Chest
Chest x-ray
*We use 1.2, 1.6 or 2 mm2 focal spot sizes to increase the mA output and therefore
the time is decreased, which helps in freezing involuntary motion of the heart.
* We use 400, 600 0r 800 (fast) film /screen combination.
* Why do we use high kVp in chest radiographs?
To see all the structures on the film (lungs, heart, hilus, trachea, bronchi, diaphragm,
aorta, superior vena cava, carina, lung parenchyma through the ribs)
* What is the advantage of using high kVp in chest radiography?
1. to give good penetration
2. to decrease the patient dose
3. to decrease the time, which prevents motion and enhances the sharpness, and to
decrease mAs because when we increase the kVp the quantity is already
increased and compensates for mAs action.
* What are the disadvantages of having high KVp?
1. the contrast is decreased
2. a lot of scattered radiation are produced, which have to be avoided by good
protection.
* Why does Lorthotic chest done?
To show if there are tumers, or pulmonary tuberculosis in the apex.
PA chest:
* I know that it is PA not AP chest because the medial aspect of the clavicles is directed
inferiorly.
* The patient did not take a deep breath, because I can see less than 10 ribs and because
the clavicles are not raised.
* The cassette is not put properly, it must be put 5 cm above the apex.
* KVp is very high because I can not differentiate between the ribs and lung tissue.
*It has high density; this is shown by the dark blackening of the edges.
* Fluid level determines that the patient has plural diffusion. ( see blue line)
* The scapula is not away from the lung field and this is another bad thing of this film.
PA chest:
* This is digital ( because it has a high contrast) PA chest ( it is PA not AP chest because
the medial aspect of the clavicles is directed inferiorly).
* The patient has plural diffusion (see blue line). (In plural effusion, there is fluid level
but in plural diffusion there is no fluid level).
* There is tilt in the clavicles.
* The shoulders were not brought down to be at the same level.
* Kvp is good, because I can differentiate between the heart, ribs and lungs.
*There is air in the stomach fundus.
Lateral chest:
* No marker.
* The patient is not in the center of the film.
* The patient is not in the middle of the cassette.
* Because of bad positioning and centering, the diagram is opened and this causes scatter
radiation ( bad contrast).
* The technologist had to ask the patient to stand strait and then ask him to flex, but the
technologist did not. He asked him to flex directly.
* The chest must be in the middle of the film.