Thoracic radiographic interpretation: The mediastinum (Proceedings)
Aug 01, 2010
CVC IN KANSAS CITY PROCEEDINGS
A systematic approach to evaluating the mediastinum is critical to establishing normality for a given small animal. One can think of roentgen abnormalities of the mediastinum as either primary (an abnormality of the mediastinum itself) or secondary (an abnormality caused by a mediastinal structure or organ). Examples of primary mediastinal abnormalities would include abnormal fluid or gas collections within the mediastinum. Examples of secondary mediastinal abnormalities would include lymphomegaly, cardiac abnormalities, esophageal disorders, tracheal disorders and abnormal hemorrhage of tumors of the thymus.
Objectives of the Presentation
1. Technical factors including technique, phase of respiration and the positioning of the patient have to be taken into account when interpreting thoracic radiographs. High quality, well positioned thoracic radiographs are the most critical first step to evaluating patients with intrathoracic disease (and possibly mediastinal abnormalities).
2. The basic pathophysiology related to diseases of the mediastinal structures should be understood for completing the exercise in the formulation of differentials for the described mediastinal abnormalities.
3. The description of the mediastinal abnormalities is NOT the end point but should be considered the initiation point for formulating a reasonable list of differential diagnoses for the described roentgen signs.
1. One should try to compartmentalize radiographic abnormalities into extrathoracic, pleural, pulmonary and mediastinal (including cardiac), recognizing that any disease can be multicompartmental in nature.
2. One should try to determine the anatomic location of pathology within the lung first and foremost and then worry about the pulmonary pattern. Even though there may be several pulmonary patterns, one must identify the dominant pattern in order to evaluate for differentials.
3. Echocardiography can not diagnosis when a patient is in left sided heart failure with pulmonary edema.
Key Therapeutic Points
Key Prognostic Points