A posteroanterior and lateral chest film should be obtained primarily to exclude competing diagnoses. They may be entirely normal in mild disease. As COPD progresses, abnormalities reflect emphysema, hyperinflation, and pulmonary hypertension. Emphysema is manifested by an increased lucency of the lungs. In smokers, these changes are more prominent in the upper lobes, while in a1AT deficiency, they are more likely in basal zones. Local radiolucencies >1 cm in diameter and surrounded by hairline arcuate shadows indicate the presence of bullae and are highly specific for emphysema. With hyperinflation, the chest becomes vertically elongated with low flattened diaphragms. The heart shadow is also vertical and narrow. The retrosternal airspace is increased on the lateral view, and the sternal-diaphragmatic angle exceeds 90°. In the presence of pulmonary hypertension, the pulmonary arteries become enlarged and taper rapidly. The right heart border may become prominent and impinge on the retrosternal airspace. The presence of "dirty lung fields" may reflect the presence of bronchiolitis.
Computed tomography has greater sensitivity and specificity for emphysema than the plain film but is rarely necessary except for the diagnosis of bronchiectasis and evaluation of bullous disease. Nonhomogeneous distribution of emphysema is thought by some to be an indicator of suitability for lung volume reduction surgery (LVRS).
- ► 2014 (114)
- ► 2013 (213)
- ► 2012 (229)
- ► 2011 (282)
- ► 2010 (171)
- ► 2009 (191)
- ► 2008 (194)
- ► 2007 (131)
- ► 2006 (221)
- ► 2005 (158)
- Sequestrum- A large rod-like sequestrum is observe...
- Chest radiograph demonstrates decreased pulmonary ...
- STRING OF BEADS
- Fibromuscular dysplasia condition of unknown ae...
- Pulmonary edema
- Lateral radiograph of a lumbar vertebral body demo...
- Paget's disease Lateral radiograph of the skull d...
- Barium swallow in a child showing typical appearan...
- sheperd's crook deformity femur-typical of fibrous...
- air bronchogram-- a classical sign described by fl...
- small densely calcified nonfunctioning right kid...
- IMAGING IN BILIARY ATRESIA
- the classic waterlily sign of hydatid!!!!!COPYRIGH...
- History of X-rays
- indian conference calender
- hydatid cyst lung.. a classical CXR appearance alt...
- MITRAL STENOSIS-RADIOLOGICAL FINDINGS
- on line book purchasing
- cranial USG showing bilateral subdural effusion.. ...
- choledocolithiasis-the classical meniscus sign at ...
- MR imaging bladder
- normal barium meal follow through jejunum has valv...
- "pneumatocele" a characterstic of staphylococcal p...
- visit my message board
- "widened intercondylar notch knee" classical featu...
- Nonvisualization of Appendix on CT Linked With Low...
- OSTEOSARCOMA-"SUNRAY APPEARANCE"
- HEMOLYTIC ANEMIA
- posterior urethral valve
- Short Service Commission Notification with the Arm...
- important facts radiotherapy
- MR SAFETY AND CEREBROSPINAL FLUID SHUNT VALVES
- COPD X-RAY changes
- Alobar Holoprosencephaly Holoprosencephaly is a c...
- Renal Transit Time with MR Urography in Children
- Müllerian Duct Anomalies: Imaging and Clinical Iss...
- interesting syndrome
- RSNA 2004
- WHITAKER TEST
- official links for indian medicos
- Radiology quiz
- Radiology of pulmonary infections
- Reviews to My Book "Review of Radiology"
- quote of the day
- RADIOTHERAPY TUTORIAL
- SGPGI FORMS OUT!!!
- Immediate Computed Tomography Scanning of Acute St...
- radiologists, say good bye to cardiac CT!!!!
- PRIMARY PULMONARY TUBERCULOSIS
- PGI forms out
- DOUBLE BUBBLE SIGN
- quote of the day
- orbital cysticercosis
- PUTTY KIDNEY
- ultrasound simulators
- ▼ October (57)