CHEST RADIOLOGY (51-93 SAMPLES)

1. Munier-Kuhn Syndrome

1. Neuroblastoma

• 3 month-old male with chest x-ray for cold symptoms

1. Pancoast Tumor

• 73 year-old with left arm pain

1. Pericardial Cyst, calcified

1. Pneumococcal Pneumonia

1. Pneumocystis Carinii Pneumonia

32 year old HIV-positive male

1. Pneumomediastinum 

10 year-old asthmatic

1. Pneumothorax (Deep Sulcus Sign) 

1. Ping-Pong Ball Plombage

1. Pseudotumor

1. Pulmonary Alveolar Microlithiasis

• 43 year-old mild shortness of breath

Axial non-enhanced CT Images of the Lower Chest

1. Pulmonary Artery Pseudoaneurysm

• 60 year-old female with hemoptysis

1. Pulmonary Contusion 

1. Pulmonary Edema - Noncardiogenic

• 73 year-old with shortness of breath

1. Pulmonary Laceration 

24 year-old in motor vehicle accident

1. Pulmonary Thromboembolism

1. Radiation Pneumonitis 

1. Re-expansion Pulmonary Edema

1. Respiratory Distress Syndrome of the Newborn 

1. Right Middle Lobe Syndrome

• 59 year-old female with persistent cough

1. 1. Rounded Atelectasis
   
   
   
   1. Round Pneumonia
   
   
   
   
   
   
   
   1. Sarcoid
   
   
   
   
   
   1. Scleroderma - Lungs\
   
   
   • 51 year-old female with dysphagia

   
   
   
   1. Septic Emboli

1. Sequestration

1. Silicone Embolism Syndrome

• 31 year-old transgender male with shortness of breath

Frontal radiograph of the chest

1. Silicosis

1. Sternal Dehiscence

Sternal Dehiscence

General considerations Follows median sternotomy usually for cardiothoracic surgery Defined as complete separation of the sternum Frequently associated with sternal wound infection, most often by S. aureus May or may not be associated with mediastinitis Definitions for post-sternal mediastinitis and sternal wound infection vary, some including clinical findings only, some requiring microbiological confirmation Incidence has been reported in 4.5% of coronary artery bypass graft (CABG) surgery While diagnosis is usually made clinically, imaging plays a key role in either initial diagnosis and/or confirmation of the clinical diagnosis Females are at greater risk than male Risk factors Hypertension Smoking COPD Obesity Diabetes Prolonged bypass time Prolonged post-operative support on ventilators Re-operation Clinical findings Pain Most incisional pain normally subsides over first month Fever “Clicking” sound from the sternum Imaging findings Originally it was thought that a mid-sternal stripe of lucency seen on frontal chest radiographs was an indicator of sternal dehiscence but this is now felt to be of little diagnostic value With dehiscence, sternal wires are displaced to one side or the other as they tend to pull through the sternum, rather than break Most frequently 2 cm of displacement is seen in 2 or more wires Sternal wire breaks alone are not an indicator of sternal dehiscence and single breaks are usually of no clinical significance CT findings of mediastinitis can include small air bubbles or an air-fluid level in a mediastinal collection Treatment Wide debridement of devitalized infected soft tissue and bone Culture-specific antibiotics Flap closure (e.g., muscle, musculocutaneous, omentum) for best wound healing Prognosis While mortality rate has dropped, it is still significant Had been reported as high as 25% Mortality rate from sternal wound dehiscence has now dropped to less than 10% Sternal dehiscence. The blue arrows point to one group of sternal wires that are displaced to the right of the midline while the red arrow points to a lower wire that has traveled with the left half of the dehisced sternum (see below). Normally, the sternal wires should align in the midline. The black arrow points to a prosthetic aortic valve. For the same photo without the arrows, click here Axial CT images of Sternal Dehiscence. Four axial contrast-enhnaced CT images of the chest are shown, from highest (top left) to lowest (bottom right). The sternum has separated (white arrow) with some of the wires attached to the right half (blue circles) and one of the wires attached to the left half (red circle). There is a fluid collection between the two halves of the sternum (green arrow).

Wandering Wires: Frequency of Sternal Wire Abnormalities in Patients with Sternal Dehiscence  American Journal of Roentgenology, Vol 173, 777-780 Phillip M. Boiselle, Alberto V.  Mansilla, Mary S. Fisher, Theresa C. McLoud

1. Subcutaneous Emphysema 

1. Substernal Thyroid Goiter

1. Tuberculosis of the lungs

1. Teratoma, mediastinal

• 23 year-old female with retrosternal discomfort

1. Thymoma

• 45 year-old with blurred vision

1. Thyroid Goiter

1. Thoracoplasty for Old Tuberculosis

• 85 year-old male with shortness of breath

1. Traction Diverticulum

1. Transient Tachypnea of the Newborn (TTN) 

• Term infant at birth with mild respiratory distress

1. Tuberculous Empyema

• 71 year old with cough

1. Vanishing Lung Syndrome

1. Vanishing tumor

1. Varicella Pneumonia

• 45 year-old male with rhinitis and fever

1. Wegener's Granulomatosis