Intensive soft tissue shadow in epigastrium Lung emphysema /diaphragmatic lobes Spondyloarthritis LS 1,2,3,4 and 7 vertebrae

3 d post

10 d post

pre

post

4+3

VD

RCr

LCr1 LCr2

RM Acc RCd LCd

perihilar

Cd drs

Cr Vtr Cd Vtr

LUNG PATTERNS AND DO WE NEED THEM?

DENIS NOVAK WWW.VETNOVAK.COM

Normal lung

Lungs - radiolucent
Vessels - radiodense

Thoracic radiology
Easy Safe Fast Next step

kVp

mAs

UNDER

GOOD

OVER

ANATOMICAL EXAMINATION

Normal dog
Locate Aorta Caudal vena cava Pulmonary vessels Trachea Tracheal bifurcation - carina Bronchi Diaphragm Cranial mediastinum Caudoventral mediastinal fold cardiophrenic ligament Pleural fat Skin folds Nipple shadows

DV

VD

 Ddx / dog
Heart axis more horizontal Heart more caudal Diaphragm more caudal
crual blending T12-L1

Smaller ribs Longer vertebral body

Pulmonary Radiology
Lung structures that cast shadows All may be seen if there is gas (air) in the airways and alveolar spaces vessels airways interstitium

Pulmonary vessels
Arteries and veins paired towards hilar area Similar diameters Taper Sharp margins

Pulmonary airways Mineralised bronchi Osteomas Taper

bronchial

interstitial

vascular

alveolar

interstitial

BRONCHIAL PATTERN

bronchial mineralisation allergic bronchitis chronic bronchitis peribronchial cuffing i.e. oedema, bronchopneumonia

Bronchial pattern

Bronchial pattern - cat

Interstitial pattern

pneumonia oedema haemorrhage neoplasia

Interstitial pattern
Interstitium fills with fluid/cells Indistinct pattern Difficult to identify vessels clearly

Interstitial pattern

Interstitial pattern

Cardiogenic edema

Pulmonary edema

MVD

MVD pre and post tx

alveolar pattern

Localised: bronchopneumonia oedema haemorrhage neoplasia lung collapse/ atelectasis dirofilariasis pulmonary infarct

Diffuse: severe bronchopneumonia severe oedema haemorrhage near-drowning smoke inhalation

Air bronchogram

Air bronchogram

Alveolar Pattern

Alveolar Pattern

Vascular Pattern

ABV

Blood vessels

Enlarged arteries pulmonary hypertension,i.e. R to L shuntng PDA, dirofilariasis Enlarged veins congestion due to mitral insufficiency Enlarged arteries and veins overcirculation, i.e. L to R shunt, overhydration

Small arteries and veins hypovolaemia, tetralogy of Fallot

Pulmonary vasculature
Compare size of arteries and veins Increased or decreased in size Are both arteries and veins affected Shape of vessels / tortuous, truncated

Pulmonary vessels

A V

Arteriogram

Pulmonary hypertension in dirofilariasis

Vessel size in PDA vs normal

Undercirculation in shock

Lung hyperlucency
Diffuse:
Overexposure Weight loss Hypovolaemia Overinflation Air trapping Emphysema

Focal:
Bulla Lobar emphysema Pulmonary embolism

Bronchiectasis

Pleural effusion
White thoracic cavity Loss of clarity