RESPIRATORY, CARDIOVASCULAR, AND NERVOUS SYSTEMS
Section I. THE RESPIRATORY SYSTEM
Advances in technology take place every day. The bronchographic studies are
being used less and less, replaced by other modalities. Computed tomography is used
primarily, as well as pulmonary angiography, nuclear medicine, and magnetic
resonance imaging. These are now the preferred modalities for imaging the respiratory
system. Of all the organs and structures that comprise the human body, the lungs are
most frequently examined by radiologic means. The major components of the
respiratory system are generally demonstrated via standard PA (posterior-anterior) and
lateral chest projections. However, certain respiratory diseases and bronchial
conditions require detailed examination of the bronchial tree before a definite diagnosis
can be made. The radiographic study of the bronchial structures using a contrast
medium is called bronchography. Computed tomography is the modality of choice and
has replaced bronchography.
ALTERNATIVE MODALITIES OR PROCEDURES
a. Computed Tomography (CT). CT is most frequently used to examine and
identify masses or other pathology in either the mediastinum or in the lung.
b. Bronchography. CT is the modality of choice and has replaced
bronchography. Bronchography, performed in the past to examine the bronchial tree
and lungs after introduction of a catheter and positive contrast media into the bronchi
(see figures 3-1 through 3-5). PA, lateral, and frequently obliques were then taken to
rule out pathologies such as obstructions, fistulas, carcinoma, bronchitis, or
c. Sonography (Ultrasound). Ultrasound may be used to detect pleural
effusion (fluid within the pleura space) or for guidance when inserting a needle to
aspirate the fluid (thoracentesis).
d. Nuclear Medicine. Certain nuclear medicine procedures involving
radionuclides can be used to evaluate and diagnose pulmonary diffusion conditions or
e. Magnetic Resonance Imaging (MRI). Cardiovascular MRI procedures can
be used to demonstrate and evaluate certain pathology such as congenital heart
disorders, graft patency, cardiac tumors, thrombi, pericardial masses, and evaluation of
aortic dissection and aneurysms.