Submit Search
Upload
The radiology assistant chest x ray - basic interpretation
•
26 likes
•
3,345 views
kosar kamal
Follow
basic chest interpretation
Read less
Read more
Health & Medicine
Report
Share
Report
Share
1 of 56
Download now
Download to read offline
Recommended
chest radiology
Radiology: Chest Imaging
Radiology: Chest Imaging
SCGH ED CME
Basics of CT chest
Basics of CT Chest
Basics of CT Chest
Pulmonologist Dr. Zannatul Rayhan
Basics of CT chest interpretation
Basics of CT chest
Basics of CT chest
Mahmoud Elhusseiny Abolmagd
Rathachai Kaewlai
Emergency Radiology
Emergency Radiology
Narenthorn EMS Center
Upakar Paudel B.Sc MIT UCMSTH Bhairahawa
CT Procedure of Thorax (CT Chest)
CT Procedure of Thorax (CT Chest)
Upakar Paudel
Collapse- RADIOLOGY
Collapse- RADIOLOGY
Navdeep Shah
Describes cross sectional anatomy of the mediastinum , and lobar and segmental anatomy of the lung with teaching points and radiological guidelines and multiple examples of lobar and segmental pathologies and how we localize these pathologies .Also the types of chest CT images and indications of chest CT.
CT CHEST ANATOMY
CT CHEST ANATOMY
Sakher Alkhaderi
Just a basic overview of the most commonly encountered signs in chest Xray for a Radiology resident and clinicians .
Signs in Chest Xray
Signs in Chest Xray
Archana Koshy
Recommended
chest radiology
Radiology: Chest Imaging
Radiology: Chest Imaging
SCGH ED CME
Basics of CT chest
Basics of CT Chest
Basics of CT Chest
Pulmonologist Dr. Zannatul Rayhan
Basics of CT chest interpretation
Basics of CT chest
Basics of CT chest
Mahmoud Elhusseiny Abolmagd
Rathachai Kaewlai
Emergency Radiology
Emergency Radiology
Narenthorn EMS Center
Upakar Paudel B.Sc MIT UCMSTH Bhairahawa
CT Procedure of Thorax (CT Chest)
CT Procedure of Thorax (CT Chest)
Upakar Paudel
Collapse- RADIOLOGY
Collapse- RADIOLOGY
Navdeep Shah
Describes cross sectional anatomy of the mediastinum , and lobar and segmental anatomy of the lung with teaching points and radiological guidelines and multiple examples of lobar and segmental pathologies and how we localize these pathologies .Also the types of chest CT images and indications of chest CT.
CT CHEST ANATOMY
CT CHEST ANATOMY
Sakher Alkhaderi
Just a basic overview of the most commonly encountered signs in chest Xray for a Radiology resident and clinicians .
Signs in Chest Xray
Signs in Chest Xray
Archana Koshy
PowerPoint presentation on the topic HRCT Chest. This presentation is divided into 5 different parts. 1)Introduction to HRCT chest 2)Technichal aspects of HRCT 3) Relevant anatomy for HRCT interpretation 4)Pattern of lung disease in HRCT 5)HRCT pattern in various ILD’s
HRCT Chest - By Dr. Tinku Joseph
HRCT Chest - By Dr. Tinku Joseph
Dr.Tinku Joseph
opaque hemithorax case wise discussion
Imaging in opaqe hemithorax [autosaved]
Imaging in opaqe hemithorax [autosaved]
Ajay Singh
Dr Md Main Uddin (MBBS, FCPS), Assistant Professor (Medicine), Cox’s Bazar Medical College, Bangladesh
Interpretation of X-Ray and other imaging
Interpretation of X-Ray and other imaging
drmainuddin
Approach to ct chest 578
Approach to ct chest 578
divitto1
A comprehensive approach to Interpretation of Chest XRay with common pathologies
Chest x ray basic interpretation
Chest x ray basic interpretation
Vikram Patil
About common abnormalities you see in chest xrays like SPN
Abnormal Chest xray
Abnormal Chest xray
Roshan Valentine
for download go to
Chest xray
Chest xray
Abino David
Imaging in haemoptysis
Imaging in haemoptysis
Imaging in haemoptysis
Rakesh Ca
Presentation1.pptx, radiological anatomy of the chest.
Presentation1.pptx, radiological anatomy of the chest.
Abdellah Nazeer
Mediastinum-RADIOLOGY
Mediastinum-RADIOLOGY
Navdeep Shah
Chest imaging
Chest imaging
Shakeel Yousaf
Assignment
Radiology of Pulmonary Hypertension
Radiology of Pulmonary Hypertension
Hatlan Al Hatlan
Causes of rib notching
Rib notching
Rib notching
Madhu Reddy
Chest x ray
Chest x ray
Chest x ray
Dr,saket Jain
Reupload
Presentation1.pptx. interpretation of x ray chest.
Presentation1.pptx. interpretation of x ray chest.
Abdellah Nazeer
Concise overview of all the information that a Medico must know for his knowledge as well as to appear for entrance exams as well as for physicians for their routine practice.
Chest XRAY made easy-for UG/PG
Chest XRAY made easy-for UG/PG
Chandni Wadhwani
CT Angiography Lower Limb
CT Angiography Lower Limb
CT Angiography Lower Limb
Dr. Yash Kumar Achantani
Detailed explanation on contrast reaction and its management.
Contrast reactions and its management
Contrast reactions and its management
Mohammad Naufal
Thoracic anatomy on imaging modalities
Thoracic anatomy on various imaging modalities
Thoracic anatomy on various imaging modalities
Dev Lakhera
Radiology
Pleural diseases chest radiology part1
Pleural diseases chest radiology part1
drneelammalik
cxr basics
Chest x ray - basics
Chest x ray - basics
Rikin Hasnani
systemic approach to CXR
The radiology assistant chest x ray - lung disease
The radiology assistant chest x ray - lung disease
kosar kamal
More Related Content
What's hot
PowerPoint presentation on the topic HRCT Chest. This presentation is divided into 5 different parts. 1)Introduction to HRCT chest 2)Technichal aspects of HRCT 3) Relevant anatomy for HRCT interpretation 4)Pattern of lung disease in HRCT 5)HRCT pattern in various ILD’s
HRCT Chest - By Dr. Tinku Joseph
HRCT Chest - By Dr. Tinku Joseph
Dr.Tinku Joseph
opaque hemithorax case wise discussion
Imaging in opaqe hemithorax [autosaved]
Imaging in opaqe hemithorax [autosaved]
Ajay Singh
Dr Md Main Uddin (MBBS, FCPS), Assistant Professor (Medicine), Cox’s Bazar Medical College, Bangladesh
Interpretation of X-Ray and other imaging
Interpretation of X-Ray and other imaging
drmainuddin
Approach to ct chest 578
Approach to ct chest 578
divitto1
A comprehensive approach to Interpretation of Chest XRay with common pathologies
Chest x ray basic interpretation
Chest x ray basic interpretation
Vikram Patil
About common abnormalities you see in chest xrays like SPN
Abnormal Chest xray
Abnormal Chest xray
Roshan Valentine
for download go to
Chest xray
Chest xray
Abino David
Imaging in haemoptysis
Imaging in haemoptysis
Imaging in haemoptysis
Rakesh Ca
Presentation1.pptx, radiological anatomy of the chest.
Presentation1.pptx, radiological anatomy of the chest.
Abdellah Nazeer
Mediastinum-RADIOLOGY
Mediastinum-RADIOLOGY
Navdeep Shah
Chest imaging
Chest imaging
Shakeel Yousaf
Assignment
Radiology of Pulmonary Hypertension
Radiology of Pulmonary Hypertension
Hatlan Al Hatlan
Causes of rib notching
Rib notching
Rib notching
Madhu Reddy
Chest x ray
Chest x ray
Chest x ray
Dr,saket Jain
Reupload
Presentation1.pptx. interpretation of x ray chest.
Presentation1.pptx. interpretation of x ray chest.
Abdellah Nazeer
Concise overview of all the information that a Medico must know for his knowledge as well as to appear for entrance exams as well as for physicians for their routine practice.
Chest XRAY made easy-for UG/PG
Chest XRAY made easy-for UG/PG
Chandni Wadhwani
CT Angiography Lower Limb
CT Angiography Lower Limb
CT Angiography Lower Limb
Dr. Yash Kumar Achantani
Detailed explanation on contrast reaction and its management.
