CHEST RADIOLOGY

  CLINICAL PRESENTAION: 47 year old male status post urethroplasty 4 days back , developed acute sudden chest pain that subsided after few minutes but the patient continue to have shortness of breath.   FINDINGS: The portable chest radiography demonstrate premiant right inferior pulmonary artery ( Fleishner's sign ) with abrupt caliber change ( Chang's sign ) highly suggestive of acute pulmonary embolism. The patient has a previous radiograph, one year back ; which demonstrate normal pulmonary artery size.   CTPA demonstrate bilateral main pulmonary arteries filling defects in keeping with acute pulmonary embolism.

  CLINICAL PRESENTAION: 41 year old female presented with acute hemoptysis without other respiratory or constitutional symptoms.  FINDINGS: Frontal chest radiograph demonstrate right upper lung zone opacity.  CT scan of the chest reveals right upper lobe , posterior segment , cavitary lesion with satellite nodules , the findings are highly suggestive of post-primary mycobacterium tuberculosis. Confirmed by culture. 

  Clinical presentation: 62 year old male patient with suspicion of malignancy.  Imaging findings: Accessory sternalis muscle of the left anterior chest wall is a normal variant.  Should not be mistaken as pathology. 

Clinical presentation: 80 year old ex-smoker female with chronic cough Imaging manifestations: Right middle lobe syndrome refer to chronic right middle lobe collapse without obstructing lesion that is associated with bronchiectasis. 

Clinical presentation: Patient often complaining of dyspnea on exertion, chest pain, cough and syncope. High risk patients: Cancer patient; chronic cardiac or pulmonary disease and clotting disorders. Imaging manifestations: Chest radiography would be normal early in the course of the development of CTEPH; later on there will be enlargement of the pulmonary arteries. Subpleural opacities representing recent or remote pulmonary infarction may be encountered.  CTPA: The study of choice. Enlarged pulmonary artery. Eccentric filling defects representing organizing thrombi.  Linear intraluminal filling defects representing intravascular webs. Abrupt narrowing of the pulmonary arteries with reduction in the arterial diameter. Markedly hypertrophied bronchial arteries.  Right ventricular enlargement and hypertrophy.   HRCT: Mosaic perfusion. Small foci of subpleural scarring related to prior pulmonary infarction.  Enlarged ...