Assessment of chest x-ray technical adequacy (approach)
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Described below are some points on an approach to the assessment of the chest x-ray technical adequacy. Rarely, a technically inadequate chest x-ray will prohibit diagnostic interpretation but knowledge of the limitations will impact on diagnostic confidence.
Exposure/penetration
- assessed by looking at the lower thoracic vertebral bodies, whose outline should just be visible on a PA projection
- the spine should be seen through the heart 1
- poor penetration: pulmonary vessels and interstitial markings appear more prominent, loss of detail at the lung bases and vertebrae, results in increased density
Inspiratory effort
- anterior aspect of at least six ribs must be noted above the dome of the right diaphragm
- alternatively, posterior aspects of at least eight to nine ribs should be visualized 1
- poor effort: the cardiac shadow may appear spuriously enlarged, crowding of vessels at lung bases
Rotation
- thoracic spinous processes are equidistant from the medial end of each clavicle on a frontal image
- rotation to the right may cause: pseudo-mediastinal mass, hyperlucency of the right lung
- rotation to the left may cause: aortic arch may appear spuriously enlarged, hyperlucency of the left lung
Magnification
- Films on anteroposterior views slightly magnify the heart 1
Angulation
- medial ends of the clavicles should be projected over the posterior third or fourth ribs1
Exposure/penetration
-
assessed by looking at the lower thoracic vertebral bodies, whose outline should just be visible onclavicles will have aPA projection
S shape 1
poor penetration: pulmonary vessels and interstitial markings appear more prominent, loss of detail at the lung bases and vertebrae, results in increased density
-<p>Described below are some points on an <strong>approach</strong> to the <strong>assessment of the chest x-ray technical adequacy</strong>. Rarely, a technically inadequate chest x-ray will prohibit diagnostic interpretation but knowledge of the limitations will impact on diagnostic confidence. </p><h4>Inspiratory effort</h4><ul>- +<p>Described below are some points on an <strong>approach</strong> to the <strong>assessment of the chest x-ray technical adequacy</strong>. Rarely, a technically inadequate chest x-ray will prohibit diagnostic interpretation but knowledge of the limitations will impact on diagnostic confidence. </p><h4>Exposure/penetration</h4><ul>
- +<li>assessed by looking at the lower thoracic vertebral bodies, whose outline should just be visible on a PA projection</li>
- +<li>the spine should be seen through the heart <sup>1</sup>
- +</li>
- +<li>poor penetration: pulmonary vessels and interstitial markings appear more prominent, loss of detail at the lung bases and vertebrae, results in increased density</li>
- +</ul><h4>Inspiratory effort</h4><ul>
- +<li>alternatively, posterior aspects of at least eight to nine ribs should be visualized <sup>1</sup>
- +</li>
-</ul><h4>Angulation</h4><ul><li>clavicles should be projected over the posterior third ribs</li></ul><h4>Exposure/penetration</h4><ul>-<li>assessed by looking at the lower thoracic vertebral bodies, whose outline should just be visible on a PA projection</li>-<li>poor penetration: pulmonary vessels and interstitial markings appear more prominent, loss of detail at the lung bases and vertebrae, results in increased density</li>-</ul>- +</ul><h4>Magnification </h4><ul><li>Films on anteroposterior views slightly magnify the heart <sup>1</sup>
- +</li></ul><h4>Angulation</h4><ul>
- +<li>medial ends of the clavicles should be projected over the posterior third or fourth ribs <sup>1</sup>
- +</li>
- +<li>clavicles will have a S shape <sup>1</sup>
- +</li>
- +</ul><h4> </h4>
References changed:
- 1. William Herring. Learning Radiology. (2015) <a href="https://books.google.co.uk/books?vid=ISBN9780323328074">ISBN: 9780323328074</a><span class="ref_v4"></span>