Contrast reactions and its management
Contrast reactions and its management
Mohammad Naufal
Thoracic anatomy on imaging modalities
Thoracic anatomy on various imaging modalities
Thoracic anatomy on various imaging modalities
Dev Lakhera
Radiology
Pleural diseases chest radiology part1
Pleural diseases chest radiology part1
drneelammalik
What's hot
(20)
HRCT Chest - By Dr. Tinku Joseph
HRCT Chest - By Dr. Tinku Joseph
Imaging in opaqe hemithorax [autosaved]
Imaging in opaqe hemithorax [autosaved]
Interpretation of X-Ray and other imaging
Interpretation of X-Ray and other imaging
Approach to ct chest 578
Approach to ct chest 578
Chest x ray basic interpretation
Chest x ray basic interpretation
Abnormal Chest xray
Abnormal Chest xray
Chest xray
Chest xray
Imaging in haemoptysis
Imaging in haemoptysis
Presentation1.pptx, radiological anatomy of the chest.
Presentation1.pptx, radiological anatomy of the chest.
Mediastinum-RADIOLOGY
Mediastinum-RADIOLOGY
Chest imaging
Chest imaging
Radiology of Pulmonary Hypertension
Radiology of Pulmonary Hypertension
Rib notching
Rib notching
Chest x ray
Chest x ray
Presentation1.pptx. interpretation of x ray chest.
Presentation1.pptx. interpretation of x ray chest.
Chest XRAY made easy-for UG/PG
Chest XRAY made easy-for UG/PG
CT Angiography Lower Limb
CT Angiography Lower Limb
Contrast reactions and its management
Contrast reactions and its management
Thoracic anatomy on various imaging modalities
Thoracic anatomy on various imaging modalities
Pleural diseases chest radiology part1
Pleural diseases chest radiology part1
Viewers also liked
cxr basics
Chest x ray - basics
Chest x ray - basics
Rikin Hasnani
systemic approach to CXR
The radiology assistant chest x ray - lung disease
The radiology assistant chest x ray - lung disease
kosar kamal
A case of SLE polyserositis & pneumonitis
A case of SLE polyserositis & pneumonitis
Stanley Medical College, Department of Medicine
Pulmonary manifestations of lupus
Pulmonary manifestations of lupus
mohmeet
Pericardial effusion
Pericardial effusion
Todd Peterson
Sepsis
Sepsis
軒名 林
Surviving Sepsis Campaign International Guidelines for Management of Severe Sepsis and Septic Shock: 2012 Critical Care Medicine 2013 Feb;41(2):580-637
Surviving Sepsis Guidelines 2012
Surviving Sepsis Guidelines 2012
Sun Yai-Cheng
this topic describes indetail regarding the SYSTEMIC LUPUS ERYTHAMETOSUS (SLE) and its management
Systemic lupus
Systemic lupus
Siva Nanda Reddy
андрология 1
андрология 1
imad almasri
Professional Persona Project - John Patino PPP
Professional Persona Project - John Patino
Professional Persona Project - John Patino
John Patino
Materi Praktikum
Pertemuan ke 1 pengenalan komputer
Pertemuan ke 1 pengenalan komputer
Harry-antho Putheraa
Talk presented to the wide technical audience at Rackspace for the internal tech conference Rax.io. Talks about how ZeroVM can be used together with Openstack to revolutionise several industries, most notable the Visual Effects industry and other industries focused on processing large amounts of binary data.
How to revolutionise an industry with ZeroVM
How to revolutionise an industry with ZeroVM
Jakub Krajcovic
Professional Persona Project - John Patino
Professional Persona Project - John Patino
Professional Persona Project - John Patino
John Patino
андрология 2
андрология 2
imad almasri
International group F
Food art
Food art
Elpida Adalopoulou
soon
soon
soon
chloekaiyun
Place and community based education - Prof Greg Smith
Place and community based education - Prof Greg Smith
Meg Collis
Openstack presentation presented to the Sysadmins Guild in Australia. Talks about what Openstack is, where it's coming from, how it is evolving and growing and where it's going.
Openstack SAGE-AU
Openstack SAGE-AU
Jakub Krajcovic
อุปกรณ์พื้นฐานคอมพิวเตอร์
อุปกรณ์พื้นฐานคอมพิวเตอร์
BoMz Zilch
Conventions of a Thriller
Conventions of a Thriller
charlottemedia13
Viewers also liked
(20)
Chest x ray - basics
Chest x ray - basics
The radiology assistant chest x ray - lung disease
The radiology assistant chest x ray - lung disease
A case of SLE polyserositis & pneumonitis
A case of SLE polyserositis & pneumonitis
Pulmonary manifestations of lupus
Pulmonary manifestations of lupus
Pericardial effusion
Pericardial effusion
Sepsis
Sepsis
Surviving Sepsis Guidelines 2012
Surviving Sepsis Guidelines 2012
Systemic lupus
Systemic lupus
андрология 1
андрология 1
Professional Persona Project - John Patino
Professional Persona Project - John Patino
Pertemuan ke 1 pengenalan komputer
Pertemuan ke 1 pengenalan komputer
How to revolutionise an industry with ZeroVM
How to revolutionise an industry with ZeroVM
Professional Persona Project - John Patino
Professional Persona Project - John Patino
андрология 2
андрология 2
Food art
Food art
soon
soon
Place and community based education - Prof Greg Smith
Place and community based education - Prof Greg Smith
Openstack SAGE-AU
Openstack SAGE-AU
อุปกรณ์พื้นฐานคอมพิวเตอร์
อุปกรณ์พื้นฐานคอมพิวเตอร์
Conventions of a Thriller
Conventions of a Thriller
Similar to The radiology assistant chest x ray - basic interpretation
Cxr new
Cxr new
LPS Institute of Cardiology Kanpur UP India
Pediatric x-ray techniques of chest and abdomen
GROUP 6B PEDIATRIC CHEST AND ABDOMEN XRAY TECHNIQUE, PITFALLS.pptx
GROUP 6B PEDIATRIC CHEST AND ABDOMEN XRAY TECHNIQUE, PITFALLS.pptx
YasinKidiri
Fetal MRI
Fetal MRI
Fetal MRI
Patty G.
AAMD Presentation
AAMD Presentation
Lee Culp, M.S., C.M.D, R.T.(T.)
Myo protect
Myo protect
Sandeep Jose K
Martin Utley, Director of the Clinical Operational Research Unit at University College London, reflects upon his involvement in the launch of specific tools to monitor care quality for paediatric cardiac surgery.
Engaging with data
Engaging with data
Nuffield Trust
Chest x-ray
CHEST XRAY RDG 303.pptx
CHEST XRAY RDG 303.pptx
EmmanuelOluseyi1
✍️
Interventional Radiography
Interventional Radiography
Jessica Myers
Libro sobre como la radiología ayuda en el diagnóstico de las enfermedad pulmonares.
Imagen Torácica
Imagen Torácica
Cesar Rosenberg González
ICS State of the Art Meeting 2015
Intensivist-delivered echo: dangerous in the wrong hands? - Price
Intensivist-delivered echo: dangerous in the wrong hands? - Price
intensivecaresociety
Basic knowledge for 5th year medical students
07 radiology in surgery tutorial hajhamad m msu
07 radiology in surgery tutorial hajhamad m msu
Mohammed M. H. Hajhamad
It is Journal Club presentation on Chest Tube drainage
Journal club presentation (chest tube) _.pptx dr shakil
Journal club presentation (chest tube) _.pptx dr shakil
Shakil Ahmad
C.V Hany
C.V Hany
Hany Kerbalou
radiologi
9241541792 eng
9241541792 eng
Nurmaniar Majid
Siêu Âm Thai
Echocardiographic anatomy in the fetus 2009 pg
Echocardiographic anatomy in the fetus 2009 pg
Nguyen Phong Trung
Presentation for ISU PARM 2223 Paramedic Course
2020 fun with thoracostomy's
2020 fun with thoracostomy's
Robert Cole
TIRADS
Protocol
Protocol
Sahana Subramani
The thyroid is a gland at the front of your neck beneath your voice box (larynx). A healthy thyroid is a little larger than a quarter. It usually can’t be felt through the skin. The thyroid has two parts (lobes). A thin piece of tissue (the isthmus) connects the two lobes. The thyroid makes hormones: -- Thyroid hormone: The thyroid follicular cells make thyroid hormone. This hormone affects heart rate, blood pressure, body temperature, and weight. For example, too much thyroid hormone makes your heart race, and too little makes you feel very tired. -- Calcitonin: The C cells in the thyroid make calcitonin. This hormone plays a small role in keeping a healthy level of calcium in the body. Four or more tiny parathyroid glands are on the back of the thyroid. These glands make parathyroid hormone. This hormone plays a big role in helping the body maintain a healthy level of calcium. http://www.cancer.gov/cancertopics/wyntk/thyroid
Thyroid Cancer
Thyroid Cancer
fitango
Notes from the Cambridge University Hospital Damage Control Resuscitation Symposium in Dubai.
