Chest and cardiac radiological imaging is a specialized field under radiology. It consists of diagnostic imaging of the lungs, heart, airways, pleura, mediastinum, diaphragm, chest wall, and other structures within the thorax. This radiological evaluation is effective in diagnosing acute and chronic cardiopulmonary conditions.
Chest and cardiac imaging is effective to detect pulmonary infections, interstitial lung disease, lung malignancies, pulmonary embolism, coronary artery disease, cardiomyopathies, valvular disorders, congenital anomalies, heart failure, and diseases of the thoracic aorta. These radiological imaging techniques are also commonly used in emergency departments to detect critical conditions like acute thoracic trauma, severe lung infection, sudden fluid accumulation in chest, etc.
Given below is the list of imaging modalities appropriate for each organ:
Lungs and airways are prone to several complications like airspace filling, loss of normal aeration, abnormal expansion or collapse, thickening of alveolar walls, airway narrowing or dilatation, and disruption of normal lung architecture. These anomalies can occur due to a number of reasons. Chest X-ray is the most common modality to detect lung collapse, overexpansion, air-fluid levels, and shifts in lung volume. To observe finer details, a CT scan will be appropriate. It can be helpful to accurately observe lung parenchyma and airways.
The heart and its chambers are prone to distinct changes such as changes in chamber size, wall thickness, shape, and motion. These changes can lead to structural distortion and cardiac filling. Generally, ECG is the primary modality to detect major cardiac changes. However, highly accurate anatomical-level parameters like chamber volumes, myocardial thickness, and structural symmetry can only be observed using an MRI.
The common issues that could occur with the pleural space consist of thickening, separation of pleural layers, or abnormal accumulation of air or fluid. Structural deformations and disruptions could ail the chest wall. For such complications, chest x-rays work efficiently. CT is an effective imaging modality for the detailed assessment of pleural anatomy, whereas ultrasound allows radiologists to observe real-time movements and fluid dynamics.
For the imaging of the chest and cardiac area, certain imaging modalities are commonly used for it. These modalities are listed below:
Chest X-ray is generally the primary evaluation method for the initial screening of cardiac and chest complications. It is a cost-effective and rapid method to visualize lung fields, heart size, mediastinal contours, pleural spaces, and gross vascular abnormalities. Due to its simple nature and fast results availability, chest X-rays are frequently used in emergency/STAT cases.
CT provides high-quality anatomical images using a cross-sectional imaging technique. Using CT, radiologists can observe the lungs, heart, mediastinum, great vessels, and chest wall in detail. CT can be used in the diagnosis of both cardiac and pulmonary issues with appropriate adjustments. High-resolution CT (HRCT) is especially used for the imaging of diffuse lung diseases such as pulmonary fibrosis, interstitial lung disease, emphysema, and chronic inflammatory conditions. CT angiography (CTA) is used to diagnose complications related to thoracic and coronary blood vessels.
MRI is a prominent method used to observe soft tissues in the body, especially those with higher water content. MRI has an added advantage of multiplanar imaging, unlike X-rays, where only a single-angle 2D image can be observed. A cardiac MRI is the gold standard to analyze cardiac function, myocardial tissue characterization, and viability. It can be used in the diagnosis of cardiomyopathies, myocarditis, ischemic heart disease, congenital heart disorders, and pericardial disease.
Radiologists can detect a range of cardiac and thoracic complications as listed below:
Pneumonia
Pulmonary edema
Acute respiratory distress syndrome (ARDS)
Chronic obstructive pulmonary disease (COPD)
Bronchiectasis
Interstitial lung disease
Pulmonary fibrosis
Pleural effusion
Pneumothorax
Empyema
Cardiomegaly
Heart failure
Cardiomyopathy
Valvular heart disease
Congenital heart disease
Myocarditis
Pericardial effusion
Cardiac tamponade
Coronary artery disease
Acute coronary syndrome
Pulmonary embolism
Aortic aneurysm
Aortic dissection
Pulmonary hypertension
Mediastinal lymphadenopathy
Mediastinal tumors
Mediastinitis
Thoracic trauma-related injuries
Cardiac and chest radiology have a structured workflow to diagnose cardiac conditions. This workflow is explained below:
The first step before a radiological analysis is collection of complete patient history and clinical diagnosis
Based on this information, the consulting clinician refers the patient to a radiologist (general or specialist).
