Sternal notch : T2T3 Sternal angle : T4T5 Nipple : T7-T8 Xiphoid tip : T10

The Lung zones:

Upper Middle Lower

Superior vena cava Right atrium Right ventricle

Aorta

Pulmonary trunk

Inferior vena cava

Left ventricle

6 feet

STANDARD VIEWS

SPECIAL VIEWS

Postero Anterior Antero Posterior Lateral

LAO RAO Expiratory view Supine Lordotic view Apicogram Lateral Decubitus

FFD MAS MA GRID CASSETTE KV INSTRUCTION

: 180cm : 8 12 : 300 : NO : 14X14, 14X17 : 50 65 : ARRESTED INSPIRATION

4 feet

POSTERO-ANTERIOR VIEW
Patient in standing/sitting position No overlapping of scapulae on lung fields Clavicle is not foreshortened Ribs course obliquely No Cardiac magnification

ANTERO-POSTERIOR VIEW
Patient in supine position

Scapulae overlap lung fields

Clavicle is foreshortened Ribs assume a horizontal course Cardiac magnification

Lower lobe vessels are more prominent compared to upper lobe vessels

More equalization of the pulmonary vasculature when the size of the lower lobe vessels are compared to the upper.
Fundic air not seen

Fundic air seen

COSTOPHRENIC ANGLES

CARDIOPHRENIC ANGLES

Demonstrate the mediastinal mass or localize the position of lesion. Central ray to the mid line of the cassette through mid axillary line

Useful in demonstrating anterior mediastinal masses. Moving or stationary grid. Central ray : Perpendicular to cassette middle at the mid- axillary line. kVp : 60-70 mAs : 20- 25

The diaphragm and heart borders should be sharp with no motion

INDICATION
Enhances visualization of minor fissure in suspected right middle lobe atelectasis

To demonstrate the apices, opacities obscured by the overlying ribs or clavicle shadow. POSTERO ANTERIOR with x ray tube30 degree cauded tilt. ANTERO POSTERIOR with x ray tube 30 degree cephelad tilt ANTERO POSTERIOR with coronal plane angled 15 degree with cassette and x ray tube tilted 15 degree cephalad.

Low kVp (45-55 kVp)

High contrast radiograph

Intermediate (55 65)kVp High kVp (90-120 kVp)

Low contrast radiograph

HIGH CONTRAST RADIOGRAPH

Miliary shadowing and calcification more clearly seen

LOW CONTRAST RADIOGRAPH

Increased visualization of hidden areas of the lung

NORMAL CONTRAST RADIOGRAPH

CR

CL

CR + CL = Transverse Cardiac Diameter T= Transverse Thoracic Diameter CT RATIO = CR + CL T

2 3

4
5 6 7 8

9
10

EXPIRATION

INSPIRATION

Air Black Water (fluid, blood and soft tissue) Grey

Fat Intermediate between air and soft tissue

Metal (Calcium, contrast, metallic) White

RADIOGRAPHIC INTERPRETATION
Request Form Technical Trachea Heart & Mediastinum Diaphragms Pleural spaces Lungs Hidden areas Hila Below diaphragm Soft tissues
Name, Age, Sex, Date of Exam, Clinical information

Adequate inspiration, Centering, Patient position/rotation, Side Markers, Exposure/ Adequate penetration, Collimation
Position, outline Size, shape, displacement Outline, shape, relative position Position of horizontal fissure, costo- and cardiophrenic angles Local, generalized abnormality
Comparison of translucency and vascular markings of the lungs

Apices, Posterior sulcus, Mediastinum, Hila, Bones Density, Position, Shape Gas shadows, calcification Mastectomy, gas, densities, etc Destructive lesions, etc.

Bones

MRI

CT

US