Damage Control Symposium 24th Nov 2014
Damage Control Symposium 24th Nov 2014
Alan Batt
My presentation about W.E. Ladd.
WE Ladd - Seminar - EN - 2018
WE Ladd - Seminar - EN - 2018
Oguz Kizilkaya
Similar to The radiology assistant chest x ray - basic interpretation
(20)
Cxr new
Cxr new
GROUP 6B PEDIATRIC CHEST AND ABDOMEN XRAY TECHNIQUE, PITFALLS.pptx
GROUP 6B PEDIATRIC CHEST AND ABDOMEN XRAY TECHNIQUE, PITFALLS.pptx
Fetal MRI
Fetal MRI
AAMD Presentation
AAMD Presentation
Myo protect
Myo protect
Engaging with data
Engaging with data
CHEST XRAY RDG 303.pptx
CHEST XRAY RDG 303.pptx
Interventional Radiography
Interventional Radiography
Imagen Torácica
Imagen Torácica
Intensivist-delivered echo: dangerous in the wrong hands? - Price
Intensivist-delivered echo: dangerous in the wrong hands? - Price
07 radiology in surgery tutorial hajhamad m msu
07 radiology in surgery tutorial hajhamad m msu
Journal club presentation (chest tube) _.pptx dr shakil
Journal club presentation (chest tube) _.pptx dr shakil
C.V Hany
C.V Hany
9241541792 eng
9241541792 eng
Echocardiographic anatomy in the fetus 2009 pg
Echocardiographic anatomy in the fetus 2009 pg
2020 fun with thoracostomy's
2020 fun with thoracostomy's
Protocol
Protocol
Thyroid Cancer
Thyroid Cancer
Damage Control Symposium 24th Nov 2014
Damage Control Symposium 24th Nov 2014
WE Ladd - Seminar - EN - 2018
WE Ladd - Seminar - EN - 2018
More from kosar kamal
lecture 1 -positioning
Upper limb radiography
Upper limb radiography
kosar kamal
high diploma final exam slides this is based on the common daily work cases
Final exam practical
Final exam practical
kosar kamal
this is a short presentation quiz about common GIT cases
GIT
GIT
kosar kamal
a short presentation quiz in chest conditions that are daily faced
Chest
Chest
kosar kamal
this is a quiz basically set for review of common cases in neuroradiology
neuroradiology quiz module
neuroradiology quiz module
kosar kamal
CXR- collapse
Lecture 7
Lecture 7
kosar kamal
second part of basic chest x-ray interpretation
Lectures 6
Lectures 6
kosar kamal
mediastinal masses
Chest radiology essentials mediastinal masses
Chest radiology essentials mediastinal masses
kosar kamal
chapter 2 of the book
Chest radiology essentials signs
Chest radiology essentials signs
kosar kamal
chest x-ray
basic approach for CXR interpretation
basic approach for CXR interpretation
kosar kamal
a quiz about problems of first trimester pregnancy problems
Quiz 2
Quiz 2
kosar kamal
introduction to late pregnancy ultrasound
Second and third trimester emergencies
Second and third trimester emergencies
kosar kamal
first trimester problems ... a simplified way of explanation
First trimester ultrasound
First trimester ultrasound
kosar kamal
a simplified , short presentation on FAST examination
Extended focused abdominal assesment in trauma patients
Extended focused abdominal assesment in trauma patients
kosar kamal
More from kosar kamal
(14)
Upper limb radiography
Upper limb radiography
Final exam practical
Final exam practical
GIT
GIT
Chest
Chest
neuroradiology quiz module
neuroradiology quiz module
Lecture 7
Lecture 7
Lectures 6
Lectures 6
Chest radiology essentials mediastinal masses
Chest radiology essentials mediastinal masses
Chest radiology essentials signs
Chest radiology essentials signs
basic approach for CXR interpretation
basic approach for CXR interpretation
Quiz 2
Quiz 2
Second and third trimester emergencies
Second and third trimester emergencies
First trimester ultrasound
First trimester ultrasound
Extended focused abdominal assesment in trauma patients
Extended focused abdominal assesment in trauma patients
Recently uploaded
Call Girls Kurnool Just Call 8250077686 Top Class Call Girl Service Available Easy & Fast Booking Procedure Of Kurnool Escorts Call girls are ready and waiting to provide the quality essentialness that will help ease away life's tensions Kurnool Escorts are regular companions of elite gentlemen and can take them places they could only dream of visiting. These ladies take great care in maintaining themselves to look appealing; visiting salons and spas regularly keeps them looking their best; their portfolios can be found online via an escort’s agency website. EXCITING OPTIONS AVAILABLE AT OUR INDEPENDENT ESCORTS Candlelight dinner Evening date Night clubs or parties Hotels or your flats Business trip Business party Stripping party Kurnool Escort Service are adept at performing wild anal sex, deep throat sex and cum eating - perfect for satisfying all your sexual needs and playing any game imaginable. Affordable professional assistants are readily available and ready to assist with any situation - be it romantic date or solo night. Their beautiful appearances and striking personalities will leave you speechless, while they can accompany you to restaurants or bars where their presence will surely leave an impression.
Call Girls Kurnool Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kurnool Just Call 8250077686 Top Class Call Girl Service Available
Dipal Arora
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 9004268417 Neha Thakur Booking Contact Details WhatsApp Chat: +91-9004268417 Mumbai Escort Service includes providing maximum physical satisfaction to their clients as well as engaging conversation that keeps your time enjoyable and entertaining. Plus they look fabulously elegant;$S2 making an impressionable. Independent Escorts Mumbai understands the value of confidentiality and discretion - they will go the extra mile to meet your needs. Simply contact them via text messaging or through their online profiles; they'd be more than delighted to accommodate any request or arrange a romantic date or fun-filled night together. We provide - Flexibility Choices and options Lists of many beauty fantasies Turn your dream into reality Perfect companionship Cheap and convenient In-call and Out-call services And many more.
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Anamika Rawat
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋 Call Mr Chirag Ji +91-7877925207 NORTH/SOUTH INDIANS HIGH CLASS MODELS/COLLEGE GIRLS/ HOUSEWIVES/BODY TO BODY MASSAGE, SANDWICH MASSAGE, SHOWER BATHING, BLOW JOB, LICKING, FRONT AND BACK SHOT, RUBBING, KISSING SMOOCHING ETC ETC... UNLIMITED FUN Call 24/7. Your assistance for your service... ☛ ✔✔ secure✔✔ 100% safe ✔✔ Vip Callgirl Service offers you the most beautiful High Profile sexy independent female Escorts in genuine ✔✔✔ To enjoy with hot and sexy girls ✔✔✔ A03524SW ★providing:- • Models • vip Models • Russian Models • Foreigner Models • TV Actress and Celebrities • Receptionist • Air Hostess • Call Center Working Girls/Women • Hi-Tech Co. Girls/Women • Housewife • Collage Going Girls. • Travelling Escorts. • Ramp-models • Foreigner And Many More.. ★OUR BEST SERVICES: - FOR BOOKING ★ A-Level (5 star escort) ★ Strip-tease ★ BBBJ (Bareback Blowjob)
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
TANUJA PANDEY
☑️░ 9630942363 ░ CALL GIRLS ░ VIP ░ ESCORT ░ SERVICES ░ AGENCY ░ 9630942363 THE GENUINE ESCORT AGENCY VIP LUXURY CALL GIRLS HIGH CLASS MODELS CALL GIRLS GENUINE ESCORT BOOK BOOK APPOINTMENT - 9630942363 THE GENUINE ESCORT AGENCY BEST VIP CALL GIRLS & ESCORTS SERVICE 9630942363 VIP CALL GIRLS ALL TYPE WOMEN AVAILABLE INCALL & OUTCALL BOTH AVAILABLE BOOK NOW 9630942363 VIP GENUINE INDEPENDENT ESCORT AGENCY VIP PRIVATE AUNTIES BEAUTIFUL LOOKING HOT AND SEXT GIRLS AND PARTY TYPE GIRLS YOU WANT SERVICE THEN CALL THIS NUMBER 9630942363 ROOM ALSO PROVIDE HOME & HOTELS SERVICE FULL SAFE AND SECURE WORK WITHOUT CONDOMS, ORAL, SUCKING, LIP TO LIP, ANAL, BACK SHOTS, SEX 69, WITHOUT BLOWJOB AND MUCH MORE FOR BOOKING 9630942363
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
GENUINE ESCORT AGENCY
☑️░ 9630942363 ░ CALL GIRLS ░ VIP ░ ESCORT ░ SERVICES ░ AGENCY ░ 9630942363 THE GENUINE ESCORT AGENCY VIP LUXURY CALL GIRLS HIGH CLASS MODELS CALL GIRLS GENUINE ESCORT BOOK BOOK APPOINTMENT - 9630942363 THE GENUINE ESCORT AGENCY BEST VIP CALL GIRLS & ESCORTS SERVICE 9630942363 VIP CALL GIRLS ALL TYPE WOMEN AVAILABLE INCALL & OUTCALL BOTH AVAILABLE BOOK NOW 9630942363 VIP GENUINE INDEPENDENT ESCORT AGENCY VIP PRIVATE AUNTIES BEAUTIFUL LOOKING HOT AND SEXT GIRLS AND PARTY TYPE GIRLS YOU WANT SERVICE THEN CALL THIS NUMBER 9630942363 ROOM ALSO PROVIDE HOME & HOTELS SERVICE FULL SAFE AND SECURE WORK WITHOUT CONDOMS, ORAL, SUCKING, LIP TO LIP, ANAL, BACK SHOTS, SEX 69, WITHOUT BLOWJOB AND MUCH MORE FOR BOOKING 9630942363
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
GENUINE ESCORT AGENCY
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl In 5 Star Hotel Service Available Booking Contact Details WhatsApp Chat: +91-8617370543 Guwahati Escort Service includes providing maximum physical satisfaction to their clients as well as engaging conversation that keeps your time enjoyable and entertaining. Plus they look fabulously elegant; making an impressionable Independent Escorts Guwahati understands the value of confidentiality and discretion - they will go the extra mile to meet your needs. Simply contact them via text messaging or through their online profiles; they'd be more than delighted to accommodate any request or arrange a romantic date or fun-filled night together. We provide - Flexibility Choices and options Lists of many beauty fantasies Turn your dream into reality Perfect companionship Cheap and convenient In-call and Out-call services And many more.
