Manuel Jr. Viamonte – författare

The reasons for errors in chest radiography and how to avoid them are the thrust of this book.

There are many diagnostic imaging techniques for the radiological exarmna- tion of the abdomen. Noninvasive methods include supine and upright views of the abdomen (sometimes fluoroscopy and decubitus films); posteroanterior (PA) views of the chest; contrast studies of the alimentary tract; ultrasonogra- phy (US), scintigraphy, computed tomography (CT), and magnetic resonance imaging (MRI). Biopsy under fluoroscopic control and angiography are inva- sive techniques. Most of the errors described in this book are related to faulty interpretation; others are due to improper technique. For example, a patient with acute abdominal pain secondary to a perforated hollow viscus may be studied only by supine and upright views of the abdomen that do not include the subdi- aphragmatic regions. A complementary PA view of the chest or a left lateral decubitus film would, however, detect free air in the pentoneal cavity that the incomplete two-film study might have missed.Errors of techmque are due to under- or overexposure, long exammation times or an uncooperative patient (both of which can induce motion artIfacts), improper processing, and failure to perform the proper standard noninvasive or mvaSlVe modalitIes for examining the hollow viscus and the solid organs of the alimentary tract. In order to visualize the diaphragm and the supra- and mfradiaphragmatIc spaces, frontal and lateral chest roentgenograms complement the standard views of the abdomen. Fluoroscopy IS of great value m assessing diaphrag- matic motion as well as being essential when contrast media are utilized.

This monograph deals primarily with the kidneys, ureters, and urinary blad­ der. The kidneys are retroperitoneal structures that parallel the psoas muscle. The left kidney is usually slightly higher than the right and is slightly more medially located. The vertical axis of the kidneys, when compared with the midline, is about 20°. There is often considerable mobility of the kidneys as a result of respiration and body position. Several centimeters of excursion have been demonstrated on deep inspiration or in the upright position. During late embryological development, each kidney occupies the flank region, capped by the liver on the right side and the spleen on the left. Abnor­ malities of the liver and spleen can affect the position of the kidneys. Also, retroperitoneal masses may displace the kidney. A palpable abdominal mass which radiographically may appear to be an intraperitoneal structure can be accurately localized as a retroperitoneal tumor by observing displacement of the kidney, particularly if the kidney is pushed caudally and medially, superi­ orly and laterally, or medially. Anomalies of the kidneys include abnormal position, abnormal number, changes in shape, and alterations in the inner structure that may affect the renal parenchyma, the pelvocalyceal systems, or both.

The reasons for errors in chest radiography and how to avoid them are the thrust of this book.