After another thorough analysis, the radiologist selects a suitable imaging modality (X-ray, CT, MRI)
Radiological processes make use of ionizing radiation, wherein patient safety must be the first priority.
Before the imaging process, the patient is screened for prior imaging, renal function (for contrast studies), allergies, implanted devices, or pregnancy status.
For cardiac examination, the patient may be screened by heart rate control or breath-hold methods.
After proper safety checks are performed, the radiological examination is finally performed.
Radiologists use standardized protocols to perform the examination and obtain the images.
Once the images are obtained, the radiologist analyzes the image to rule out the incorrect complications.
These findings are correlated with the clinical indications to determine the etiology
Based on the diagnosed findings, the case might be categorized under the routine, urgent, or STAT category.
In case immediate attention is needed, the radiologist might verbally communicate the results.
The next stage in the radiological workflow is generating a report based on the findings
This report must be clear, concise, and accurately communicate the radiological findings.
This is a finalized test report that is entered into the hospital system for future references.
Chest and cardiac radiological procedures are generally noninvasive and safe. However, just like any other analysis method, there might be certain risks that are discussed below:
Exposure to ionizing radiation during X-ray, CTs, etc.
Contrast agents used to enhance CT might mount an allergic reaction in the patient
Irregular heart rhythm or heart rate could interfere with the diagnostic findings
Although MRIs do not carry the risk of radiation exposure, the strong magnetic field might interact with any metallic objects.
Accidental movement or patient nervousness may cause a spike in the heart rate, causing false results.
The aim of a chest/cardiology examination is to obtain the most accurate results in the least amount of radiation. These strategies consist of:
The radiological examination must be clinically justified
Using low-dose protocols for initial screening and follow-up
Making use of modern radiological technologies which use minimum dosing
Use of targeted screening and echocardiography to determine the clinical cause
Proper patient positioning and making use of appropriate shielding
Having the least number of follow-ups as possible
We, at Statim Healthcare, provide quality services for radiology reporting for partnering institutions like hospitals, diagnostic centers, and healthcare providers. This helps such institutions to provide timely radiological services to their patients. The focus is on quality, global standards, data security, and customer satisfaction. Each case is given individual priority and is interpreted using standardized protocols. There are clear instructions for workflows and staff responsibilities.
For cardiac/chest imaging, Statim offers chest X-rays, chest CTs, cardiac CTs, CT angiography, and related cardiothoracic interpretation and analysis facilities. These services enable healthcare institutions to provide radiological services to the patients even during day-offs and night hours. Once an image is received in our system, it is assigned to a relevant radiologist for examination. Each image is analyzed, keeping in mind the clinical history and organ-based approach. There are structured reporting formats in place to gain consistency in the reports. The findings are then securely transferred back to the institution. In case of life-threatening findings like acute vascular or cardiopulmonary abnormalities, the findings are immediately communicated to the physician.
Yes. Using portable imaging setups and under strict expert monitoring, cardiac/chest radiological examinations can be performed for critically ill or ICU patients.
Fasting is generally not required in cardiac or chest radiological examinations. However, it might be necessary for certain contrast-enhanced CTs.
Breathing or heart movements can give rise to artifacts. These artifacts can give rise to false positive and false negative findings.
Yes. Prior findings are extremely important to observe the course of the cardiac condition. The place of origin of the results does not affect the legitimacy of the results.
CT or other cardiac-based X-rays typically take anywhere between 5 and 15 minutes. MRIs for cardiac imaging require comparatively longer times.