Abnormal Chest X-rays

Chest xraysA variety of chest imaging studies can be performed for assessing structures within the chest, but the two most common imaging procedures are the chest xray and chest CT scan. A standard chest xray is generally done with 2 views: a frontal view with the chest facing the xray machine, and a side view with the shoulders facing the xray machine. The standard chest xray is a very useful tool in assessing basic respiratory complaints, such as Shortness of Breath, Chronic Cough, among others. Compared to many imaging techniques, a chest xray is relatively inexpensive and uses a small amount of radiation. A chest xray is limited in that the smallest abnormality detectable is more than 1 centimeter, and abnormalities in the center of the chest are difficult to assess because of all the overlapping structures.

A chest CT scan images the lungs as slices from top to bottom, typically producing 60 or more separate images. This imaging method can identify abnormalities as small as 2 or 3 millimeters, and does an excellent job of imaging the central structures. In some cases, intravenous contrast dye is injected just before the scan to help better distinguish the large arteries and veins in the center of the chest (which are filled with the contrast) from surrounding structures such as lymph nodes. The two main disadvantages of the chest CT include the significantly higher cost, and greater radiation exposure compared to a two view chest xray.

SEC Lung is frequently asked to evaluate abnormalities seen on either a chest xray or CT scan. These abnormalities can include any of the following, often in combination:

  • Nodules ( solid tissue within surrounding normal lung tissue, less than 3 centimeters in diameter)
  • Lung masses (solid tissue larger than 3 centimeters or greater in diamter)
  • Pleural effusion (fluid around the outside of the lung)
  • Interstitial abnormalities (abnormal thickening of the structural tissues within the lung tissue)
  • Infiltrates (filling of the lung tissue spaces with fluid or cells)

At SEC Lung, Dr. Garver personally reviews the actual images and performs a full medical history and physical exam along with Lung Function Tests in order to determine the significance of the abnormality, and whether any further assessment is necessary.

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