509

.. , . . . .

Glossary of Terms for Thoracic Radiology:

Recommendations of the Nomenclature Committee of the
Fleischner Society1

The Fleischner Society was founded in 1969 by a group of sented here, and that those who do not will, at least, become
radiologists to honor the memory of Felix Fleischner and to more thoughtful in their choice of words.
promote the exchange of information between basic scientists Thanks are due to those members of the Society who
and clinical investigators interested in chest disease. Today launched this effort: Gordon Cumming (Midhurst, England)
this multidisciplinary group is best known for the Symposia and E. Robert Heitzman (Syracuse, NY); to those who sus-
on Chest Disease that it conducts annually, but it has sought, tamed it: John J. Fennessy (Chicago, IL), Paul J. Friedman
in the words of its motto, “to advance knowledge of the (San Diego, CA), Ronald Grainger(Sheffield, England), William
normal and diseased chest” in various other ways. The Glos- H. Northway, Jr. (Palo Alto, CA), and the late George Jacob-
sary presented here represents one such effort. son (Los Angeles, CA); and most particularly to those on
The Glossary was originally proposed at the first general whom fell the burden of bringing it to fruition: John H. M.
meeting of the Society of 1 971 in the belief that standardiza- Austin (New York, NY), Robert G. Fraser (Birmingham, AL),
tion of terms with respect to the description of radiographic David H. Trapnell (London, England) and Morris Simon (Bos-
findings would facilitate the exchange of information. Various ton, MA).
members of the Society have contributed to its development William J. Tuddenham
over the intervening years, and though such an undertaking Chairman, Nomenclature Committee
is never truly completed, the Glossary is now judged to be The Fleischner Society
sufficiently inclusive to be of general interest. The Society,
therefore, authorized its publication as a report of the Nomen-
Editor’s Note
clature Committee in May 1983.
The development of a glossary is a process that casts light At its recent meeting in Santa Fe, the Fleischner Society
on both the meaning of words and on the basics of human reaffirmed its hope this Glossary will prove helpful in refining
behavior. The use of words, it appears, is a highly personal the radiographic vocabulary for describing and thinking about
attribute of the individual, and any disagreement with that thoracic disease. The Society also realizes these definitions
usage is instinctively viewed as a personal assault: A nomen- and comments on their usage (evaluations) may not satisfy
clature committee does not need a chairman; it needs a all readers. A certain dogmatism has been required to reach
“peace-keeping force”! It is, therefore, a great tribute to those final statements about terms that may be used differently by
who participated that they were ultimately able to put personal others. To achieve a wider consensus on the acceptance of
bias and national linguistic differences aside and to agree on controversial terms, the Society invites comments, criticisms,
the definitions presented here. and suggested additions. These may be directed to the AJR
The Committee, comprising more “splitters” than “lumpers,” Editorial Office or to Dr. Robert Fraser (Department of
has sought to identify nuances of meaning that distinguish Radiology, University of Alabama Medical Center, 619 5. 19th
words of similar connotation and has systematically rejected St., Birmingham, AL 35233). Dr. Fraser is the new chairman
the argument that “everyone says it that way” as a justification of the Nomenclature Committee; the committee will
for the misuse of a word. It has also attempted to indicate synthesize constructive suggestions into revisions in the
whether specific terms are truly descriptors or are, in fact, Glossary. Readers are urged to respond to this invitation and
diagnostic conclusions; and if the latter, whether or not they to help the Society reduce imprecision in our vocabulary so
can appropriately be based solely on radiographic evidence. the complexities of thoracic disease may be better understood
It is hoped that publication of this Glossary will stimulate and communicated.
interest in the standardization of descriptive terminology in
chest radiology, that some will adhere to the definitions pre- MMF

