ANATOMY

Mamdouh mahfouz M D

mamdouh.m5@gmail.com

www.ssregypt.com

Indications

Patient preparation Fasting 4-6 hours

Patient position Supine

Scanogram Frontal

• To assess equivocal plain X-ray findings

• Staging of lung neoplasms

• Metastatic workup of extrathoracic malignancies

• Diagnosis of diffuse lung disease with HRCT

• Assessment of bronchiectasis

• Assessment of suspected post-traumatic complications

• Diagnosis of medistinal and chest wall lesions

• Diagnosis of suspected pulmonary embolism

Indications

Patient preparation Fasting 4-6 hours

Patient position Supine

Scanogram Frontal

No required preparation unless the patient is going to be sedated

or injected with contrast material

FASTING FOR 4 - 6 HOURS

Contrast injection 50-100ml of water soluble contrast material

[urographine, isovist,…] bolus injection

Not indicated when

Evaluating diffuse lung disease.

Evaluating bronchiectasis

Screening for lung deposits

Some cases of trauma.

10mm sections from lung apex to the C/P angles

Mediastinal window, lung window, bone window?!

Reconstructed images

Scanning techniques

Standard Examination

High resolution [HRCT]

Standard CT High Resolution CT,HRCT

Scanning techniques Spiral, Helical, volumetric CT

Multi-Detector, Multi-Slice CT

Normal pulmonary vascularity

Normal pulmonary vascularity

LA

D

L

I

M

A

CT Angiography

3DCTA Angiography demonstrates a filling defect of the right Iliac artery

Detailed examination of the Superior Mesenteric Artery and Celiac Artery. Scan time = 9.4 seconds. 1mm slice thickness

F 35Y

Mediastinal anatomy

App

An An

P Ap

App = Apicoposterior

An = Anterior

P = Posterior

An

App

An

Ap

P

App = Apicoposterior

An = Anterior

P = Posterior

An

App

SL

Ap

P An

SL

SL = Superior LL

An = Anterior

App = Apicoposterior

P = Posterior

SL

S

I

L

M

SL

AN P L AN

L,M P

SL = Superior LL

AN = Anterior LL

P = Posterior LL

L,M = Lateral, Medial LL

A

B

C

D

M 44Y with malignant liver

F 45Y with post irradiation

changes after radical mastectomy

Atelectasis in the lateral

segment of the middle lobe

Post irradiation scarring in the

anterior segment of the right

upper lobe

35Y male with fever and expectoration

Pneumonic consolidation in the

anterior segment of the left upper lobe

45Y male with chest pain and hemoptysis

Bronchogenic carcinoma in the

superior segment of the left lower lobe

43Y male with acute chest

pain and hemoptysis

Multiple infarcts in the superior and

inferior segments of the lingula as well

as the posterior segment of the left

lower lobe

2Y male child with acute chest pain, fever,

expectoration

Pneumonic consolidation in the anterior

segment of the upper as well as the superior

segment of the lower lobes on the right side

23Y male with acute chest pain and

fever

Pneumonic consolidation in the posterior

segment of the left lower lobe

66 year’s old patient with multiple TB abscesses

Anterior segment LUL

Apico-posterior segment LUL

Posterior segment RLL

Posterior segment LLL

Both segments

of Ligula

سبحانك اللهم و بحمدك نشهد ان ال اله اال انت نستغفرك و نتوب اليك

Thank you

THANK

YOU

سبحانك اللهم و بحمدك نشهد ان ال اله اال انت نستغفرك و نتوب اليك

Thank you

Figures 7A, B & C Small branches arising from the left

pulmonary artery are seen on the CT scan. The relationship

of the

azygos, aorta and esophagus isshown.

Figures 8A, B & CThe azygos arch is seen enter-ing

the superior vena cava.Note the small lymph nodes lying

within fat anterior to the trachea. This space is readily

accessible to the mediastino-scope.

Figures 9A, B & C The superior vena cava is lateral to the

aortic arch.

Figures 1OA, B & C Five vessels are seen cut in cross-

section.

•Cavitating neoplasm with pul. deposits

•Lat. normal

M 45Y PANCOAST’S TUMOR

63Y male with multiple hydatid cysts

Emphysematous bulla Peumatocele