Digital Chest Radiography
Phillip M. Boiselle, Charles S. White in New Techniques in Cardiothoracic Imaging, 2007
The chest radiograph is a complex image containing information on many structures in the thorax. In this image, one can see the lungs and their diseases; the pulmonary vessels and their diseases; the heart; the mediastinum; the bony thorax; the chest wall; and portions of the neck, abdomen, and arms. Because of the great differences in the absorption and inherent tissue contrast in these regions, the ideal chest radiograph has conflicting requirements. All current chest radiographs, both analog and digital, represent compromises to accommodate these conflicting optimal requirements. Digital radiography currently comes closer to meeting these requirements than analog radiography, but current systems are still not able to produce the ideal image and further developments are needed.
Chronic respiratory failure – pathophysiology
Claudio F. Donner, Nicolino Ambrosino, Roger S. Goldstein in Pulmonary Rehabilitation, 2020
Despite recent technological advances, chest radiography remains the cornerstone of thoracic imaging. The chest radiograph is justifiably regarded as an integral part of the examination of the patient with CRF. The technique has changed surprisingly little over the years, although digital technology has recently been used to overcome some of the shortcomings of conventional radiography. An ideal chest radiograph is taken with the patient standing erect, suspending respiration at total lung capacity, and with the x-ray beam traversing the thorax from back to front, the posteroanterior view. Chest radiograph should always be looked at carefully before submitting a patient to more sophisticated imaging techniques, such as computed tomography (CT scan), because of its expense and radiation burden.
Tuberculosis in Childhood and Pregnancy
Lloyd N. Friedman, Martin Dedicoat, Peter D. O. Davies in Clinical Tuberculosis, 2020
Radiographic improvement of intrathoracic disease in children occurs very slowly. A common practice is to obtain a chest radiograph at diagnosis and 4–8 weeks into therapy to be sure that no progression or unusual changes have occurred. If these radiographs are satisfactory, interim chest radiographs are not necessary, and an end of treatment radiograph is recommended. A significant proportion of children with intrathoracic adenopathy have abnormal radiographic findings for 1–3 years, after effective antituberculosis treatment has been completed. If clinical and radiographic improvement has occurred after 6 months of therapy, medications can be discontinued, and the child can be followed at intervals of 6–12 months with appropriate chest radiographs to determine continued improvement in radiographic appearance.
Risk factors for latent tuberculosis infection in children in South Korea
Published in Postgraduate Medicine, 2018
Minji Son, Yoon Seon Park, Min Ho Jung, Jin Han Kang, Ui Yoon Choi
LTBI screening included medical history-taking, physical examinations, chest radiographs, and TSTs. The chest radiograph was reviewed and interpreted by a radiologist. The TST was performed according to the Mantoux method: two tuberculin units (0.1 ml) of purified protein derivative RT 23 (Statens Serum Institute, Copenhagen, Denmark) was intradermally injected into the inner surface of the forearm. The TST reaction was evaluated by a well-trained investigator, between 48 and 72 h after administration, and the transverse diameter of induration was measured in millimeters using a caliper [13,14]. Following the Korean Guidelines for Tuberculosis and World Health Organization (WHO) guideline, a TST with an induration of 10 mm or greater was considered positive, unless children were not immunosuppressed, regardless of the BCG status [13,14]. There are discrepancies between guidelines regarding the use of TST or IGRA as the diagnostic method for LTBI [13,15,16]. A majority of the guidelines recommend the use of IGRA alone for children with BCG vaccination [15,16]. However, there is a lack of data concerning the use of IGRA in children in Korea; the Korean Guideline for Tuberculosis recommends the use of TST alone except in children immunized with BCG twice or who received the BCG vaccine after 1 year of age [13]. According to the Korean guideline, the TST was chosen as the diagnostic method for LTBI in this study.
Liquid laundry detergent capsules (PODS): a review of their composition and mechanisms of toxicity, and of the circumstances, routes, features, and management of exposure
Published in Clinical Toxicology, 2019
Rachael Day, Sally M. Bradberry, Simon H. L. Thomas, J. Allister Vale
Supplemental oxygen should be administered to those developing hypoxemia and bronchodilators can be given if laryngospasm or bronchospasm develops. Intubation and assisted ventilation are required rarely [8,10,34,51]. A chest radiograph should be performed if respiratory features develop. Endoscopy should be performed in patients with swallowing difficulties, drooling or oropharyngeal burns, which will need to be repeated in an appropriate timeframe should abnormalities be found initially. If substantial damage is present, MRI should be considered. In addition, intravenous fluids will be required if prolonged vomiting or diarrhea occur. Correction of acid-base disturbances, usually hyperlactatemia and mild metabolic acidosis, may be achieved usually by the administration of crystalloid fluids alone, without the need for sodium bicarbonate.
Does the initial chest radiograph severity in COVID-19 impact the short- and long-term outcome? – a perspective from India
Published in Infectious Diseases, 2022
Maria M. D’souza, Aruna Kaushik, Jeanne Maria Dsouza, Ratnesh Kanwar, Vivek Lodhi, Rajnish Sharma, Anil Kumar Mishra
Chest radiograph anteroposterior (AP) projections were taken at the time of presentation on a digital portable X-Ray unit. Radiographic features such as ground-glass opacification and consolidation were described as per the glossary of terms for thoracic imaging of the Fleischner Society [6]. Distribution of lung lesions was classified as peripheral (involving predominantly the peripheral third of the lungs), central (involving predominantly the inner two-third of the lungs) or both (involving both central and peripheral part of the lungs). Note was also made of whether the lesion was unilateral or bilateral. Additionally, a semiquantitative assessment of lesion load was made using the Brixia scoring system [7]. The lung was accordingly divided into three zones – upper, middle and lower. The upper zone was limited inferiorly up to the level of the inferior wall of the aortic arch. The middle zone was delineated between the inferior wall of the aortic arch and the right inferior pulmonary vein while the lower zone was below the right inferior pulmonary vein. Each zone was subsequently scored depending on the pattern of pulmonary infiltration in the manner adopted by Balbi et al. [8] as follows: 0 – if no infiltrates, 1 – if only ground-glassing, 2 – if mixed pattern of ground-glassing and consolidation and 3 – if pure consolidation. The individual scores in each zone were then summated to obtain the overall score. The number of zones involved was also noted. All CXRs were assessed by a trained radiologist with over 23 years experience.
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