Radiografía torácica: Patrones normales (sesión 4). Preguntas e imágenes proporcionadas por el Dr. Franck Durieux, Dip ECVDI - Aquivet.

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Pregunta nº1

Estas radiografías torácias pertenecen a un Pastor Alemán y son las vistas Dorso-Ventral (DV) y Ventro-Dorsal (VD), respectivamente.

¿En que posición se observa mejor la zona del lóbulo accesorio?

  • NO. Esta es la posición Dorso-Ventral. En este caso, la región del lóbulo accesorio está menos debido al desplazamiento craneal del diafragma debido a la presión de los órganos abdominales. El apex del corazón está desplazado a la izquierda dependiendo de cómo es el torax y de la raza del animal.Esta posición fisiológica da una representación buena de la silueta cardiaca. Las diferencias entre las posiciones lateral derecha e izquierda y DV frente a VD son más pronunciadas en perros medianos y grandes.

  • CORRECTO. Esta radiografía es Ventro-Dorsal. En esta posición se ve mejor el lóbulo accesorio. La cúpula del diafragma no presiona la parte caudal del pulmón. Esto ayuda especialmente cuando se buscan metástasis.Las diferencias entre las posiciones lateral derecha e izquierda así como DV y VD son más pronunciadas en animales medianos y grandes.

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Pregunta nº2

¿Qué factor o factores pueden influir en el aspecto de la silueta cardiaca?

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Pregunta nº3

¿Esta rediografía es lateral izquierda o lateral derecha?

  • FALSO. In right lateral radiographs, the cardiac silhouette is oval or egg shaped. The diaphragmatic crura are usually parallel to each other, with the right crus being more cranial than the left. The right diaphragmatic crus can usually be identified by tracing the dorsal border of the caudal vena cava to the point where it becomes confluent with the right crus at the caval hiatus. Air within the fundus of the stomach may be visible behind the left diaphragmatic crus. Overlap between the right and left cranial lobe pulmonary arteries and veins is common on right lateral radiographs which will make assessment of the relative size of the pulmonary arteries and veins difficult in this view compared with the left lateral one. In the left lateral view, the left diaphragmatic crus is usually more cranial than the right. The right and left crura diverge form each other as the diaphragm is traced from a ventral to dorsal position, forming a Y aspect. The caudal vena cava can be traced to silhouette with the right crus, usually at a point caudal to the left crus. Food and air within the fundic portion of the stomach can be identified caudal to the left crus. The apex of the heart tends to become displaced from the sternum, giving a circular appearance to the overall cardiac shape. This should not be mistaken with a right ventricular hypertrophy or a false pneumothorax.

  • VERDADERO. In the left lateral view, the left diaphragmatic crus is usually more cranial than the right. The right and left crura diverge from each other as the diaphragm is traced from a ventral to dorsal position, forming a Y aspect. The caudal vena cava can be traced to silhouette with the right crus, usually at a point caudal to the left crus. Food and air within the fundic portion of the stomach can be identified caudal to the left crus. The apex of the heart tends to become displaced from the sternum, giving a circular appearance to the overall cardiac shape. This should not be mistaken with a right ventricular hypertrophy or a false pneumothorax. In right lateral radiographs, the cardiac silhouette is oval or egg shaped. The diaphragmatic crura are usually parallel to each other, with the right crus being more cranial than the left. The right diaphragmatic crus can usually be identified by tracing the dorsal border of the caudal vena cava to the point where it becomes confluent with the right crus at the caval hiatus. Air within the fundus of the stomach may be visible behind the left diaphragmatic crus. Overlap between the right and left cranial lobe pulmonary arteries and veins is common on right lateral radiographs, which will make assessment of the relative size of the pulmonary arteries and veins difficult in this view compared with the left lateral.

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Pregunta nº4

¿Que posiciones se prefieren de forma standar para evaluar el corazón?

  • NO. Two orthogonal views are preferable to assess the thorax and particularly the heart. The Dorso-Ventral and right lateral view do not affect the aspect of the cardiac silhouette. On the left lateral views the cardiac silhouette may fall away from the sternum as the right middle lung lobe inflates. This produces a radiolucency between the sternum and the heart which should not be confused with pneumothorax.

