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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,
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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.
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Radiation protection
Direct lead rubber waist level protection, posterior at low kV,
anteriorly at higher kV.
Avoid irradiation of the eyes and thyroid.
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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.
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Exposure Factors
| Kv |
mAS |
FFD (cm) |
Grid |
Focus |
AEC |
Cassette |
| 80 |
2.5 |
180 |
non |
fine |
non |
35x43 |
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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
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Related Projections
Left Lateral
Apical
Thoracic inlet
Trachea
Oblique for upper ribs
Lower Ribs
Decubitus
Additional modalities
CT, RNI, MRI
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