X光影像判讀 Ped R4 吳瑋超

Normal Chest X-ray

Soft tissue Bony structure Lung Cardiovascular Airway Others

量 C/T ratio 對比 / 亮度 放大 / 縮小 量長度距離

Pneumothorax

Pneumothorax : Collection of gas in the pleural space resulting in collapse of the lung on the affected site

Tension Pneumothorax

One more complicated case…

Pneumonia

Pneumonia : Infection of lung, presented as radio-opaque patches in the chest X-ray film Silhouette Sign

Take a lateral view to confirm the location…

RML Pneumonia with Pleural Effusion RUL Segmental Pneumonia

Respiratory Distress Syndrome (RDS)

Respiratory Distress Syndrome (RDS) Grade I : slightly reticular (granular) pattern, decrease in transparency of lung, no certain difference to normal findings Grade II : soft decrease in transparency with an aerobronchogram, which overlaps the heart Grade III : like stage II, but with gradual stronger decrease in transparency as well as blurry diaphragm and heart Grade IV : white lung, homogenic lung opacity

RDS grade I : slightly reticular (granular) pattern, decrease in transparency of lung, no certain difference to normal findings

RDS grade II : soft decrease in transparency with aerobronchogram, which overlaps the heart

RDS grade III : like stage II, but with gradual stronger decrease in transparency as well as blurry diaphragm and heart

RDS grade IV : white lung, homogenic lung opacity

Necrotizing Enterocolitis (NEC)

Stage Systemic Signs Intestinal Signs Radiologic Signs I. Suspected Temperature instability, apnea, bradycardia Elevated pregavage residuals, mild abdominal distension, occult blood in stool Normal or mild Ileus B Same as IA Same as IA, plus gross blood in stool II. Definite Same as I, plus absent bowel sound, abdominal tenderness Ileus, pneumatosis intestinalis Same as IA, plus mild metabolic acidosis, mild thrombocytopenia Same as IIA, plus abdominal cellulitis, RLQ mass Same as IIA, plus portal vein gas with or without ascites III. Advanced Same as IIB, plus hypotension, bradycardia, respiratory acidosis, DIC, neutropenia Same as IIB, plus generalized peritonitis Same as IIB, plus definite ascites Same as IIIA Same as IIB, plus pneumoperitonium

Pneumatosis Intestinalis

Bowel Distension and Obstruction

Bowel Distension Relatively normal small bowel gas Distended small bowel gas

Bowel Obstruction

Bowel Obstruction

Ileus and Bowel Perforation

Ileus and Bowel Perforation

The Position of Catheters and Tubing

Umbilical Artery Catheterization : High catheterization -- T6-T9 Low catheterization -- below L3-L4 Umbilical Vein Catheterization :

Position of Central Venous Catheter

Position of Central Venous Catheter 喔哦…跑錯位置了… 換個方向再來一次

Endotracheal tube and NG tube

覺得霧裡看花，越看越花嗎 ? 有問題不要客氣哦 覺得霧裡看花，越看越花嗎 ? 有問題不要客氣哦