  • NO. Two orthogonal views are preferable to assess the thorax and particularly the heart. The Dorso-Ventral and right lateral views do not affect the aspect of the cardiac silhouette.

  • Si. Two orthogonal views are preferable to assess the thorax and particularly the heart. The Dorso-Ventral and the right lateral views do not affect the aspect of the cardiac silhouette. On a DV view, the cardiac shape is more oval because of its upright position, and the apex is often displaced to the left by cranial excursion of the diaphragm pushing the heart to the left. Better visualisation of the caudal lobar pulmonary vessels and bronchi can be achieved in the DV view because of they are magnified and perpendicular to the X-ray beam.

  • NO.Two orthogonal views are preferable to assess the thorax and particularly the heart. The Dorso-Ventral and right lateral views do not affect the aspect of the cardiac silhouette. The cardiac silhouette tends to be more elongated and narrower than in a DV radiograph. Changes in the descending aorta and great vessels are more conspicuous on the VD view. The accessory lung lobe region between the cardiac silhouette and diaphragm is elongated.

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Pregunta nº5

Hay dos conformaciones de torax diferentes. Las radiografías 1 y 2 representan las posiciones laterales de dos razas de perros.

¿Que raza no está representada?

  • There is no picture representing a thoracic lateral view of a Weimaraner. Dogs with intermediate thoracic conformation have a wider cardiac silhouette that, on the lateral radiograph, is inclined cranially within the thorax and has more sternal contact than dog with deep narrow conformation. The cardiac silhouette has a reverse D shape in the DV radiograph, and the cardiac apex is usually positioned slightly to the left of the midline.

  • The picture 1 is a right lateral view from an adult Greyhound. This is a deep narrow conformation. Dogs with this thoracic conformation have an elongated, thin, oval or egg-shaped heart, which often seems relatively small when compared with the thoracic volume. On the lateral views of these dogs, the apex-base axis of the heart is almost perpendicular to the spine with minimal sternal contact.

  • The picture 2 is a right lateral view from an adult English Bulldog. Dogs with shallow, wide thoracic conformation have a short, round cardiac silhouette that, on the lateral radiograph, has a marked cranial inclination and a long area of sternal contact. On the Ventro-Dorsal view or Dorso-Ventral radiograph, the cardiac apex usually is located to the left of the midline and is often more difficult to identify because of its broad shape. This type of dog has a heart that always appears to be enlarged relative to the thoracic volume.

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Pregunta nº6

En los perros braquicefálicos, puede parecer que el lado derecho del corazón tiene un aumento de tamaño.

  • Dogs with shallow, wide thoracic conformation have a short, round cardiac silhouette that, on the lateral radiograph, has a marked cranial inclination and a long area of sternal contact. On the Ventro-Dorsal or Dorso-Ventral views, the cardiac apex is usually located to the left of the midline and is often more difficult to identify because of its broad shape. This type of dog has a heart that always appears to be enlarged relative to the thoracic volume, and a large sternal contact between the right ventricule and the sternum.

  • Dogs with shallow, wide thoracic conformation have a short, round cardiac silhouette that, on the lateral radiograph, has a marked cranial inclination and a long area of sternal contact. On the Ventro-Dorsal or Dorso-Ventral views, the cardiac apex usually is located to the left of the midline and is often more difficult to identify because of its broad shape. This type of dog has a heart that always appears to be enlarged relative to the thoracic volume, and a large sternal contact between the right ventricule and the sternum.

  • Dogs with deep narrow thoracic conformation have an elongated, thin, oval or egg-shaped heart, which often seems relatively small when compared with the thoracic volume. On the lateral views of these dogs, the apex-base axis of the heart is almost perpendicular to the spine with minimal sternal contact.

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Pregunta nº7

Esta es una vista lateral derecha del torax de un perro adulto.

¿A qué estructura vascular señalan las flechas?

  • The cranial vena cava is not visible. This vessel is included in the opacity delimiting the cranial mediastinum. The different structures included within the cranial mediastinum can be distinguished in case of pneumomediastinum.

  • The azygos vein is normally not visible. It runs along the right side of the aorta toward the cranial vena cava.

  • This is the caudal vena cava. The size of the caudal vena cava can sometimes vary significantly throughout the respiratory cycle and cardiac. Its measurement must be performed with caution.

