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Ngoài ra thường gặp các lĩnh vực như ngực và hình ảnh bụng, đặc biệt là sự chú ý đã được cho các chủ đề của hình ảnh và chấn thương cột sống cổ thẳng thừng. Mục bao gồm hình ảnh chấn thương ngực, bụng, xương chậu, xương sống cổ tử cung và đầu là bao gồm. | Imaging the chest Fig. 1.58 Cystic fibrosis CF . The widespread interstitial pattern shadowing is typical of CF. Note the right-sided portacath and a right-sided apical pneumothorax. 52 Case illustrations plain films and CT Question 19 Fig. 1.59 Quiz case. 46-year-old smoker. On surgical waiting list for hernia surgery Fig. 1.59 . What is the diagnosis 1 Answer Emphysema There is hyperexpansion of both lungs with flattening of the diaphragms. At the level of the diaphragm there are eight anterior ribs normal is six to seven . There are decreased lung markings throughout the lungs particularly affecting the lung bases a pattern found in alpha-1-antitrypsin deficiency. Radiological changes of chronic bronchitis and emphysema chronic obstructive pulmonary disease COPD include hyperinflation increased retrosternal clear space on lateral film flattening of diaphragms reduced lung markings emphysema peribronchial thickening bullae increased risk of pneumothorax cardiac enlargement enlarged pulmonary arteries pulmonary hypertension . 53 Imaging the chest Question 20 1 70-year-old man. Awaiting total hip replacement. Seen in surgical pre-assessment clinic. History of cough. Describe the abnormality seen on the chest X-ray Fig. 1.60 . What are the most likely differential diagnoses How would you manage the patient Fig. 1.60 Quiz case. Answer Solitary pulmonary nodule or mass There is a solitary nodule seen in the mid-zone of the right lung. No other pulmonary nodules or rib lesions are seen. Nipple shadows can often cause confusion on plain films as they may resemble lung nodules. If any doubt exists then metallic skin markers should be positioned and further X-rays taken. This case example was a nipple shadow see Fig. 1.61 . A common cause of true pulmonary nodule in a patient of this age would be bronchogenic carcinoma metastasis granuloma or infection are further possibilities. Solitary pulmonary nodule With this type of film especially in a viva situation you give the .
