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E. CXR-HILA

E. CXR-HILA

1. Shape

  • Appear as gentle C shapes on either side without lumps or bumps.
  • Contents: pulmonary arteries + veins, bronchi, lymph nodes.

2. Position

  • Left hila is ALWAYS (< 2cm) higher than the right.
  • A low left/right hilum could mean that it is either pushed/pulled up or down.

3. Size - Nodal vs. Vascular enlargement

  • Vascular enlargement - appear like ‘elephants’ trunks, bilateral. Cause: pulmonary hypertension.
  • Nodal enlargement - appears craggy. May be due to rotation or skeletal abnormality (scoliosis). Beware: the lesion may not be in the hila.

4. Interval change

  • For any suspected pathology, comparison to previous imaging is the first step to further evaluation.


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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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