1 Address reprint requests to W. J. Tuddenham, Department of Radiology. Pennsylvania Hospital, 8th and Spruce Sts., Philadelphia, PA 19107.
AJR 143:509-517, September 1984 0361-803X/84/1433-0509 0 American Roentgen Ray Society
 510 FLEISCHNER SOCIETY GLOSSARY AJR:143, September 1984

A but including the respiratory bronchioles. monic window. -Evaluation: 2. A specific feature
-adj. Pathol/Physiol/Radiol. Of or pertaining to of radiologic anatomy. An acceptable term.
abscess, n, -es. 1. Pathol. An inflammatory mass any process believed to be confined to the ana- arterlovenous flstUla, n, -ae. 1. Pathol anat. A
within lung parenchyma, the central part of which tomic airspace or to a part thereof(e.g., airspace direct communication between an artery and a
has undergone purulent liquefaction necrosis. It consolidation). -Synonyms: acinar, alveolar. - vein that bypasses the capillary bed. 2. Radio!. A
may communicate with the bronchial tree. 2. Evaluation: Inferred conclusion appropriately shadow complex, comprising a nodular pulmo-
Radio!. A mass within lung parenchyma which, if based on radiologic evidence and an acceptable nary opacity associated with dilated vascular
it communicates with the bronchial tree, contains descriptor. shadows, that is presumed to represent an arte-
a cavity. Otherwise, a pulmonary mass can be air trapping, n. 1. Pathophysiol. The retention of riovenous fistula in the anatomic sense. (Such
considered to represent an abscess in the mor- excess air in all or part of the lung as a result of lesions are often multiple.) -Synonyms: arterio-
phologic sense only by inference. -Qualifiers: airway closure during the expiratory maneuver; venous aneurysm, arteriovenous malformation.
Expressing clinical course: acute, chronic. Ex- classically implies an increasing amount of re- Arteriovenous fistula or aneurysm refers to a
pressing etiology: bacterial, fungal, etc. Express- tamed air at equivalent expiratory positions in lesion of congenital or traumatic origin; arterio-
ing site of involvement: lung, mediastinal, etc. - successive expiratory maneuvers. 2. Radio!. The venous malformation should be reserved for le-
Evaluation: An inferred conclusion, the use of retention of excess air in all or in some part of sions ofcongenital origin. -Qualifiers: traumatic,
which as a radiobogic diagnosis is appropriate the lung at any stage of expiration. -Evaluation: congenital. -Evaluation: In conventional radi-
only with reference to masses of presumed infec- 2. A specific radiologic statement to be used only ographs, an inferred conclusion sometimes justi-
tious origin; cf. cavity. if excess air retention is demonstrated by a dy- fled by the radiographic evidence alone. In pub-
absorber, n, -s. Radio!phys. Any object that atten- namic study (e.g. , inspiration-expiration radiog- monary arteriography, an explicit radiographic
uates an x-ray beam. raphy or fluoroscopy). Not to be used with refer- diagnosis.
acinar pattern, n, -a. Radio!. A collection of round, ence to ovennflation of the lung at full inspiration atelectasis, n. 1. Pathol phys. Less than normal
poorly defined, discrete or partly confluent opac- (total lung capacity). kiflation ofall or part ofthe lung with correspond-
ities in the lung, each 4-8 mm in diameter and airway, n. Anat. 1. A collective term for the air- ing diminution in lung volume. 2. Radio!. Radio-
together producing an extended, inhomogeneous conducting passages from the larynx to and in- logic evidence of diminished volume affecting all
shadow. -Synonyms: rosette pattem, acinono- duding the terminal bronchioles. 2. Any air-con- or part of a lung, which may or may not include
dose pattem (used specifically with reference to ducting tube or passage. bss ofnormal lucency in the affected part of lung.
endobronchial spread of tuberculosis), alveolar -adj. Pathol/Physiol/Radiol. Of or pertaining to (This finding is not to be confused with diminished
pattem (inaccurate descriptor; not recom- the anatomic airway or a part thereof (e.g.. do- volume produced by resection of pulmonary tis-
