Imaging Techniques

There are no absolute contraindications to the use of non-invasive imaging studies, with the exception of MRI. The presence of metallic objects in the eye or brain of the patient precludes MRI.

Among the imaging techniques include the use of X-rays, MRI, nuclear medicine diagnostics and sonography. There are no absolute contraindications to the use of non-invasive imaging studies, with the exception of MRI. The presence of metallic objects in the eye or brain of the patient precludes MRI. A permanent pacemaker or internal cardioverter are a relative contraindication. when used as contrast agents in MRI also increases gadolinium, the risk of nephrogenic systemic fibrosis in patients with chronic kidney disease stage 4 or 5. Röntgentechniquen The X-ray techniques that are used to represent the thorax, including plain films, fluoroscopy, high resolution and helical (spiral) CT and CT angiography. Chest x-ray Plain chest radiographs and fluoroscopy are used to provide images of the lungs and surrounding structures. With a simple chest X-ray recording, the structures are displayed in and around the chest. It is extremely useful for the identification of pathological processes in the field of heart, lung parenchyma, pleura, chest wall, diaphragm, mediastinum and hilum. Normally it is the study method first used in the lung diagnostics. The usual standard chest X-ray picture is taken from back to front (postero-setting), to minimize the stray radiation, which could increase the cardiac silhouette artificial, and from the side (side of recording). For the diagnosis of nodules or exclusion of overlay artifacts and recordings in Lordosehaltung or inclination can be made. These special recordings have been largely replaced by the CT, which provides more information. Side shots lying down can be used to distinguish sliding of encapsulated pleural effusions, but this CT or ultrasonography are meaningful. For detailed Pneumothoraxdiagnostik expiratory chest films can be made. Often, chest x-ray images are used as screening tests, however, are almost never indicated in this regard; An exception are asymptomatic patients with a positive Tuberkulintestergebnis in which one p. a. customizing recording without lateral view, in order to decide on additional diagnostic methods and / or the therapy of pulmonary tuberculosis. The use of mobile X-ray machines for chest images (usually a. P.) Is always means the second choice and should be limited to patients who are too sick to be transported to the radiology department. Thorax fluoroscopy means the use of a continuous X-rays to visualize movements. It is used for the diagnosis of unilateral diaphragmatic paralysis. During the “sniff tests” in which the patient is instructed to inhale as rapidly and vigorously through the nose, the paralyzed hemidiaphragm moved (paradoxically) cranially, the healthy side kaudal.Computertomographie (CT) CT forms intrathoracic structures and pathologies more clearly, than normal radiographs. The conventional (planar) chest CT provides multiple 10 mm thick cross-sections of the thorax. Its main benefit lies in the widespread. Disadvantages are motion artifacts and limited resolution of detail of individual structures within the 10-mm sections. A chest CT is performed usually with complete inspiration. If the lungs ventilated during imaging, the best pictures of the lung, respiratory tract and the vascular system and abnormal findings such as lesions, infiltrates or fibrosis can be delivered. High-resolution CT (HRCT) in 1-mm-thick slice images. HRCT is particularly useful in the evaluation of interstitial lung disease (eg. As lymphangitis carcinomatosis, sarcoidosis, fibrosing alveolitis) bronchiectasis It may be helpful to both take HRCT images during the whole exhalation and during the complete inhalation. Images that have arisen during exhalation, can air lock, which is typical of bronchiolitis obliterans and other airway diseases, document images that are taken in the prone position by the patient, can help a dependent atelectasis to differentiate (because of lung disease with himself different body position changes), the milk glass clouding caused in the dependent rear parts of the lung that despite changing position of the patient persist (z. B. fibrosis due to idiopathic pulmonary fibrosis, asbestosis, or systemic sclerosis). The spiral CT provides multiplanar images of the entire thorax. The patient is then carefully moved through the CT-arm as he holds his breath for about 8-10 s. In most indications, the helical CT is considered to be at least as good as compared to conventional CT. Its main advantages are shorter examination times, lower radiation exposure and the possibility of three-dimensional images. The software can also create images of the bronchial mucosa (virtual bronchoscopy). The main disadvantages are a lower-proliferation and the need that the patient holds his breath, which can be difficult for lung disease patients. The newer multidetector CT technology allows for faster scanning of the entire