ExpertDDx: Chest

Melissa L. Rosado de Christenson, MD, FACR, FAAWR, is Attending Radiologist with the Division of Cardiothoracic Imaging at Department of Medical Imaging, Banner - University Medical Group Tucson, and is Professor of Medical Imaging at the University of Arizona College of Medicine - Tucson in Tucson, Arizona Dr. Santiago Martínez-Jiménez is with the Department of Radiology at Saint Luke's Hospital of Kansas City and is Professor of Radiology at the University of Missouri-Kansas City School of Medicine, in Kansas City, Missouri. He's a board-certified practicing radiologist who specializes in cardiothoracic radiology

Introduction

Approach to Imaging Modalities

Radiography

Computed Tomography

Magnetic Resonance Imaging

FDG PET/CT

Ultrasound

Approach to Clinical Presentation

Chest Pain

Chest Trauma

Cough

Acute Dyspnea

Chronic Dyspnea

Hemoptysis

Immunosuppression

Intensive Care Unit

Oncology

Stridor

Wheezing

Lungs and Airspaces

Approach to Lungs and Airspaces

Approach to Lungs and Airspaces

General Imaging Patterns

Acinar Nodules

Air Bronchogram

Apical Opacity

Architectural Distortion

Atelectasis

Bullous Disease

Calcification/Ossification

Cavity

Consolidation

Cysts

Lucencies

Migratory Opacities

Micronodules

Peripheral (Subpleural) Consolidation

Pulmonary Mass

Solitary Pulmonary Nodule

Multiple Pulmonary Nodules

Pulmonary Nodules with Cavitation

Modality-Specific Imaging Findings: Radiography

Low Lung Volumes

Large Lung Volumes

Lucent Hemithorax

Opaque Hemithorax

Luftsichel Sign

Silhouette Sign

S-Sign of Golden

Modality-Specific Imaging Findings: Computed Tomography

Air Crescent Sign

CT Halo Sign

Ground-Glass Opacity

Reverse Halo Sign

Interstitium

Approach to Interstitium

Approach to Interstitium

General Imaging Patterns

Interstitial Opacities

Reticular Opacities

Honeycombing

Upper Lung Zone Predominant Lung Disease

Lower Lung Zone Predominant Lung Disease

Peripheral (Subpleural) Lung Disease

Modality-Specific Imaging Findings: Computed Tomography

Interlobular Septal Thickening

Mass-Like Fibrosis

Miliary Nodules

Perilymphatic Nodules

Airways

Approach to Airways

Approach to Airways

General Imaging Patterns

Tracheal Dilatation

Tracheal Narrowing

Finger-in-Glove Sign

Modality-Specific Imaging Findings: Computed Tomography

Airway Wall Thickening (Focal)

Airway Wall Thickening (Diffuse)

Tracheal Lesion

Endobronchial Lesion

Mosaic Attenuation and Air-Trapping

Centrilobular Nodules

Tree-in-Bud Opacities

Bronchiectasis

Mediastinum and Hila

Approach to Mediastinum

Approach to Mediastinum

General Imaging Patterns

Focal Mediastinal Enlargement

Diffuse Mediastinal Enlargement

Anterior/Prevascular Compartment Lesion

Middle/Visceral Compartment Lesion

Posterior/Paravertebral Compartment Lesion

Cardiophrenic Angle Lesion

Azygoesophageal Recess Lesion

Lymphadenopathy

Pneumomediastinum

Modality-Specific Imaging Findings: Radiography

Hilum Overlay Sign

Mediastinal Shift

Modality-Specific Imaging Findings: Computed Tomography

Fat-Containing Mediastinal Lesion

Cystic Mediastinal Lesion

Soft Tissue Lesion

Enhancing Soft Tissue Lesion

Mediastinal Calcification

Modality-Specific Imaging Findings: Magnetic Resonance Imaging

Mediastinal Mass

Pulmonary Arteries

Approach to Pulmonary Arteries

Approach to Pulmonary Arteries

General Imaging Patterns

Pulmonary Artery Enlargement

Modality-Specific Imaging Findings: Computed Tomography

Pulmonary Artery Filling Defect

Pulmonary Artery Mass

Pulmonary Artery Invasion

Focal Pulmonary Artery Enlargement

Thoracic Aorta

Approach to Thoracic Aorta

Approach to Thoracic Aorta

General Imaging Patterns

Dilatation of Thoracic Aorta (Diffuse)

Dilatation of Thoracic Aorta (Focal)

Dilatation of Ascending Thoracic Aorta

Narrowing of Thoracic Aorta

Aortic Calcification

Modality-Specific Imaging Findings: Radiography

Reverse 3 Sign

Modality-Specific Imaging Findings: Computed Tomography

Aortic Wall Thickening

High-Attenuation Mural Thickening

Acute Aortic Syndrome

Aortic Mass

Mural Thrombus

Pleura

Approach to Pleura

Approach to Pleura

General Imaging Patterns

Free Pleural Effusion

Loculated Pleural Effusion

Pleural Thickening

Pleural Nodule/Mass

Pleural Calcification

Pneumothorax

Pleural Air-Fluid Level

Chest Wall and Diaphragm

Approach to Chest Wall and Diaphragm

Approach to Chest Wall and Diaphragm

General Imaging Patterns

Elevated Hemidiaphragm

Congenital Deformity

Chest Wall Asymmetry

Diaphragmatic Mass

Hernia

Modality-Specific Imaging Findings: Radiography

Incomplete Border Sign

Modality-Specific Imaging Findings: Computed Tomography

Chest Wall Mass (Soft Tissue)

Chest Wall Mass (Osseous)

Chest Wall Fluid Collection

Modality-Specific Imaging Findings: Magnetic Resonance Imaging

Chest Wall Mass

Heart

Approach to Heart

Approach to Heart

General Imaging Patterns

Left Atrial Enlargement

Right Atrial Enlargement

Left Ventricular Enlargement

Right Ventricular Enlargement

Multichamber Enlargement

Wall Motion Abnormality

Myocardial Thickening

Atrial Mass

Ventricular Mass

Valvular Mass

Modality-Specific Imaging Findings: Computed Tomography

Atrial Calcification

Ventricular Calcification

Valve Calcification

Coronary Artery Anomaly

Modality-Specific Imaging Findings: Magnetic Resonance Imaging

Delayed Enhancement

Pericardium

Approach to Pericardium

Approach to Pericardium

General Imaging Patterns

Pericardial Thickening

Pericardial Calcification

Pericardial Effusion

Pneumopericardium

Modality-Specific Imaging Findings: Computed Tomography

Pericardial Nodules/Masses