einseitig vermehrte Transparenz Thorax
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Unilateral hypertranslucent hemithorax has many potential causes. It may be the result of rotation away from an optimal position or because of pathology.
Rotation
A unilateral hypertranslucent hemithorax may be caused by the positioning of the patient. Rotation away from the radiation beam alters the attenuation of the beam differently on either side of the thorax. When the patient is turned to the right, the right side will be hypertranslucent.
- poor patient positioning
- scoliosis
Pathology
Where rotation isn't thought to be the cause of the differential transradiancy, it may be useful to consider the potential causes by the structures they involve, in the order in which the radiation beam hit them. The age of the patient is also a factor that should be considered.
A helpful mnemonic is SAFEPOEM.
Chest wall defects - muscle abnormalities
- mastectomy
- Poland syndrome (absent pectoralis major muscle)
- surgical removal of pectoralis major muscle for flap surgery
- unilateral fatty atrophy to chest wall muscles
Pleura and pleural space
- pneumothorax
- pleural effusion (contralateral)
Mediastinal
Pulmonary (ventilation)
- airway obstruction
- bronchial compression (hilar mass, cardiomegaly)
- endobronchial obstruction with air trapping (foreign body, tumor, mucous plug)
- obliterative bronchiolitis
- Swyer-James syndrome
- pulmonary emphysema (asymmetric)
- congenital lobar overinflation (previously called congenital lobar emphysema)
- unilateral bullous/bullae
- compensatory hyperinflation
- pneumonectomy
- unilateral lung transplant: 'abnormal' side may be ipsilateral or contralateral, depending on the reason for transplantation
Vascular (perfusion)
- pulmonary embolism (if Westermark sign present)
- congenital heart disease
- congenital pulmonary artery hypoplasia/pulmonary artery stenosis
- shunt (e.g. Blalock-Taussig)
- unilateral absence of pulmonary artery
See also
Siehe auch:
- Pneumothorax
- Pleuraerguss
- Lungenarterienembolie
- Westermark-Zeichen
- Bronchiolitis obliterans
- Skoliose
- Lungenemphysem
- Herzfehler
- Poland-Syndrom
- fehlender Mammaschatten in der Thoraxaufnahme nach Mastektomie
- Bronchoventilmechanismus
- bullöses Emphysem
- kongenitales lobäres Emphysem
- Swyer-James-Syndrom
- Emphysem
- fibrosierende Mediastinitis
- idiopathisches Lungenemphysem mit riesigen Bullae
- pulmonale Bullae
- agenesis (pulmonary)
- fibrosis (mediastinal)
- Blalock Taussig
und weiter:
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