01
Tracheal and bronchial lesions
Computed tomography (CT) is recommended, while ordinary chest X-ray is of limited value and is generally used for health screening and initial disease screening.
02
Lung infections
For example, CT examination is recommended for bacterial infection of the lungs, viral infection, pneumonic pseudotumor, lung abscess, tuberculosis, pulmonary mycosis, pulmonary parasitic disease, etc., and chest X-ray examination is mostly used for initial disease screening or case follow-up.
03
Lung tumors and pulmonary nodules
For lung cancer, lung metastases, and other lung tumors, CT is recommended.
For the clinical staging of lung cancer, positron emission tomography (PET/CT) and magnetic resonance imaging (MRI) PET are the first choice.
Pulmonary nodules are a common manifestation of lung cancer, but some pulmonary nodules are benign lesions of the lungs, which are completely different from the diagnosis and treatment of lung cancer, so it is particularly important to carry out imaging diagnosis and differential diagnosis of pulmonary nodules. Most pulmonary nodules up to < 1 cm in diameter are not visible on chest x-ray, so chest x-ray is not recommended as a routine evaluation modality, and CT is recommended, which can be scanned with a thin layer of lesion (maximum diameter ≤ 1 mm) at the pulmonary nodule. For solid nodules with a maximum diameter of >8 mm that cannot be determined, PET/CT is recommended to distinguish between benign and malignant.
04
Pulmonary edema
Both chest x-ray and CT are acceptable, and CT is more advantageous in showing lesions with a more limited range.
05
Pulmonary embolism
Computed tomography (CTPA) is recommended.
06
Pneumoconiosis
Both chest X-ray and CT can be examined, and CT examination has advantages in showing the number and distribution of lesions, mediastinal lymph nodes, fibrotic lesions, etc., so CT examination is more recommended.
07
Pleural lesions
For pleurisy, both chest x-ray and CT are acceptable, and CT is more advantageous in showing pleural thickening and lung compression, so CT is more recommended.
For pleural tumors, noncontrast CT and contrast-enhanced testing are recommended.
08
Pneumothorax and fluid pneumothorax
CT is recommended because it can detect small amounts of gas or fluid and show more clearly compressed lung tissue.
09
Mediastinal lesions
CT is recommended for mediastinal tumors such as thymoma, teratoma, lymphoma, neurogenic tumors, neoplasia such as intrathoracic goiter, mediastinal inflammation, and mediastinal emphysema.
10
Chest trauma
Chest x-ray can be used as a preliminary examination to show rib fractures, pneumothorax, fluid pneumothorax, and subcutaneous emphysema, but CT is recommended to determine whether there is pulmonary contusion, pulmonary laceration, pulmonary hematoma, and tracheobronchial injury after trauma, and CT examination is more advantageous for incomplete rib fractures and a small amount of pneumothorax and fluid pneumothorax.
Content Sources:
People's Medical Publishing House published "100 Questions and Answers on Medical Imaging Examination"
Editor-in-Chief of the book:
Chinese People's Liberation Army Army Characteristic Medical Center Li Xue, Wang Yaling, Zhang Letian, Zhao Li
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