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CHESTNormal CT ANATOMY

BYMAMDOUH MAHFOUZ MD

Cairo university

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IndicationsIndications

Patient preparationPatient preparation Fasting 4Fasting 4--6 hours6 hours Patient positionPatient position SupineSupine

ScanogramScanogram FrontalFrontal

• 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 vascular injury

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IndicationsIndications

Patient preparationPatient preparation Fasting 4Fasting 4--6 hours6 hours

Patient positionPatient position

SupineSupine

ScanogramScanogram FrontalFrontal

No required preparation unless the patient is going to be sedated

or injected with contrast material

FASTING FOR 4FASTING FOR 4 -- 6 HOURS6 HOURS

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Contrast injection50-100ml 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.

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

Mediastinal window, lung window, bone window?!

Reconstructed images

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Scanning techniquesScanning techniquesStandard Examination

High resolution [HRCT]

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Standard CT High Resolution CT,HRCTHRCT

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Scanning techniquesScanning techniques

Spiral, Helical, volumetric CT

Multi-Detector, Multi-Slice CT

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Normal pulmonary vascularity

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Normal pulmonary vascularity

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LI

M

 A

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CT AngiographyCT Angiography

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

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

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F 35Y

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Mediastinal anatomy

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 App

 An An

P

 Ap

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 An

 App

 An

 Ap

P

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 An App

 An

 Ap

P App

 AnL

P

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PL  An

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 An

 App

 An Ap

P

 App App

 An

L

P

PL

 An

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SS IILL

MM

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7

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1

4

3

7

6

5 2

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M 44Y with malignant liver 

F 45Y with post irradiation

changes after radical mastectomy

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35Y male with fever and expectoration

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45Y male with chest pain and hemoptysis

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43Y male with acute chest

pain and hemoptysis

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Thank

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سبح نك للهم و بحمدك نشهد ن ال له ال نت نستغفرك و نتوب ليك 

Thank you

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THANK

YOU

 نتوب ليك

 و

 نستغفرك

 ال له ال نت

 نشهد ن

 بحمدك

 و

 سبح نك للهم

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Thank

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Thank you

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

pulmonary artery are seen on the CT scan. The relationship

of theazygos, aorta and esophagus isshown.

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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.

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

aortic arch.

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

section.

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•Cavitating neoplasm with pul. deposits

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•Lat. normal

M 45Y PANCOAST’S TUMOR

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M 45Y PANCOAST’S TUMOR

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66 year ’ s old patient with multiple TB abscesses

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63Y male with multiple hydatid cysts

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Emphysematous bulla Peumatocele