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Dipal Arora
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lonely Housewife In Top Rated Hotel WhatsApp Chat : +91-9257276172 Get More Information About Jaipur Escorts Service Jaipur Escorts offer their services to their clients at any time of day or night - including sex, travel and tours. Contact them via telephone or the internet. Hire an escort as your movie partner, date or party companion - they're sure to exceed all your expectations. Girls available 24/7 make for great companions who offer sensual body massages and drinks/food service during your time together. Find one who fits with your personality or budget - these girls have you covered.
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
khalifaescort01
Top Rated Bangalore Call Girls Majestic ⟟ 9332606886 ⟟ Call Me For Genuine Sex Service At Affordable Rate Booking Contact Details Whatsapp Chat :+91- 9332606886 These professional and Call girls in Bangalore can satisfy your every desire - be it sensual massage or an erotic shower, they are always more than willing to meet them. Furthermore, they pay close attention to body language cues to ensure you enjoy every minute spent in their company - both in-call and outcall services are offered. Is an excellent choice for anyone seeking an exciting and thrilling night of fun and excitement The Oberoi, Bengaluru Taj West End The Leela Palace Bengaluru JW Marriott Hotel Bengaluru The Ritz-Carlton, Bangalore Sheraton Grand Bangalore Hotel at Brigade Gateway Conrad Bengaluru ITC Gardenia, Bengaluru Renaissance Bengaluru Race Course Hotel The Lalit Ashok Bangalore 30 apr 24 (LK)
Top Rated Bangalore Call Girls Majestic ⟟ 9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Majestic ⟟ 9332606886 ⟟ Call Me For Genuine S...
narwatsonia7
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Genuine Sex Service At Affordable Rate Booking Contact Details Whatsapp Chat :+91- 9332606886 These professional and Call girls in Bangalore can satisfy your every desire - be it sensual massage or an erotic shower, they are always more than willing to meet them. Furthermore, they pay close attention to body language cues to ensure you enjoy every minute spent in their company - both in-call and outcall services are offered. Is an excellent choice for anyone seeking an exciting and thrilling night of fun and excitement The Oberoi, Bengaluru Taj West End The Leela Palace Bengaluru JW Marriott Hotel Bengaluru The Ritz-Carlton, Bangalore Sheraton Grand Bangalore Hotel at Brigade Gateway Conrad Bengaluru ITC Gardenia, Bengaluru Renaissance Bengaluru Race Course Hotel The Lalit Ashok Bangalore 30 apr 24 (LK)
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...
narwatsonia7
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service Available Easy & Fast Booking Procedure Of Tirupati Escorts Call girls are ready and waiting to provide the quality essentialness that will help ease away life's tensions Tirupati Escorts are regular companions of elite gentlemen and can take them places they could only dream of visiting. These ladies take great care in maintaining themselves to look appealing; visiting salons and spas regularly keeps them looking their best; their portfolios can be found online via an escort’s agency website. EXCITING OPTIONS AVAILABLE AT OUR INDEPENDENT ESCORTS Candlelight dinner Evening date Night clubs or parties Hotels or your flats Business trip Business party Stripping party Tirupati Escort Service are adept at performing wild anal sex, deep throat sex and cum eating - perfect for satisfying all your sexual needs and playing any game imaginable. Affordable professional assistants are readily available and ready to assist with any situation - be it romantic date or solo night. Their beautiful appearances and striking personalities will leave you speechless, while they can accompany you to restaurants or bars where their presence will surely leave an impression.
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service Available
Dipal Arora
"Call Girls Indore VIP Service.. Booking Open Now We Are Providing Safe & Secure High Class girl women sucking men Services Affordable Rate 100% Satisfaction, Unlimited Enjoyment. Any Time for Model/ women seeking men in royal call girl High class luxury and premium call girl agency. ✔️High class luxury and premium escorts agency We Provide Well Educated, Royal Class Female, High-class Escorts agency offering a top high class escort service in the royal Escorts ✔️ Get High Profile queens , Well Educated , Good Looking , Full Cooperative Model Services. you can see me at my comfortable Hotels or I can visit you in hotel Our Service Available IN All Services 3/5/7 Star Hotels, In call /Out call Service 24/7.. ✔️ All Meetings We Provide Hottest Female With Me Are Safe And Consensual With Most Limits Respected Complete Satisfaction Guaranteed...Service Available In:- 24/7 3 * 5 *7 *Star Hotel Service In. In Call Out call service Avilable also. ✔️ I guarantee you to have an unforgettable experience with me A curvy body, long hair and silky smooth skin. She is an independent royal Escorts/Women Seeking Men model will give you more pleasure & Full satisfaction. ✔️ I am very sensual and flirtatious with charming personality! I love to laugh and my bright smile is ever Present. ,Hotel & Home Services CALL PLZZ ✔️Available Near All 3* 4* 5* 7* Hotels Of I Want Only Hotel Name , Guest Name , Room No. Only For Confirmation.✔️ Nandani... agency...⭐⭐⭐⭐⭐ VIP...Service ✣ ✤ ✥ ✦ TIME WASTERS AND BARGAINERS ARE PLEASE EXCUSE, WE RESPECT YOUR SAFETY AND PRIVACY AND EXPECT TH WHATSAPP CALL ME "
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
mahaiklolahd
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Profile Most Luxurious Call Girl With Real Photos Booking Details Are here 05-May-2024( Mj) Click On WhatsApp Chat +91-8445551418 Jaipur Escorts Make You Feel Like Royalty Jaipur Escorts catering to high profile clients are available 24-7 to meet their clients' needs and are also available for dinner dates, business conferences, foreign travel trips and clubbing activities. Their customers are contacted directly through in order to prevent risky situations from developing.is home to some of India's most beautiful women. These girls come highly educated with great backgrounds; furthermore they are extremely beautiful and will make you feel like royalty if hired for hours or days! Siya Khan | FOR BOOKING CALL Our All Services :- 1 )★ (Oral to consummation) bjnonCovered 2 )★ Special Massage 3 )★ O-Level (Oral sex) 4 )★ Blow Job; 5 )★ COB (Come On Body) 6 )★. Extraball (Have sex ordinarily) 7 )★ A-Level (5 star escort) 8 )★ Strip-bother 9 )★ BBBJ (Bareback Blowjob) 10 )★ Spending time in my rooms 11 )★ BJ (Blowjob Without a Condom) 12 )★ COF (Come On Face) 13 )★ Completion
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
parulsinha
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 Star Hotel Service Available Booking Contact Details WhatsApp Chat: +91-8617370543 Patna Escort Service includes providing maximum physical satisfaction to their clients as well as engaging conversation that keeps your time enjoyable and entertaining. Plus they look fabulously elegant; making an impressionable Independent Escorts Patna understands the value of confidentiality and discretion - they will go the extra mile to meet your needs. Simply contact them via text messaging or through their online profiles; they'd be more than delighted to accommodate any request or arrange a romantic date or fun-filled night together. We provide - Flexibility Choices and options Lists of many beauty fantasies Turn your dream into reality Perfect companionship Cheap and convenient In-call and Out-call services And many more.
