By Sebastian Lange
This absolutely revised and extended 3rd variation covers all elements of recent
thoracic radiology, and comprises very important new sections on laptop tomographic
signs, interventional radiology of the thorax and the most recent advancements in
cardiac CT and MRI diagnostics, in addition to a brand new bankruptcy on excessive resolution/thin
section CT styles. The part on diffuse lung ailment has been multiplied and
many new CT illustrations were additional. The publication includes complete
information at the position of latest applied sciences, together with MDCT, within the assessment
of thoracic disorder, the function of PET/PET-CT within the thorax, and the increasing
roles of MDCT and MRI in assessment of the heart.
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Extra resources for Radiology of chest diseases
A b c Fig. 46 Axial image (a) from a volumetric MDCT study with coronal (b) and sagittal(c) reformats. 5−3 mm and allows for much better resolution of pulmonary parenchymal structures than was possible when incremental CT with 8−10 mm collimation images were acquired as standard practice. 5 mm collimation noncontiguous HRCT images are acquired, excellent visualization of lung parenchymal detail is also possible. The visibility of a structure depends, in part, on attenuation differences between it and adjacent structures.
Only about 25 % of the lung capillaries are perfused in this resting state. When cardiac output increases during exercise, additional capillaries are recruited and the major vessels dilate. There is only a slight concomitant increase in pulmonary artery pressures (see Fig. 35). The compliance of the pulmonary vessels is also responsible for the normal orthostatic perfusion gradient (orthostatic caudalization) that exists in the lungs. In the upright position and on deep inspiration, there is an increasing perfusion gradient from lung apex to base.
However, there is no redistribution and rest imaging requires a second injection. Normal scintigraphic studies show a relatively homogeneous distribution of radionuclide throughout the myocardium. Regions of decreased activity signify areas of diminished blood flow. Radionuclide uptake by myocardial cells is determined during exercise or pharmacological stress and then at rest. Approximately 100 MBq of thallium-201 chloride or 240 MBq of Tc 99 m-HMIBI are injected intravenously during exercise, and image acquisition begins immediately.