Tuesday, December 6, 2011

AP Projection / View

Lat. Decubitus Position

Pathology Demonstrated:
  • Abnormal masses, air-fluid levels, and possible accumulations of intraperitoneal air are demonstrated
  • Small amounts of free intraperitoneal air are best demonstrated with chest technique on erect PA chest.
Important: Patient should be on side a minimum of 5minutes before exposure ( to allow air to rise or abnormal fluids to accumulate); 10 to 20 minutes is preferred, if possible, for best visualization of potentially small amounts of interperitoneal air.
Lateral decubitus Abdomen
Left Lateral Decubitus Abdomen
Left lateral decubitus best visualized free intraperitoneal air in the area of the liver in the right upper abdomen away from the gastric bubble.

Technical Factor:
  • IR size 35 x 43cm (14 x 17 inches), crosswise to the table (lengthwise with the patient)
  • Moving or stationary grid
  • 70 to 80 kV range
X-ray Marker:
  • Place arrow or other appropriate marker to indicate "up" side.
  • Use gonadal shielding on males.
Patient Position:
  • Lateral recumbent on radiolucent pad, firmly against table or vertical grid device (with wheels on cart locked so as not to move away from table)
  • Patient on frm surface, such as a cardiac or back board, position under the sheet to prevent sagging and anatomy cutoff
  • Knees partially flexed, one on top of the other, to stabilized patient
  • Arms up near head; clean pillow provided
Part Position:
  • Adjust patient and cart so that center of IR and CR are approximately 2 inches (5cm) above level of iliac crest (to include diaphragm).
  • Promiximal margin of cassette will be approximately at level of axilla.
  • Ensure no rotation of pelvis or shoulders.
  • Adjust height of cassette to center midsagital plane of patient to center of IR, but ensure that upside of abdomen is clearly included on the IR.
Central Ray:
  • CR horizontal, directed to center of IR, at about 2 inches (or 5cm) above level of illiac crest
  • Use of a horizontal beam to demonstrate air-fluid levels and free intraperitoneal air
  • Minimum SID of 40 inches (100cm)
  • Collimate on four sides; do not cut off upper abdomen.
  • Make exposure at end of expiration.

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