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Dipal Arora
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service Available Easy & Fast Booking Procedure Of Guntur Escorts Call girls are ready and waiting to provide the quality essentialness that will help ease away life's tensions Guntur Escorts are regular companions of elite gentlemen and can take them places they could only dream of visiting. These ladies take great care in maintaining themselves to look appealing; visiting salons and spas regularly keeps them looking their best; their portfolios can be found online via an escort’s agency website. EXCITING OPTIONS AVAILABLE AT OUR INDEPENDENT ESCORTS Candlelight dinner Evening date Night clubs or parties Hotels or your flats Business trip Business party Stripping party Guntur Escort Service are adept at performing wild anal sex, deep throat sex and cum eating - perfect for satisfying all your sexual needs and playing any game imaginable. Affordable professional assistants are readily available and ready to assist with any situation - be it romantic date or solo night. Their beautiful appearances and striking personalities will leave you speechless, while they can accompany you to restaurants or bars where their presence will surely leave an impression.
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service Available
Dipal Arora
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426 Call Girls in Call\\Us))),(Delhi) We are Provide best Genuine Normal, High class call girls. escort service at affordable price. We Are One Of The Oldest Escorts and Call girls Agencies in Delhi You Will Find That Our Female Escorts Are Full Of Fun, Sexy And They Would Love Enjoy Your Company. We Have A Fantastic Selection Of Callo Girls Ladies Available For In-Calls As Well As Out-Calls. Our Escorts Are Not Only Beautiful But All Have Great Personalities Making Them The Perfect Companion For Any Occasion. In-Call: — You Can Come at Our Location in Delhi Which Is Very Clean Hygienic 100% safe Accommodation. Out-Call: — You have To come and Pick Girl From My Place We are Also Provide Door Step Services in Delhi , Gurgaon, Noida. Hygienic: — Full Ac Neat And Clean Rooms Available In Hotel 24 * 7 Hour In Delhi NCR, We Are Providing : — all Types of girls Indian, North East , Foreigner , Airhostess, many More. Service type — In-call Shot 1500, 2,000– In — Call Night /Out-call Night 6,000, to 7,000 — Hi-Fi Rates Shot — 2,000 to 4,000 Full Night 8,000 to 10,000 More Details, Call//WhatsApp, 97111 🔝 ⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
jennyeacort
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available Easy & Fast Booking Procedure Of Rishikesh Escorts Call girls are ready and waiting to provide the quality essentialness that will help ease away life's tensions Rishikesh Escorts are regular companions of elite gentlemen and can take them places they could only dream of visiting. These ladies take great care in maintaining themselves to look appealing; visiting salons and spas regularly keeps them looking their best; their portfolios can be found online via an escort’s agency website. EXCITING OPTIONS AVAILABLE AT OUR INDEPENDENT ESCORTS Candlelight dinner Evening date Night clubs or parties Hotels or your flats Business trip Business party Stripping party Rishikesh Escort Service are adept at performing wild anal sex, deep throat sex and cum eating - perfect for satisfying all your sexual needs and playing any game imaginable. Affordable professional assistants are readily available and ready to assist with any situation - be it romantic date or solo night. Their beautiful appearances and striking personalities will leave you speechless, while they can accompany you to restaurants or bars where their presence will surely leave an impression.
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Dipal Arora
Call Girls Kakinada Just Call 9907093804 Top Class Call Girl Service Available Easy & Fast Booking Procedure Of Kakinada Escorts Call girls are ready and waiting to provide the quality essentialness that will help ease away life's tensions Kakinada Escorts are regular companions of elite gentlemen and can take them places they could only dream of visiting. These ladies take great care in maintaining themselves to look appealing; visiting salons and spas regularly keeps them looking their best; their portfolios can be found online via an escort’s agency website. EXCITING OPTIONS AVAILABLE AT OUR INDEPENDENT ESCORTS Candlelight dinner Evening date Night clubs or parties Hotels or your flats Business trip Business party Stripping party Kakinada Escort Service are adept at performing wild anal sex, deep throat sex and cum eating - perfect for satisfying all your sexual needs and playing any game imaginable. Affordable professional assistants are readily available and ready to assist with any situation - be it romantic date or solo night. Their beautiful appearances and striking personalities will leave you speechless, while they can accompany you to restaurants or bars where their presence will surely leave an impression.
Call Girls Kakinada Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Kakinada Just Call 9907093804 Top Class Call Girl Service Available
Dipal Arora
Model Call Girl Services in Delhi reach out to us at 🔝 9953056974 🔝✔️✔️ Our agency presents a selection of young, charming call girls available for bookings at Oyo Hotels. Experience high-class escort services at pocket-friendly rates, with our female escorts exuding both beauty and a delightful personality, ready to meet your desires. Whether it's Housewives, College girls, Russian girls, Muslim girls, or any other preference, we offer a diverse range of options to cater to your tastes. We provide both in-call and out-call services for your convenience. Our in-call location in Delhi ensures cleanliness, hygiene, and 100% safety, while our out-call services offer doorstep delivery for added ease. We value your time and money, hence we kindly request pic collectors, time-passers, and bargain hunters to refrain from contacting us. Our services feature various packages at competitive rates: One shot: ₹2000/in-call, ₹5000/out-call Two shots with one girl: ₹3500/in-call, ₹6000/out-call Body to body massage with sex: ₹3000/in-call Full night for one person: ₹7000/in-call, ₹10000/out-call Full night for more than 1 person: Contact us at 🔝 9953056974 🔝. for details Operating 24/7, we serve various locations in Delhi, including Green Park, Lajpat Nagar, Saket, and Hauz Khas near metro stations. For premium call girl services in Delhi 🔝 9953056974 🔝. Thank you for considering us!
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
9953056974 Low Rate Call Girls In Saket, Delhi NCR
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Girl UKHBET Escorts Service Available ✔ All Day And Night Booking Details Are here 05-May-2024( Mj) Click On WhatsApp Chat +91-8445551418 Jaipur Escorts Make You Feel Like Royalty Jaipur Escorts catering to high profile clients are available 24-7 to meet their clients' needs and are also available for dinner dates, business conferences, foreign travel trips and clubbing activities. Their customers are contacted directly through in order to prevent risky situations from developing.is home to some of India's most beautiful women. These girls come highly educated with great backgrounds; furthermore they are extremely beautiful and will make you feel like royalty if hired for hours or days! Siya Khan | FOR BOOKING CALL Our All Services :- 1 )★ (Oral to consummation) bjnonCovered 2 )★ Special Massage 3 )★ O-Level (Oral sex) 4 )★ Blow Job; 5 )★ COB (Come On Body) 6 )★. Extraball (Have sex ordinarily) 7 )★ A-Level (5 star escort) 8 )★ Strip-bother 9 )★ BBBJ (Bareback Blowjob) 10 )★ Spending time in my rooms 11 )★ BJ (Blowjob Without a Condom) 12 )★ COF (Come On Face) 13 )★ Completion
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
parulsinha
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 hours available Call Mr Chirag Ji +91-7427069034 We offer all types of girls of your choice with space. Our escorts are fully cooperative and understand your needs. All types of call girls like Housewives, College girls, Russian girls, Muslim girls, Afghani girls, Bengali girls, Working girls, south Indian girls, Punjabi girls, etc. In-Call: — You Can Reach At Our Place in Chennai Our place Which Is Very Clean Hygienic 100% safe Accommodation. Out-Call: — Service for Out Call You have To Come Pick The Girl From My Place We Also Provide Door-Step Services Hygienic: — Full Ac Neat And Clean Rooms Available In Hotel 24 * 7 Hrs In Chennai C010524HD Our Services and Rates: – One Shot — 2500/in call (time ½ hour), 5000/out call Two shot with one girl — 5000/in call (time 1 hour), 6000/out call Body to body massage with sex- 3000/in call (time 1 hour) full night for one person– 8000/in call, 10000/out call (shot limit 4 shot) We are available 24*7 all days of the year Call us — 7427069034 !! Thank you for Visiting.
