CXR ( Chest X-Ray )
chest PA
Indications for imaging
Congenital abnormalities (cardiac, vascular etc) ASD, VSD
Trauma pneumothorax, haemothorax
Infections , generalised, TB,
Cardiac investigations , cardiomegaly, LVF, heart failure,
Pulmonary investigations , Pulmonary embolus, infections and infarctions
Carcinomas , primary, metastasis, mesothelioma,
Anatomy Demonstrated
Lungs, trachea, heart, major mediastinal vessels, diaphragm and ribs
Basic Patient Position
The patient stands ERECT facing the cassette, the cassette is raised so the top is 3cm above the skin margins above the apices, the patient's chin is rested on the top of the cassette holder, the patient is asked to place the backs of the hands on the waist at the sides. The shoulders and arms are rolled forward to bring the scapulae towards the side of the chest.
Exposure is made on deep suspended inspiration.
Radiation protection
Direct lead rubber waist level protection, posterior at low kV, anteriorly at higher kV.
Avoid irradiation of the eyes and thyroid.
Central Ray
The horizontal central ray is centered in the midline at the level of T4 and angled down to T6 bringing the upper border of the field level with the top of the cassette.
Exposure Factors
Kv mAS FFD (cm) Grid Focus AEC Cassette
110 2.5 180 non fine non 35x43
Evaluation of the Image
ID and markers must be present and correct in the appropriate area of the film.
Limits of anatomy, superiorly the skin margins of the apices, inferiorly the costaphrenic angles, laterally the ribcage.
No rotation, the medial ends of the clavicle should be equidistant from the spine.
Centering, the image should be centered in the midline at the level of T6/7
The medial ends of the clavicles should be projected at the level of T4/5
The scapulae should be clear of the lungfields
There should be sufficient inspiration to demonstrate 9+ posterior intercostal spaces.
Penetration the vertebral outlines should be visible in the mediastinum.
Density the average density of the lungfields should be approximately 1
Congenital abnormalities (cardiac, vascular etc) ASD, VSD
Trauma pneumothorax, haemothorax
Infections , generalised, TB,
Cardiac investigations , cardiomegaly, LVF, heart failure,
Pulmonary investigations , Pulmonary embolus, infections and infarctions
Carcinomas , primary, metastasis, mesothelioma,
Anatomy Demonstrated
Lungs, trachea, heart, major mediastinal vessels, diaphragm and ribs
Basic Patient Position
The patient stands ERECT facing the cassette, the cassette is raised so the top is 3cm above the skin margins above the apices, the patient's chin is rested on the top of the cassette holder, the patient is asked to place the backs of the hands on the waist at the sides. The shoulders and arms are rolled forward to bring the scapulae towards the side of the chest.
Exposure is made on deep suspended inspiration.
Radiation protection
Direct lead rubber waist level protection, posterior at low kV, anteriorly at higher kV.
Avoid irradiation of the eyes and thyroid.
Central Ray
The horizontal central ray is centered in the midline at the level of T4 and angled down to T6 bringing the upper border of the field level with the top of the cassette.
Exposure Factors
Kv mAS FFD (cm) Grid Focus AEC Cassette
110 2.5 180 non fine non 35x43
Evaluation of the Image
ID and markers must be present and correct in the appropriate area of the film.
Limits of anatomy, superiorly the skin margins of the apices, inferiorly the costaphrenic angles, laterally the ribcage.
No rotation, the medial ends of the clavicle should be equidistant from the spine.
Centering, the image should be centered in the midline at the level of T6/7
The medial ends of the clavicles should be projected at the level of T4/5
The scapulae should be clear of the lungfields
There should be sufficient inspiration to demonstrate 9+ posterior intercostal spaces.
Penetration the vertebral outlines should be visible in the mediastinum.
Density the average density of the lungfields should be approximately 1
Related Projections
Left Lateral Apical Thoracic inlet Trachea Oblique for upper ribs Lower Ribs Decubitus Additional modalities CT, RNI, MRI |
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