Classic imaging signs of congenital cardiovascular abnormalities.

Cardiovascular imaging is a rapidly evolving field that requires familiarity with the appearances of pediatric and adult cardiovascular diseases on chest radiographs as well as images obtained with computed tomography, magnetic resonance imaging, and angiography. To accurately identify congenital abnormalities affecting the heart and vessels of the thorax, radiologists must recognize the imaging features and understand their pathophysiologic origin. The cardiovascular imaging signs of congenital anomalies that are most often seen in radiologic practice include the egg on a string (seen in transposition of the great arteries), snowman (total anomalous pulmonary venous return), scimitar (partial anomalous pulmonary venous return), gooseneck (endocardial cushion defect), figure of three and reverse figure of three (aortic coarctation), boot-shaped heart (tetralogy of Fallot), and box-shaped heart (Ebstein anomaly).

Lines and stripes: where did they go?--From conventional radiography to CT.

Frontal and lateral radiography has traditionally been used to evaluate the chest, although computed tomography (CT) and high-resolution CT are increasingly being used as an adjunct to conventional radiography for the evaluation of parenchymal and mediastinal disease. Nevertheless, radiography remains a very important modality in this context, and use of chest radiography alone can provide a vast amount of useful information. This information is derived from the configurations and interrelationships of the anatomic structures in the lung, mediastinum, and pleura and forms the basis of the "lines and stripes" concept, which plays a valuable role in establishing a diagnosis before proceeding to CT. The inability to recognize that a chest radiograph is abnormal owing to displacement of one of these lines or stripes may lead to failure to request a potentially valuable CT examination. Radiologists must be familiar with the anatomic basis of these mediastinal lines and stripes and be able to recognize their normal and abnormal appearances. In this way, they can develop an appropriate differential diagnosis prior to obtaining additional information with chest CT.

ICU chest radiographs - ICU calamities: evaluation of the portable chest radiograph.

Familiarity with anatomy and anatomic variants, with tubes and catheters and their correct positioning, as well as complications of these positionings, is critical for the radiologist interpreting plain film radiographs taken in the intensive care unit.