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
hotbabesbook
Recently uploaded
(20)
Call Girls Kurnool Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kurnool Just Call 8250077686 Top Class Call Girl Service Available
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
Top Rated Bangalore Call Girls Majestic ⟟ 9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Majestic ⟟ 9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service Available
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service Available
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kakinada Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Kakinada Just Call 9907093804 Top Class Call Girl Service Available
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
The radiology assistant chest x ray - basic interpretation
1.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 1/56 The Radiology Assistant : Chest XRay Robin Smithuis and Otto van Delden Radiology Department of the Rijnland Hospital, Leiderdorp and the Academical Medical Centre, Amsterdam, the Netherlands Publicationdate February 18, 2013 The chest xray is the most frequently requested radiologic examination. In fact every radiologst should be an expert in chest film reading. The interpretation of a chest film requires the understanding of basic principles. In this article we will focus on: Normal anatomy and variants. Systematic approach to the chest film using an insideout approach. Pathology of the heart, mediastinum, lungs and pleura. Normal and Variants PA view
2.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 2/56 On the PA chestfilm it is important to examine all the areas where the lung borders the diaphragm, the heart and other mediastinal structures. At these borders lungsoft tissue interfaces are seen resulting in a: Line or stripe for instance the right para tracheal stripe. Silhouette for instance the normal silhouette of the aortic knob or left ventricle These lines and silhouettes are useful localizers of disease, because they can be displaced or obscured with loss of the normal silhouette. This is called the silhouette sign, which we will discuss later. The paraspinal line may be displaced by a paravertebral abscess, hemorrhage due to a fracture or extravertebral extension of a neoplasm. Widening of the paratracheal line (> 23mm) may be due to lymphadenopathy, pleural thickening, hemorrhage or fluid overload and heart failure. Displacement of the paraaortic line can be due to elongation of the aorta, aneurysm, dissection and rupture. The anterior and posterior junction lines are formed where the upper lobes join anteriorly and posteriorly. These are usely not well seen and we will not discuss them. An important mediastinallung interface to look for is the azygoesophageal line or recess (arrow). Azygoesophageal recess. The blue arrow indicates the paraaortic line. The azygoesophageal recess is the region inferior to the level of the azygos vein arch in which the right lung forms an interface with the mediastinum between the heart anteriorly and vertebral column posteriorly.
3.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 3/56 It is bordered on the left by the esophagus. Deviation of the azygoesophageal line is caused by (5): Hiatal hernia Esophageal disease Left atrial enlargement Subcarinal lymphadenopathy Bronchogenic cyst Notice the deviation of the azygoesophageal line on the PAfilm. It is caused by a hiatal hernia. Vena azygos lobe A common normal variant is the azygos lobe. The azygos lobe is created when a laterally displaced azygos vein makes a deep fissure in the upper
4.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 4/56 part of the lung. On a chest film it is seen as a fine line that crosses the apex of the right lung. Here another patient with an azygos lobe. The azygos vein is seen as a thick structure within the azygos fissure. In some patients an extra joint is seen in the anterior part of the first rib at the point where the bone meets the calcified cartilageneous part (arrow). This may simulate a lung mass.
5.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 5/56 Pectus excavatum In patients with a pectus excavatum the right heart border can be illdefined, but this is normal. It produces a silhouette sign and thus simulating a consolidation or atelectasis of the right middle lobe. The lateral view is helpful in such cases. Pectus excavatum is a congenital deformity of the ribs and the sternum producing a concave appearance of the anterior chest wall. Lateral view On a normal lateral view the contours of the heart are visible and the IVC is seen entering the right atrium. The retrosternal space should be radiolucent, since it only contains air. Any radiopacity in this area is suspective of a proces in the anterior mediastinum or upper lobes of the lung.
6.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 6/56 As you go from superior to inferior over the vertebral bodies they should get darker, because usually there will be less soft tissue and more radiolucent lung tissue (red arrow). If this is not the case, look carefully for pathology in the lower lobes. The contours of the left and right diaphragm should be visible. The right diaphragm should be visible all the way to the anterior chest wall (red arrow). Actually we see the interface between the air in the lungs and the soft tissue structures in the abdomen. The left diaphragm can only be seen to a point where it borders the heart (blue arrow). Here the interface is lost, since the heart has the same density as the structures below the diaphragm. The left main pulmonary artery (in purple) passes over the left main bronchus and is higher than the right pulmonary artery (in blue) which passes in front of the right main bronchus.
7.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 7/56 Once you know how the normal hilar structures look like on a lateral view, it is easier to detect abnormalities. In this case on the PAview there is hilar enlargement. On the PAview it is not clear whether this is due to dilated vessels or enlarged lymph nodes. On the lateral view there are round structures in areas where you don't expect any vessels. So we can conclude that we are dealing with enlarged lymph nodes. This patient has sarcoidosis. Notice also the widening of the paratracheal line (or stripe) as a result of enlarged lymph nodes. On the lateral view spondylosis may mimick a lung mass. Any density in the area of the vertebral bodies should lead you to the PAfilm to look for spondylosis, which is usually located on the right side (arrows). On the left side the formation of osteophytes is hampered by the pulsations of the aorta.
8.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 8/56 On the PAview the superior mediastinum is widened. The lateral view is helpful in this case because it demonstrates a density in the retrosternal space. Now the differential diagnosis is limited to a mass in the anterior mediastinum (4 T's). This was a Hodgkins lymphoma. A common incidental finding in adults is a Bochdalek hernia, which is due to a congenital defect in the posterior diaphragm (arrows). In most cases it only contains retroperitoneal fat and is asymptomatic, but occasionally it may contain abdominal organs. Large hernias are sometimes seen in neonates and can be complicated by pulmonary hypoplasia. A hernia of Morgagni is also a congenital diaphragmatic hernia, but is less common. It is located anteriorly.
9.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 9/56 Systematic Approach Whenever you review a chest xray, always use a systematic approach. We use an insideout approach from central to peripheral. First the heart figure is evaluated, followed by mediastinum and hili. Subsequently the lungs, lungborders and finally the chest wall and abdomen are examined. You have to know the normal anatomy and variants. Find subtle abnormalities by using the sihouette sign and mediastinal lines. Once you see an abnormality use a pattern approach to come up with the most likely diagnosis and differential diagnosis. Old films It is extremely important to always compare with old films, as we will demonstrate in this case.
10.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 10/56 Actually someone said that the most important radiograph is the old film, since it gives you so much information. For instance a lung mass, which hasn't changed in many years is not a lung cancer. First study the chest films. Then continue. Based on the CXR that you just saw, you could have made the diagnosis of congestive heart failure, but the findings are very subtle. However once you compare it to the old film, things become more obvious and you will be much more confident in your diagnosis: 1. The size of the heart is slightly increased compared to the old film. 2. The pulmonary vessels are slightly increased in diameter indicating increased pulmonary pressure. 3. There are subtle interstitial markings as a result of interstitial edema. 4. There is pleural fluid bilaterally. Notice that the inferior border of the lower lobes has changed in position. All these findings indicate the presence of heart failure.
11.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 11/56 Silhouette sign in a consolidation located in the lingula (blue arrow). The silhouette of the left heart border will still be visible in a consolidation in the left lower lobe (red arrow). Silhouette sign This is a very important sign. It enables us to find subtle pathology and to locate it within the chest. The loss of the normal silhouette of a structure is called the silhouette sign. Here an example to explain the silhouette sign: The heart is located anteriorly in the chest and it is bordered by the lingula of the left lung. The difference in density between the heart and the air in the lung enables us to see the silhouette of the left ventricle. When there is something in the lingula with the same 'water density' as the heart, the normal silhouette will be lost (blue arrow). When there is a pneumonia in the left lower lobe, which is located more posteriorly in the chest, the left ventricle will still be bordered by air in the lingula and we will still see the silhouette of the heart (red arrow). The PAfilm shows a silhouette sign of the left heart border.
12.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 12/56 Even without looking at the lateral film, we know, that the pathology must be located anteriorly in the left lung. This was a consolidation due to a pneumonia caused by Sterptococcus pneumoniae. Here we see a consolidation which is located in the left lower lobe. There is a normal silhouette of the left heart border. On this lateral film there is too much density over the lower part of the spine. By only looking at the interfaces of the left and right diaphragm on the lateral film, it is possible to tell on which side the pathology is located. First study the lateral film. Then continue.
13.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 13/56 On a normal lateral chest film the silhouette of the left diaphragm 2 can be seen from posterior up to where it is bordered by the heart, which has the same density (blue arrow). One should be able to follow the contour of the right diaphragm 1 from posterior all the way to anterior, because it is only bordered by the lung. Here we cannot follow the contour of the right diaphragm all the way to posterior, which indicates that there is something of waterdensity in the right lower lobe (red arrow). On the PAfilm there is a normal silhouette of the heart border, so the pathology is not in the anterior part of the chest, which we already suspected by studying the lateral view. Why do we still see the silhouette of the right diaphragm on the PAfilm? What we see is actually the highest point of the right diaphragm, which is anterior to the pneumonia in the right lower lobe. The pneumonia does not border the highest point of the diaphragm.
14.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 14/56 Hidden areas There are some areas that need special attention, because pathology in these areas can easily be overlooked: apical zones hilar zones retrocardial zone zone below the dome of diaphragm These areas are also known as the hidden areas. Notice that there is quite some lung volume below the dome of the diaphragm, which will need your attention (arrow).