thorax with imaging thin incisions with high resolution. In CT angiography, for better contrast of the pulmonary arteries an i.v. Contrast agents are used, which is helpful for the diagnosis of pulmonary embolism. The contrast agents of the load corresponds to a conventional angiography, however, the process is faster and less invasive. Several studies have confirmed that CT angiography is sufficient just for the detection of pulmonary embolism, therefore, it has largely replaced the conventional pulmonary angiography, except the contrast agent and ventilation / perfusion in patients (V / Q) scintigraphy can not tolerate. Magnetic Resonance Imaging (MRI) MRI plays only a minor role in the imaging of lung disease, but is preferred in special cases, the CT such. As for the diagnosis of Pancoast tumors, possible cysts and other lesions that erode the chest wall. Even in patients with suspected pulmonary embolism, in which the I.V. Contrast medium is contraindicated, the MRI can help displaying large proximal embolism. Their use is limited in this disease. The advantages include the lack of radiation exposure, excellent display of vascular structures, in the absence of bone artefacts and the excellent contrast of connective tissue structures. The disadvantages include motion artifacts caused by breathing and heartbeat and the high cost, the cost of MRIs and the occasional absolute or relative contraindications. Sonography Sonography is often used for the diagnosis of pleural effusions and to simplify Pleurapunktionen and CVC plants. Sonography is also very helpful in the evaluation of presence and size of pleural effusions, and is now often used to guide the thoracentesis at the bedside. Ultrasound at the bedside is also becoming popular in order to diagnose a pneumothorax. Endobronchial ultrasound (EBUS) is increasingly being used in conjunction with bronchoscopy to locate lesions and enlarged lymph nodes. The diagnostic results of transbronchial Lymphknotenaspiration are higher in EBUS than conventional unguided techniques. Thoracentesis under ultrasound video created by Hospital Procedures Consultants, var model = {videoId: ‘3904436221001’, playerId ‘H1xmEWTatg_default’, imageUrl ‘’ title: ‘thoracentesis under ultrasound guidance’, description: ” credits ‘video created by Hospital Procedures Consultants,’ hideCredits: true hideTitle: false, hideDescription: true loadImageUrlWithAjax: true};. var panel = $ (MManual.utils.getCurrentScript ()) Closest ( ‘video element panel..’); ko.applyBindings (model, panel.get (0)); A nuclear medicine diagnostic nuclear medicine scanning techniques for imaging the breast include ventilation / perfusion (V / Q) scanning, positron emission tomography (PET) V / Q scintigraphy in the V / Q scintigraphy inhaled radionuclides are used to ventilation and i.v. to identify radionuclides and to detect perfusion. A ventilated areas without perfusion, perfused lung sections without ventilation or combined increase, or lack of the V / Q can be represented with 6-8 lung recordings. The V / Q scintigraphy is commonly used for the diagnosis of pulmonary embolism, but was largely replaced by CT angiography. However, a V / Q scan is still displayed in the diagnosis of chronic thromboembolic pulmonary hypertension. The function-separated Ventilationsszintigraphie, with the ventilation in each lobe can be quantified separately, is used to predict the impact of lung resections on lung function. The postoperative forced volume in one second (FEV1) seems to correspond to the percentage uptake of the radionuclide used for ventilation measurement in healthy lung share, multiplied by the preoperative FEV 1 (in liters). Values ??<0.8 l (or <40% of the predicted value) indicate a limited pulmonary reserve and the probable existence of an unacceptably high perioperative morbidity and mortality hin.PET When PET is radioactively labeled glucose (fluorodeoxyglucose) for measuring metabolic activity in tissues used. It is used in lung diseases to determine whether Lungenknoten- or lymph nodes HARBOR tumor (metabolic staging) Whether cancer irradiated relapse in previously scarred areas of the lung The PET is superior to CT in mediastinal staging, as in PET tumor tissue in normal large lymph nodes and extrathoracic structures can be identified. Thus, the need for invasive procedures such as mediastinoscopy and fine needle biopsy is reduced. The resolution of the PET is 7-8 mm; therefore, they will not help <1 cm in lesions. In the PET metastases in up to 14% of patients are detected where they would otherwise not suspected. The sensitivity of PET (80-95%) is comparable to that of histology. False-positive results can with inflammatory lesions such as granulomas occur. Slow-growing tumors (eg. As bronchoalveolar carcinoma, carcinoid tumors, some metastatic cancers) can lead to false negative results. Newer combined CT-PET devices could be the future for cost-effective method for the diagnosis and staging of lung cancer.

Health Life Media Team

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