mended). -Evaluation: An inferred conclusion structive airway disease). -Evaluation: Inferred sue.) -Qualifiers: Expressing mechanism: re-
usually used as a descriptor. An acceptable term. conclusion appropriately based on radiobogic cvi- sorption (obstructive), secondary to airway ob-
acinar shadow, n, -a. Radio!. A round or ovoid, dance. An acceptable descriptor. struction; relaxation (passive, compression), sec-
poorly defined pulmonary opacity 4-8 mm in alveolarizatlon, n. Radio!. The opacification of clus- ondary to the effect of an adjacent space-occu-
diameter, presumed to represent an anatomic ters of minute airways (presumed to be alveoli) pying process; surfactant deficit; cicatrization
acinus renderedopaque by consolidation. Usually by a contrast agent. -Evaluation: Excessive fill- (scar), secondary to fibrotic contraction. Express-
used only in the presence ofmany such opacities; ing of peripheral airways by a contrast agent ing distribution: total pulmonary, bobar, segmen-
cf. acinar pattern. -Evaluation: An inferred con- usually used for bronchography may opacity res- tal, subsegmental, platelike, discoid, platter, bin-
clusion sometimes applicable as a radiobogic de- piratory bronchioles, but seldom alveoli. Thus, ear. Expressing severity: minor (mild), moderate,
scriptor. the correct term is bronchiolar filling orbronchio- marked (severe), total (complete). -Synonyms:
acinus, n, -I. Anat. The part of the lung distal to a lar opacification. anectasis, loss of volume, collapse. Anectasis is
terminal bronchiole. It consists of respiratory alveolar pore, n, -s. Anat/Physiol. A microscopic usually used in reference to failure of lung expan.
bronchioles, alveolar ducts, alveolar sacs, alveoli, communication between alveoli. Together with sion in the newborn; atelectasis and loss of vol-
and their blood vessels, lymphatics, and support- the canals of Lambert and direct airway anasto- ume refer to acquired diminution in lung volume
ing tissues. moses, the alveolar pores provide for the collat- and do not connote severity. Collapse, in Ameri-
aerate, v. 1. To fill with air. 2. To expose to air. 3. eral passage of gas or liquid from one pulmonary can usage, refers to total atelectasis; in British
To oxygenate. unit to another; of. collateral ventilation. -Syn- usage, collapse has the more general meaning of
aerated, adj. 1. Inflated, filled wtih air (lungs). 2. onym: pore of Kohn. atelectasis (2, above). -Evaluation: A conclusion
Air-containing (paranasal sinuses). 3. Exposed to anterior junction line, n. Radio!. A vertically ori- conceming pathophysiobogy that is appropriately
air (blood). ented linear or curvilinear opacity about 1 mm based on radiographic evidence alone.
aeration, n. Physiol/radiol. 1. The state of contain- wide and commonly projected on the tracheal air attenuate, v. Radio!phys. To reduce the energy of
ing air. 2. The state or process of admitting or of shadow. It is produced by the shadows of the an x-ray beam.
being filled or inflated with air. 3. The state or right and left pleurae in intimate contact between attenuation, n. Radio! phys. A collective term for
process of being exposed to air. -Qualifiers: the aerated lungs anterior to the great vessels the processes (absorption and scattering) by
over- (preferred) or hyper- ; under- (preferred) or and sometimes the heart; hence, it never extends which the energy of an x-ray beam is diminished
hypo-. -Synonyms: inflation. See also vanilla- above the suprastemal notch. -Synonyms: an- In its passage through matter.
hen, oxygenation. -Evaluation: Acceptable terior mediastinal septum, anterior mediastinal azygoesophageal recess, n. 1. Anat. A space or
term with reference to inspiratory phase of res- line. -Evaluation: A specific feature of radiologic recess in the right side of the mediastinum into
piration. Inflation is preferred in sense 2. anatomy; preferred to cited synonyms. which the medial edge of the right bower lobe