15.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 15/56 Here an example of a large lesion in the right lower lobe, which is difficult to detect on the PAfilm, unless when you give special attention to the hidden areas. Click on the image for an enlarged view. Here a pneumonia which was hidden in the right lower lobe mainly below the level of the dome of the diaphragm (red arrow). Notice the increase in density on the lateral film in the lower vertebral region. You may have to enlarge the image to get a better view.
16.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 16/56 First study the CXR. Notice the subtle increased density in the area behind the heart that needs special attention (blue arrow). This was a lower lobe pneumonia. First study the CXR. We know that in some cases there is an extra joint in the anterior part of the first rib which may simulate a mass. However this is also a hidden area where it can be difficult to detect a mass. In this case a small lung cancer is seen behind the left first rib. Notice that is is also seen on the lateral view in the retrosternal area. Continue with the PETCT.
17.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 17/56 The PETCT demonstrates the tumor (arrow) which has already spread to the bone and liver. The diagnosis was made by a biopsy of an osteeolytic metastasis in the iliac bone. First study the CXRs. There is a subtle consolidation in the left lower lobe in the hidden area behind the heart. Again there is increased density over the lower vertrebral region. Heart and Pericardium
18.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 18/56 On a chest film only the outer contours of the heart are seen. In many cases we can only tell whether the heart figure is normal or enlarged and it will be difficult to say anything about the different heart compartments. However it can be helpful to know where the different compartments are situated. Left Atrium Most posterior structure. Receives blood from the pulmonary veins that run almost horizontally towards the left atrium. Left atrial appendage (in purple) can sometimes be seen as a small outpouching just below the pulmonary trunk. Enlargement of the left atrium results on the PAview in outpouching of the upper heart contour on the right and an obtuse angle between the right and left main bronchus. On the lateral view bulging of the upper posterior contour will be seen. Right Atrium Receives blood from the inferior and superior vena cava. Enlargement will cause an outpouching of the right heart contour. Left Ventricle
19.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 19/56 Situated to the left and posteriorly to the right ventricle. Enlargement will result on the PAview in an increase of the heart size to the left and on the lateral view in bulging of the lower posterior contour. Right Ventricle Most anterior structure and is situated behind the sternum. Enlargement will result on the PAview in an increase of the heart size to the left and can finally result in the left heart border being formed by the right ventricle. Left Atrium The upper posterior border of the heart is formed by the left atrium. Enlargement will result in bulging of the upper posterior contour Left Ventricle Forms the lower posterior border. Enlargement will displace the contour more posteriorly. Right Ventricle The lower retrosternal space is filled by the right ventricle. Enlargement of the right ventricle will result in more superior filling of this retrosternal space.
20.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 20/56 Left Atrium enlargement This is a patient with longstanding mitral valve disease and mitral valve replacement. Extreme dilatation of the left atrium has resulted in bulging of the contours (blue and black arrows). Right ventricle enlargement First study the PA and lateral chest film and then continue reading. On these chest films the heart is extremely dilated. Notice that it is especially the right ventricle that is dilated. This is well seen on the lateral film (yellow arrow). There is a small aortic knob (blue arrow), while the pulmonary trunk and the right lower pulmonary artery are dilated.
21.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 21/56 All these findings are probably the result of a lefttoright shunt with subsequent development of pulmonary hypertension. The location of the cardiac valves is best determined on the lateral radiograph. A line is drawn on the lateral radiograph from the carina to the cardiac apex. The pulmonic and aortic valves generally sit above this line and the tricuspid and mitral valves sit below this line (4). On this lateral view you can get a good impression of the enlargement of the left atrium. Cardiac incisura
22.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 22/56 Click image to enlarge. On the right side of the chest the lung will lie against the anterior chest wall. On the left however the inferior part of the lung may not reach the anterior chest wall, since the heart or pericardial fat or effusion is situated there. This causes a density on the anteroinferior side on the lateral view which can have many forms. It is a normal finding, which can be seen on many chest xrays and should not be mistaken for pathology in the lingula or middle lobe. The explanation for the cardiac incisura is seen on this CTimage. At the level of the inferior part of the heart we can appreciate that the lower lobe of the right lung is seen more anteriorly compared to the left lower lobe.
23.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 23/56 Pacemaker There are different types of cardiac pacemakers. Here we see a pacemaker with one lead in the right atrium and another in the right ventricle. A third lead is seen, which is guided through the coronary sinus towards the left ventricle. This is done in patients with asynchrone ventricular contractions. Pacing both ventricles at the same time will lead to synchrone contractions and a better cardiac output. Pericardial effusion Whenever we encounter a large heart figure, we should always be aware of the possibility of pericardial effusion simulating a large heart. On the chest xray it looks as if this patient has a dilated heart while on the CT it is clear, that it is the pericardial effusion that is responsible for the enlarged heart figure.
24.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 24/56 Especially in patients who had recent cardiac surgery an enlargement of the heart figure can indicate pericardial bleeding. This patient had a change in the heart configuration and pericardial bleeding was suspected. Ultrasound demonstrated only a minimal pericardial effusion. Continue with the CT. There is a large pericardial effusion, which is located posteriorly to the left ventricle (blue arrow). The left ventricle id filled with contrast and is compressed (red arrow). At surgery a large hematoma in the posterior part of the pericardium was found.
25.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 25/56 Notice that on the anterior side there is only a minimal collection of pericardial fluid, which explains why the ultrasound examination underestimated the amount of pericardial fluid. Here another patient who had valvereplacement. Notice the large heart size. There is redistribution of the pulmonary vessels which indicates heart failure. Continue with the CT. The CTimage shows a large pericardial effusion. Always compare these postoperative chest films with the preoperative ones.
26.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 26/56 Calcifications Detection of calcifications within the heart is quite common. The most common are coronary artery calcifications and valve calcifications. Here we see pericardial calcifications which can be associated with constrictive pericarditis. In this case there are calcifications that look like pericardial calcifications, but these are myocardial calcifications in an infarcted area of the left ventricle. Notice that they follow the contour of the left ventricle.
27.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 27/56 Pericardial fatpad Pericardial fat depositions are common. Sometimes a large fat pad can be seen (figure). Necrosis of the fat pad has pathologic features similar to fat necrosis in epiploic appendagitis. It is an uncommon benign condition, that manifests as acute pleuritic chest pain in previously healthy persons (10). Pericardial cyst Pericardial cysts are connected to the pericardium and usually contain clear fluid. The majority of pericardial cysts arise in the anterior cardiophrenic angle, more frequently on the rightside, but they can be seen as high as the pericardial recesses at the level of the proximal aorta and pulmonary arteries (11). Most patients are asymptomatic. On the chest xray it seems as if there is a elevated left hemidiaphragm.
28.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 28/56 On CT however there is a cyst connected to the pericardium. Hili The normal hilar shadow is for 99% composed of vessels pulmonary arteries and to a lesser extent veins (1). The vessel margins are smooth and the vessels have branches. The left hilum should never be lower than the right hilum. The left pulmonary artery runs over the left main bronchus, while the right pulmonary artery runs in front of the right main bronchus, which is usually lower in position than the left main bronchus. Hence the left hilum is higher than the right. Only in a minority of cases the right hilus is at the same level as the left, but never higher.
29.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 29/56 In this illustration the lower lobe arteries are coloured blue because they contain oxygenpoor blood. They have a more vertical orientation, while the pulmonary veins run more horizontally towards the left atrium, which is located below the level of the main pulmonary arteries. Both pulmonary arteries and veins can be identified on a lateral view and should not be mistaken for lymphadenopathy. Sometimes the pulmonary veins can be very prominent. The left main pulmonary artery passes over the left main bronchus and is higher than the right pulmonary artery which passes in front of the right main bronchus. These images are thick slab sagittal reconstructions of a chestct to get a better view of the hilar structures.
30.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 30/56 The lower lobe pulmonary arteries extend inferiorly from the hilum. They are described as little fingers, because each has the size of a little finger (1). On the right side the little finger will be visible in 94% of normal CXRs and on the left side in 62% of normals (1). Study the CXR of a 70year old male who fell from the stairs and has severe pain on the right flank.. Notice on the PAfilm the absence of the little finger on the right and on the lateral view the increased density over the lower vertebral column. What is your diagnosis?
31.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 31/56 There is a right lower lobe atelectasis. Notice the abnormal right border of the heart. The right interlobar artery is not visible, because it is not surrounded by aerated lung but by the collapsed lower lobe, which is adjacent to the right atrium. On a followup chest film the atelectasis has resolved. We assume that the atelectasis was a result of posttraumatic poor ventilation with mucus plugging. Notice the reappearance of the right little finger (red arrow) and the normal right heart border (blue arrow). Hilar enlargement
32.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 32/56 The table summarizes the causes of hilar enlargement. Normal hili are: Normal in position left higher than right Equal density Normal branching vessels Enlargement of the hili is usually due to lymphadenopathy or enlarged vessels. In this case there is an enlarged hilar shadow on both sides. This could be the result of enlarged vessels or enlarged lymph nodes. A very helpful finding in this case is the mass on the right of the trachea. This is known as the 123 sign in sarcoidosis, i.e. enlargement of left hilum, right hilum and paratracheal.
