Lesson 1Integrating clinical context: risk factors, timing, pleuritic pain, oxygenation, biomarkers (D-dimer, troponin) and how they change diagnostic weightingThis section explains how to integrate imaging with clinical context in acute dyspnoea, incorporating risk factors, symptom timing, pleuritic pain, oxygenation status, and biomarkers such as D-dimer and troponin to refine diagnostic probabilities.
Clinical risk factors for pulmonary embolismTiming of symptoms and disease evolutionPleuritic pain and chest wall tenderness cluesOxygenation, hemodynamics, and imaging choiceBiomarkers and imaging-based risk weightingLesson 2Pitfalls and mimics: motion artifacts, beam-hardening, dependent atelectasis, and contrast timing errorsThis section reviews frequent interpretive pitfalls and mimics in acute dyspnoea imaging, including motion artefacts, beam-hardening, dependent atelectasis, and contrast timing issues, and proposes strategies to recognise and minimise diagnostic error.
Recognizing motion and breathing artifactsBeam-hardening and streak artifact mimicsDependent atelectasis versus true consolidationContrast timing errors in CT angiographyChecklist approach to reduce interpretation errorsLesson 3Differential reasoning using signs: PE vs pneumonia vs pulmonary edema vs COPD exacerbationThis section explains how to contrast imaging patterns of pulmonary embolism, pneumonia, cardiogenic oedema, and COPD exacerbation, using key semiologic signs to build a prioritised, clinically coherent differential diagnosis.
Radiographic patterns of acute pulmonary embolismLobar and bronchopneumonia imaging distinctionsCardiogenic pulmonary edema hallmark signsCOPD exacerbation versus acute infection signsAlgorithmic imaging approach to acute dyspneaLesson 4Structured reporting for acute dyspnea: describing location, size, density, margins, distribution, and associated findingsThis section details how to structure chest imaging reports in acute dyspnoea, emphasising standardised description of lesion location, size, density, margins, distribution, and associated findings to support reproducible, actionable communication.
Standardized description of lesion locationReporting lesion size and volumetric assessmentDensity, attenuation, and enhancement patternsMargins, interfaces, and silhouette descriptionDocumenting distribution and ancillary findingsLesson 5Modalities selection: indications and strengths of chest X-ray vs CT pulmonary angiographyThis section compares chest X-ray and CT pulmonary angiography for acute dyspnoea, outlining indications, strengths, limitations, and radiation and contrast considerations to guide appropriate, patient-centred modality selection.
Initial role of chest X-ray in dyspnea workupIndications for CT pulmonary angiographyContraindications and risk–benefit balancingRadiation dose and contrast nephrotoxicityAlternative imaging when CTPA is unsuitableLesson 6Semiologic meaning of chest signs: acute vs chronic, alveolar vs interstitial, cardiogenic vs noncardiogenic pulmonary edemaThis section clarifies the semiologic meaning of major chest imaging signs, distinguishing acute from chronic changes, alveolar from interstitial patterns, and cardiogenic from noncardiogenic oedema using distribution, context, and ancillary findings.
Acute versus chronic parenchymal changesAlveolar consolidation versus interstitial patternCardiogenic versus noncardiogenic edema signsRole of distribution and symmetry in patternsAncillary signs refining semiologic interpretationLesson 7Systematic chest X-ray interpretation: zones, lines, silhouettes, and cardiothoracic ratioThis section presents a stepwise method for chest X-ray reading in dyspnoeic patients, covering division into zones, evaluation of lines and tubes, use of the silhouette sign, and assessment of heart size and mediastinal contours.
Quality checks: rotation, inspiration, exposureLung zones and systematic search patternEvaluation of lines, tubes, and devicesSilhouette sign and mediastinal contoursCardiothoracic ratio and heart size limitsLesson 8Pulmonary embolism signs on CT: filling defects, right ventricular strain, pulmonary infarct patterns, mosaic perfusionThis section focuses on CT signs of pulmonary embolism in acute dyspnoea, detailing direct vascular findings, indicators of right ventricular strain, pulmonary infarct patterns, and mosaic perfusion, and how each influences risk stratification.
Central and segmental filling defect patternsSubsegmental emboli and technical limitationsCT markers of right ventricular strainPulmonary infarct and wedge-shaped opacitiesMosaic perfusion and differential diagnosesLesson 9Key chest imaging signs: pneumothorax, consolidation, air bronchogram, ground-glass opacity, interstitial markings, Kerley B linesThis section reviews core chest imaging signs relevant to acute dyspnoea, including pneumothorax, consolidation, air bronchograms, ground-glass opacities, interstitial markings, and Kerley B lines, emphasising recognition and clinical implications.
Radiographic and CT signs of pneumothoraxConsolidation and air bronchogram correlationGround-glass opacity: causes and patternsInterstitial markings and reticular patternsKerley B lines and pulmonary venous congestionLesson 10Systematic chest CT interpretation: lung windows, mediastinal windows, vascular phases, and protocol selectionThis section outlines a systematic approach to chest CT in acute dyspnoea, covering lung and mediastinal windows, vascular phases, protocol tailoring, and structured review of airways, parenchyma, pleura, and mediastinal structures.
Lung window assessment of parenchymal diseaseMediastinal windows for nodes and massesVascular phases in CT pulmonary angiographyProtocol selection in unstable dyspneic patientsStructured checklist for chest CT review
