Chest radiology: the essentials

970 Pages·2014·130.2 MB·English

by  Janette Collins

Thank you
for purchasing this e-book.
To receive special offers and news
about our latest products,
sign up below.
Or visit LWW.com
Jannette Collins,
MD, MEd, FCCP, FACR
Ben Felson Professor and Chair of Radiology
Professor of Medicine
University of Cincinnati College of Medicine
Cincinnati, Ohio
Eric J. Stern,
MD
Professor of Radiology
Adjunct Professor of Medicine, Medical Education and Bioinformatics, and
Global Health
Vice-Chair, Academic Affairs
University of Washington
Seattle, Washington
Third Edition
Acquisitions Editor: Ryan Shaw
Product Development Editor: Amy G. Dinkel
Production Project Manager: Priscilla Crater
Design Coordinator: Stephen Druding
Manufacturing Coordinator: Beth Welsh
Prepress Vendor: S4Carlisle Publishing Services
3rd edition
Copyright © 2015 Wolters Kluwer Health
Copyright © 2008 Lippincott Williams & Wilkins, a Wolters Kluwer business.
Copyright © 1999 by Lippincott Williams & Wilkins.
All rights reserved. This book is protected by copyright. No part of this book
may be reproduced or transmitted in any form or by any means, including as
photocopies or scanned-in or other electronic copies, or utilized by any
information storage and retrieval system without written permission from the
copyright owner, except for brief quotations embodied in critical articles and
reviews. Materials appearing in this book prepared by individuals as part of their
official duties as U.S. government employees are not covered by the above-
mentioned copyright. To request permission, please contact Wolters Kluwer
Health at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103,
via email at [email protected], or via our website at lww.com (products and
services).
9 8 7 6 5 4 3 2 1
Library of Congress Cataloging-in-Publication Data