  • The aorta is located ventrally and slightly to the left of the thoracic vertebral bodies. Its greater curvature is visible on the profile view of approximately 9 to 11 o'clock. On the front , the aorta is assessed with the great vessels between 11 to 1 o'clock.

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Pregunta nº8

(Esta es una radiografía lateral derecha del torax de un perro adulto)

Which vascular structure is marked by the arrows?

  • The arrows points the artery, bronchus and vein from the right cranial lung lobe. The assessment of the pulmonary vessels is easier with the left lateral and Dorso-Ventral views.

  • On a lateral thoracic view, the artery is the upper structure and the vein is located ventrally. The bronchus lies between the artery and the vein forming a triad. The assessment of the pulmonary vessels is easier with the left lateral and Dorso-Ventral views.

  • On a lateral thoracic view, the artery is the upper structure and the vein is located ventrally. The bronchus lies between the artery and the vein forming a triad. The assessment of the pulmonary vessels is easier with the left lateral and Dorso-Ventral views.

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Pregunta nº9

(Radiografía Dorso - Ventral del torax de un perro adulto)

¿Qué estructura vascular se señala con las flechas?

  • On a Dorso-Ventral or Ventro-Dorsal thoracic view, the artery is the lateral vascular structure, and the vein is medial. The bronchus lies between the artery and the vein forming a triad. Notice the vessels form a summation shadow that is the shape of a square as they cross the ninth rib.

  • The artery is lateral and the vein is medial. The bronchus lies between the artery and the vein forming a triad. Notice the vessels form a summation shadow that is the shape of a square as they cross the ninth rib. These remarks are valid for the DV and VD views.

  • On a Dorso-Ventral or Ventro-Dorsal thoracic view, the artery is the lateral vascular structure, and the vein is medial. The bronchus lies between the artery and the vein forming a triad. Notice the vessels form a summation shadow that is the shape of a square as they cross the ninth rib.

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Pregunta nº10

Vista lateral derecha del torax de un perro con superposición de las marcas de un reloj.

¿Dónde está la aurícula izquierda?

  • The heart coud be subdivided into different locations that approximate certain areas of the great vessels and chambers of the heart. This method is helpful to familiarize with the evaluation of cardiac abdnormalities. 2 to 6 o’clock: left ventricule, 6 to 10 o’clock: right ventricule, 10 to 11 o’clock: right atrium, 11 to 1 o’clock great vessels. These values are given for information only and may vary from one individual to another and from one breed to another.

  • The heart coud be subdivided into different locations that approximate certain areas of the great vessels and chambers of the heart. This method is helpful to familiarize with the evaluation of cardiac abdnormalities. 1 to 2 o'clock: left atrium. 2 to 6 o’clock: left ventricule, 6 to 10 o’clock: right ventricule, 10 to 11 o’clock: right atrium, 11 to 1 o’clock great vessels. These values are given for information only and may vary from one individual to another and from one breed to another.

  • The heart coud be subdivided into different locations that approximate certain areas of the great vessels and chambers of the heart. This method is helpful to familiarize with the evaluation of cardiac abdnormalities. 1 to 2 o'clock: left atrium. 2 to 6 o’clock: left ventricule, 6 to 10 o’clock: right ventricule, 10 to 11 o’clock: right atrium, 11 to 1 o’clock great vessels. These values are given for information only and may vary from one individual to another and from one breed to another.

  • The heart coud be subdivided into different locations that approximate certain areas of the great vessels and chambers of the heart. This method is helpful to familiarize with the evaluation of cardiac abdnormalities. 1 to 2 o'clock: left atrium. 2 to 6 o’clock: left ventricule, 6 to 10 o’clock: right ventricule, 10 to 11 o’clock: right atrium, 11 to 1 o’clock great vessels. These values are given for information only and may vary from one individual to another and from one breed to another.

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Pregunta nº11

En un gato sano, el tamaño de las arterias y las venas debe ser comparable.

  • The artery and the vein are of equal size. This is true for the cat as the dog.

  • The artery and the vein are of equal size. This is true for the cat as the dog.

  • The artery and the vein are of equal size. This is true for the cat as the dog.

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