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B. CXR-ASSESSMENT OF TECHNICAL ADEQUACY

B. CXR-ASSESSMENT OF TECHNICAL ADEQUACY

1. Inspiratory effort

  • Anterior aspect of at least 6 ribs must be noted above the dome of the right diaphragm.
  • Poor effort: the cardiac shadow may appear spuriously enlarged, crowding of vessels at lung bases.

2. Rotation

  • SP is equidistant from the medial end of each clavicle on frontal image.
  • Rotation to the right may cause: pseudo-mediastinal mass, hyper-lucency of the right lung.
  • Rotation to the left: aortic arch may appear spuriously enlarged.

3. Angulation

  • Clavicles should be projected over the posterior 3rd rib.

4. Exposure/penetration

  • Assessed by looking at the lower thoracic vertebral bodies, whose outline should just be visible (on PA film).
  • Poor penetration: pulmonary vessels and interstitial markings appear more prominent, loss of detail at the lung bases and vertebrae, results in increased density.


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REFERENCES

1. Goodman, L. and Felson, B. (2015). Felson's principles of chest roentgenology. 3rd ed. Philadelphia, PA: Elsevier, Saunders.
2. Dähnert W. Radiology Review Manual. LWW. (2011) ISBN:1609139437. Read it at Google Books - Find it at Amazon
3. Elizabeth Puddy, Catherine Hill; Interpretation of the chest radiograph, Continuing Education in Anaesthesia Critical Care & Pain, Volume 7, Issue 3, 1 June 2007, Pages 71–75, https://doi.org/10.1093/bjaceaccp/mkm014

Ⓒ A. Manickam 2018

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