33.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 33/56 Here some more examples of sarcoidosis. Click to enlarge. 1. Lymphadenopathy and groundglass appearance of the lungs 2. Lymphadenopathy, 123 sign 3. Bulky lymphadenopathy 4. 123 sign 5. Nodular lung pattern, no lymphadenopathy 6. Hilar and paratracheal lymphadenopathy Mediastinum Mediastinal masses are discussed in more detail in Mediastinal masses. Here is just a brief overview.
34.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 34/56 The mediastinum can be divided into an anterior, middle and posterior compartment, each with it's own pathology. Mediastinal lines Mediastinal lines or stripes are interfaces between the soft tissue of mediastinal structures and the lung. Displacement of these lines is helpful in finding mediastinal pathology, as we have discussed above.
35.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 35/56 Azygoesophageal recess The most important mediastinal line to look for is the azygoesophageal line, which borders the azygoesophageal recess. This line is visible on most frontal CXRs. The causes of displacement of this line are summarized in the table. A hiatal hernia is the most common cause of displacement of the azygoesophageal line. Notice the air within the hernia on the lateral view.
36.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 36/56 Another common cause of displacement of the azygoesophageal line is subcarinal lymphadenopathy. Notice the displacement of the upper part of the azygoesophageal line on the chest xray in the area below the carina. This is the result of massive lymphadenopathy in the subcarinal region (station 7). There are also nodes on the right of the trachea displacing the right paratracheal line. On the PET we can appreciate the massive lymphadenopathy far better than on the CXR. There are also lymphomas in the neck. this is an important finding, since these nodes are accessible for biopsy. Continue with images of CT and ultrasound.
37.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 37/56 Here we see a CTimage. The azygoesophageal recess is displaced by lymph nodes that compress the left atrium. The final diagnosis of small cel lungcancer was made through a biopsy of a lymphnode in the neck. First study the chest xray. Then continue reading. Notice the following: 1. There is displacement of the azygoesophageal line both superiorly an inferiorly. 2. There is an airfluid level (arrow). Combined with the above this must be a dilated esophagus with residual fluid. The final diagnosis was achalasia. 3. The density on the left in the region of the lingula is the result from prior aspiration pneumonia.
38.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 38/56 Here we have a prior CXR of this patient. The APfilm shows a right paratracheal mass. The azygoesophageal recess is not identified, because it is displaced and parallels the border of the right atrium. The large round density in the left lung is the result of aspiration. Notice the massive dilatation of the esophagus on the CT. Aortopulmonary window The aortopulmonary window is the interface below the aorta and above the pulmonary trunk and is concave or straight laterally.
39.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 39/56 Here the APwindow is convex laterally due to a mass that fills the retrosternal space on the lateral view. On the CTimages a mass in the anterior mediastinum is seen. Final diagnosis: Hodgkins lymphoma. The PET better demonstrates the extent of the lymphnode metastases in this patient. Final diagnosis: small cell lungcarcinoma. Lungs
40.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 40/56 Lung abnormalities mostly present as areas of increased density, which can be divided into the following patterns: 1. Consolidation 2. Atelectasis 3. Nodule or mass solitary or multiple 4. Interstitial Less frequently areas of decreased density are seen as in emphysema or lungcysts. These lungpatterns will discussed in more detail in an article that will be published soon: Chest XRay Lung disease.
41.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 41/56 Consolidation Atelectasis
42.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 42/56 Interstitial pattern Click on the table to enlarge. Interstitial lung diseases are discussed here. Pleura Pleural fluid It takes about 200300 ml of fluid before it comes visible on an CXR (figure). About 5 liters of pleural fluid are present when there is total opacification of the hemithorax.
43.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 43/56 Total opacification of the right hemithorax in a patient with pleuritis carcinomatosa on both sides. On the right there is only some air visible in the major bronchi creating an air bronchogram within the compressed lung. Pleural fluid may become encysted. Here we see fluid entrapped within the fissure. This can sometimes give the impression of a mass and is called 'vanishing tumor'.
44.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 44/56 Pneumothorax The table lists the most common causes of a pneumothorax. The other cystic lungdisease which causes pneumothorax is Langerhans cell histiocytosis (LCH) which is seen in smokers. Study the CXR. There are two important findings.
45.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 45/56 The retracted visceral pleura is seen (blue arrow) which indicates that there is a pneumothorax. There is a horizontal line visible (yellow arrow). Normally there are no straight lines in the human body unless when there is an airfluid level. This means that there is a hydropneumothorax. When a pneumothorax is small, this airfluid level can be the only key to the diagnosis of a pneumothorax.
46.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 46/56 Study the CXR. There are 3 important findings. Notice that the mediastinum is slightly displaced to the left. Does this mean that there is a tension pneumothorax? Do you have an idea about the cause of the pneumothorax?
47.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 47/56 There is a hydropneumothorax. Notice the airfluid level (blue arrow). The upper lobe is still attached to the chest wall by adhesions. Maybe this patient was treated for a prior pneumothorax. There is a lung cyst in the upper lobe (red arrow). So we can assume that the pneumothorax has something to do with a cystic lung disease. Since this patient is a woman, lymphangioleiomyomatosis (LAM) is a possible diagnosis. LAM is a rare lung disease that results in a proliferation of smooth muscle throughout the lungs resulting in the obstruction of small airways leading to pulmonary cyst formation and pneumothorax. LAM also occurs in patients who have tuberous sclerosis.
48.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 48/56 Study the CXR. What is your diagnosis? This is not a pneumothorax but a skin fold. The radiography was performed supine with a CR cassette inserted underneath the patient, which resulted in a skinfold. Notice that there are lung markings beyond the apparent pneumothorax. Here two CXRs of another patient with obvious skinfolds.
49.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 49/56 Recognition of a pneumothorax depends on the volume of air in the pleural space and the position of the body. On a supine radiograph a pneumothorax can be subtle and approximately 30% of pneumothoraces are undetected. A sign to look for is the 'deep sulcus sign'. It represents lucency of the lateral costophrenic angle extending toward the hypochondrium (Figure). The image is of a patient in the ICU who is on mechanical ventilation. There was an acute exacerbation of the dyspnoe. There is a deep sulcus sign on the left. Notice that the left hemidiaphragm is depressed. This is an important finding since it indicates a tension pneumothorax.
50.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 50/56 The image on the right is after insertion of an intercostal drain. Notice that the diaphragm has regained its normal appearance. Pleural opacities The table lists the most common causes of pleural opacities.
51.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 51/56 Pleural plaques The CXR shows multiple opacities. They have irregular shapes and do not look like a lung masses or consolidations. Some of these opacities are clearly bordering the chest wall (red arrows). All these findings indicate that we are dealing asbestos related pleural plaques. Asbestos related pleural plaques are usually: 1. bilateral and extensive. 2. covering the dome of the diaphragm.
52.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 52/56 Unilateral pleural calcifications are usually due to: infection (TB) empyema hemorrhagic Pleural hematoma These images are of a patient, who had a pleural opacity after a chest trauma. It was believed to be a hematoma and resolved spontaneously. Chest wall
53.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 53/56 Ribfractures The most common identified chest wall abnormalities are old ribfractures. The CXR shows many rib deformities due to old fracturees. When a rib fracture heals, the callus formation may create a masslike appearance (blue arrow). Sometimes a CT is necessary to differentiate a healing fracture from a lung mass.
54.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 54/56 Notice the large lung volume and the enlarged pulmonary vessels. Probably we are dealing with pulmonary arterial hypertension in a patient with COPD. The second most common chest wall abnormalities that we see on a CXR are metastases in vertebral bodies and ribs. Notice the expansile mass in the posterior rib on the right. Abdomen
55.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 55/56 The most obvious finding on this CXR is free air under the diaphragm. This finding indicates a bowel perforation, unless when the patient had recent abdominal surgery and there is still some air left in the abdomen, which can stay there for several days. There is another subtle finding in the left upper lobe. A subtle density projecting over the first rib hidden area proved to be a lungcarcinoma.
56.
5/27/2016 The Radiology Assistant : Chest XRay http://www.radiologyassistant.nl/en/p497b2a265d96d/chestxraybasicinterpretation.html 56/56 Here another patient with free abdominal air. Notice the very thin regular line which is the diaphragm (arrow). At first impression one might think that this is just some platelike atelectasis due to poor inspiration.
Download now