Chest radiology (Collins)
Chest radiology : the essentials / editors, Jannette Collins, Eric J. Stern. —
Third edition.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-4511-4448-2 (hardback)
eISBN 978-1-4698-8856-9
I. Collins, Jannette, editor. II. Stern, Eric J., editor. III. Title.
[DNLM: 1. Radiography, Thoracic—methods. 2. Lung Diseases—
radiography. WF 975]
RC941
617.5'407572—dc23
2014028970
Care has been taken to confirm the accuracy of the information presented and to
describe generally accepted practices. However, the authors, editors, and
publisher are not responsible for errors or omissions or for any consequences
from application of the information in this book and make no warranty,
expressed or implied, with respect to the currency, completeness, or accuracy of
the contents of the publication. Application of this information in a particular
situation remains the professional responsibility of the practitioner; the clinical
treatments described and recommended may not be considered absolute and
universal recommendations.
The authors, editors, and publisher have exerted every effort to ensure that
drug selection and dosage set forth in this text are in accordance with the current
recommendations and practice at the time of publication. However, in view of
ongoing research, changes in government regulations, and the constant flow of
information relating to drug therapy and drug reactions, the reader is urged to
check the package insert for each drug for any change in indications and dosage
and for added warnings and precautions. This is particularly important when the
recommended agent is a new or infrequently employed drug.
Some drugs and medical devices presented in this publication have Food and
Drug Administration (FDA) clearance for limited use in restricted research
settings. It is the responsibility of the health care provider to ascertain the FDA
status of each drug or device planned for use in his or her clinical practice.
LWW.com
Ode to Jonathan
He brought ideas and words to life
Had a daughter, son, and wife
He was kind, gracious, well-read
And loved the Grateful Dead
He had a wry sense of humor,
Loved photography and music,
Hiking, windsurfing, and all things scenic
He was well-respected, a mentor
There was a man no gentler
To his final resting place, Godspeed
So many words I’ll never read
JANNETTE COLLINS
Jonathan W. “JP” Pine, Jr., was a longtime editor at Lippincott
Williams & Wilkins/Wolters Kluwer Health. He died November
28, 2013, at the age of 56.
he Essentials series is a collection of radiology textbooks following a
T
standardized format. Each book in the Essentials series is a practical
tool for those wanting to quickly acquire a broad base of knowledge in
a specialty area. The content is limited to the essentials of that specialty so as not
to overwhelm the novice, yet provides enough detail that it can serve as a quick
review for residents or practicing radiologists, a guide for those who teach the
specialty, and a reference for specialty physicians and other health care
professionals whose patients are referred for imaging in that specialty area. What
sets Essentials texts apart from other similar texts is that they (a) are compact
and of practical size for a resident to read during an initial 4-week rotational
experience, (b) include learning objectives at the beginning of each chapter, and
(c) provide an exercise for self-assessment. Each book includes citations from
the most recent literature that are called out in the text.
Self-assessment is a key component of the Essentials texts. Multiple-choice
items are included at the end of every chapter, and a self-assessment examination
is included at the end of each text. This should be of particular benefit to those
who are preparing for the new image-rich computer-based examinations that are
a component of professional certification and maintenance of certification.
The series includes not only texts related to clinical specialties that are rich
with radiologic images and illustrations, but also texts related to noninterpretive
subjects such as radiologic physics and quality and safety in medical imaging.
The goal of the Essentials series is to provide a collection of practical references
to accompany a well-rounded education in diagnostic imaging and imaging-
guided therapy.
JANNETTE COLLINS
he objective of this book is to provide a practical tool for those wanting
T
to quickly acquire a broad base of knowledge in thoracic imaging. The
content is limited to the essentials of chest radiology so as not to
overwhelm the novice, yet provides enough detail that it can serve as a quick
review for residents or practicing radiologists, a guide for those who teach
thoracic imaging, and a reference for internists, pulmonologists, thoracic
surgeons, critical care physicians, family practitioners, and other health care
professionals whose patients undergo thoracic imaging procedures. What sets
this book apart from other similar texts is that (a) it is compact and of practical
size for a resident to read during an initial 4-week chest radiology experience,
(b) it closely follows an established cardiothoracic radiology curriculum, and (c)
it provides an exercise for self-assessment.
This third edition carries over the pattern approach, use of mnemonics, and
emphasis on chest radiograph/CT correlation. However, several changes were
made to the second edition to reflect current technology, changes in terminology
and staging criteria, new management guidelines, and recently adopted screening
recommendations. New citations from the most recent literature were added.
New coronal CT images complement axial images, which is of particular value
when discussing upper-lobe predominant or other patterned diseases. The
specific behaviorally based learning objectives at the beginning of each chapter
follow the most current curriculum on cardiothoracic radiology for diagnostic
radiology residency developed by the Education Committee of the Society of
Thoracic Radiology. Approximately 100 images were retired, and over 450 new
images were added.
The content of the third edition was expanded to include the most current
lung cancer staging classification, use of the term adenocarcinoma in situ
(formerly bronchioloalveolar carcinoma), evidence-based guidelines for
evaluating suspected pulmonary embolism (including those for pregnant
patients), recently adopted lung cancer screening recommendations with low
dose CT of the chest, Fleischner Society guidelines for the follow-up of subsolid
nodules, and new management guidelines for peri-fissural nodules.
Feedback from readers of the second edition included positive comments
related to the new chapter on “Signs and Patterns” of lung disease. This chapter
was expanded in the third edition to include numerous additional signs (e.g.,
reverse halo, comet tail, hilum overlay, signet ring, knuckle, scimitar, and water
bottle).
One of the more exciting enhancements to the third edition was increased
opportunity for self-assessment. Multiple-choice items were added to the end of
every chapter, and the self-assessment examination at the end of the book was
expanded. In addition, numerous new multiple-choice items were made available
with the online version of the book. In total, more than 150 new image-based
multiple-choice items were included with the third edition. This should be of
particular benefit to those who are preparing for the new image-rich computer-
based examinations that are a component of professional certification and
maintenance of certification.
To address the inherent limitations in a book of “essentials,” selected
scientific literature and larger comprehensive textbooks are referenced at the end
of each chapter for readers who want to broaden their foundation of knowledge.
The interpretation of chest radiographs and CT scans does not always lend itself
to a “cookbook” approach, but as much as possible, this book attempts to
provide a logical approach to learning that will not only prepare readers for but
also stimulate them to pursue lifelong learning in chest radiology.
JANNETTE COLLINS
ERIC J. STERN
Series Foreword
Preface

Chapter 1 Normal Anatomy of the Chest

Chapter 2 Signs and Patterns of Lung Disease

Chapter 3 Interstitial Lung Disease

Chapter 4 Alveolar Lung Disease

Chapter 5 Monitoring and Support Devices: “Tubes and Lines”

Chapter 6 Mediastinal Masses

Chapter 7 Solitary and Multiple Pulmonary Nodules

Chapter 8 Chest Trauma