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Radiology of the Thorax

Radiology of the Thorax Radiology of the Thorax 1 A Study of the Thorax in Three Dimensions Samuel Brown , M.D. From the Roentgenological Departments of the Jewish and General Hospitals, Cincinnati, Ohio ↵ 1 Read before the Radiological Society of North America at the Fourteenth Annual Meeting, at Chicago, Dec. 3–7, 1928. Excerpt EVER since the introduction of the X-ray in the examination of the chest radiologists have fully realized that a flat plate of the thorax is insufficient for a complete analysis of the various structures, normal and abnormal, contained in the thoracic cavity. The use of the anteroposterior and lateral views so commonly resorted to in the study of the spine and extremities did not seem to appear to be applicable in the study of the thoracic contents. To overcome the limitations of the flat view, stereoscopy was introduced. Theoretically stereoscopy should answer every purpose; practically, however, such is found not to be the case. Many years of constant use of stereoscopic views of the chest in the antero-posterior position, supplemented by the lateral view, have fully convinced me that the value of stereoscopy has been overrated to a large degree. There may be a possible exception in an early case of pulmonary tuberculosis, but in the case of gross lesions of the pulmonary and cardiovascular systems the antero-posterior and lateral views are by far superior in locating abnormal shadows , determining their relation to the surrounding structures, and the interpretation of their probable nature. The routine use of lateral views has also impressed me with the existence of a fixed relationship of the various structures in the lateral aspect under normal conditions. This observation has enabled me to recognize early changes associated with any of the several structures of the thoracic cavity. Because of the importance of this observation it has always been my aim to obtain true lateral views. An oblique view will often yield valuable knowledge about any of the organs, but the correct relationship between the organs is made more difficult for an accurate analysis. The same, of course, applies to the antero-posterior view. This is the reason radiologists always insist upon true antero-posterior views. The X-ray Anatomy of the Thorax The X-ray appearance of the anatomical structures of the thorax in the anterior and posterior views is too well known to require any special description. There is, however, one thing about the antero-posterior view which commands some mention. It has been observed that there exists a constant relation between the size of the thorax and the size of the heart. Much valuable work has been done in the past in compiling numerous tables expressing the size of the heart in relation to the age, sex, height, and weight of the individual. These tables have been found so complicated that they are seldom referred to by clinicians or radiologists. In 1922 Dr. Friedlander and I (1) developed a simple formula by which we could predetermine the size of the heart in a given individual under normal conditions. The formula is based upon the factors to be enumerated. The transverse and anteroposterior diameters of the thorax are determined, the measurements being taken at the level of the fourth rib anteriorly. Copyrighted by the Radiological Society of North America, Inc. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Radiology Radiological Society of North America, Inc.

Radiology of the Thorax

Radiology , Volume 13 (6): 515 – Dec 1, 1929

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Publisher
Radiological Society of North America, Inc.
Copyright
Copyright © 1929 by Radiological Society of North America
ISSN
1527-1315
eISSN
0033-8419
DOI
10.1148/13.6.515
Publisher site
See Article on Publisher Site

Abstract

Radiology of the Thorax 1 A Study of the Thorax in Three Dimensions Samuel Brown , M.D. From the Roentgenological Departments of the Jewish and General Hospitals, Cincinnati, Ohio ↵ 1 Read before the Radiological Society of North America at the Fourteenth Annual Meeting, at Chicago, Dec. 3–7, 1928. Excerpt EVER since the introduction of the X-ray in the examination of the chest radiologists have fully realized that a flat plate of the thorax is insufficient for a complete analysis of the various structures, normal and abnormal, contained in the thoracic cavity. The use of the anteroposterior and lateral views so commonly resorted to in the study of the spine and extremities did not seem to appear to be applicable in the study of the thoracic contents. To overcome the limitations of the flat view, stereoscopy was introduced. Theoretically stereoscopy should answer every purpose; practically, however, such is found not to be the case. Many years of constant use of stereoscopic views of the chest in the antero-posterior position, supplemented by the lateral view, have fully convinced me that the value of stereoscopy has been overrated to a large degree. There may be a possible exception in an early case of pulmonary tuberculosis, but in the case of gross lesions of the pulmonary and cardiovascular systems the antero-posterior and lateral views are by far superior in locating abnormal shadows , determining their relation to the surrounding structures, and the interpretation of their probable nature. The routine use of lateral views has also impressed me with the existence of a fixed relationship of the various structures in the lateral aspect under normal conditions. This observation has enabled me to recognize early changes associated with any of the several structures of the thoracic cavity. Because of the importance of this observation it has always been my aim to obtain true lateral views. An oblique view will often yield valuable knowledge about any of the organs, but the correct relationship between the organs is made more difficult for an accurate analysis. The same, of course, applies to the antero-posterior view. This is the reason radiologists always insist upon true antero-posterior views. The X-ray Anatomy of the Thorax The X-ray appearance of the anatomical structures of the thorax in the anterior and posterior views is too well known to require any special description. There is, however, one thing about the antero-posterior view which commands some mention. It has been observed that there exists a constant relation between the size of the thorax and the size of the heart. Much valuable work has been done in the past in compiling numerous tables expressing the size of the heart in relation to the age, sex, height, and weight of the individual. These tables have been found so complicated that they are seldom referred to by clinicians or radiologists. In 1922 Dr. Friedlander and I (1) developed a simple formula by which we could predetermine the size of the heart in a given individual under normal conditions. The formula is based upon the factors to be enumerated. The transverse and anteroposterior diameters of the thorax are determined, the measurements being taken at the level of the fourth rib anteriorly. Copyrighted by the Radiological Society of North America, Inc.

Journal

RadiologyRadiological Society of North America, Inc.

Published: Dec 1, 1929

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