air, n. Radio!. Gas within the body, regardless of its sortie knob, n. RadiO!. That part of the aortic arch (crista pulmonis) extends. It is limited superiorly
composition or site. -Synonym: gas. -Evalua- that is seen end-on in a frontal radiograph. In the by the arch of the azygos vein, posteriorly by the
tion: The word air should be used to refer only to normal, it is characterized by a sharply defined, azygos vein in front of the vertebral column, and
inspired atmospheric gas. With reference to arcuate superolateral border and lies to the left medially by the esophagus and its adjacent struc-
pneumothoraces, subcutaneous emphysema or of the trachea above the main pulmonary artery. tures. (The exact relation between the medial
the content of the stomach, colon, etc., gas is -Synonyms: aortic knuckle. -Evaluation: A edge of the lung and the mediastinal structures
the preferred term. specific feature of radiobogic anatomy. An ac- varies.) 2. Radio!. In a frontal chest radiograph, a
air bronchogram, n, -a. Radio!. The radiographic ceptable term. vertically oriented interface between air in the
shadow of an air-filled bronchus peripheral to the aortopulmonary window, n. 1. Anat. A mediastirtal right lower lung and the adjacent mediastinum
hilum and surrounded by airless lung (whether by space bounded anteriorly by the ascending aorta; that represents the medial limit of the anatomic
virtue of absorption of air, replacement of air or posteriorly by the descending aorta; superiorly azygoesophageal recess. -Evaluation: 2. A spa-
both); a finding generally regarded as evidence by the aortic arch; inferiorly by the left pulmonary cific feature of radiologic anatomy. The use of the
of the patency of the more proximal airway; artery; medially by the left side of the trachea, term recess to identify a linear shadow is map-
hence, any bandlike tapering and/or branching left main bronchus, and esophagus; and laterally propriate; medial boundary or limit or azygoeso-
lucency within opacafled lung corresponding in by the left lung. Within it are situated the ductus phageal recess is preferred.
size and distribution to a bronchus or bronchi ligament. the left recurrent laryngeal nerve, lymph azygos vein, n. Radio!. A slight, ovoid prominence
and presumed to represent an air-filled segment nodes, and fat. 2. Radio!. A zone of relative of the mediastinal shadow commonly seen in
of the bronchial tree. -Evaluation: A specific lucency in the mediastinal shadow, which is best frontal chest radiographs in the angle formed by
feature of radiobogic anatomy whose identity is seen in the left anterior oblique projection and the right main bronchus and the trachea. The
often inferred. A useful and recommended term. which correspondstothe anatomic space defined shadow is produced principally by the azygos
air-fluid level, n, -s. Radio!. See fluid level. above. On a frontal chest radiograph, the lateral veln projected end-on, but azygos lymph nodes
airspace, n. Anat. The gas-containing part of the margin of this space constitutes the aortopul- may contribute to it. -Evaluation: A feature of
lung exclusive of the purely conducting airways, monary window interface. -Synonym: aortopul- radiobogic anatomy of some descriptive value rel-
MR:143, September1984 FLEISCHNER SOCIETY GLOSSARY 511

ative to the status of the systemic venous volume left heart border seen in the frontal (or right hypertension with or without evidence of enlarge-
and pressure and azygos vain flow volume; an anterior oblique) chest radiograph just below the mont of the right heart chambers occurring in
- term. left hilum and representing the junction between association with evidence of chronic lung dis-
the main pulmonary artery and the left ventricular ease. -Qualifiers: acute, chronic. -Evaluation:
myocardium. The tip of the left atilal appendage 2. An inferred radiologic conclusion that depends
may underlie the rncisura. -Evaluation: A feature on radiographic signs that are usually, but not
B of radiobogic anatomy. An acceptable term. invariably, reliable; an acceptable descriptor. Dc-
band shadow, n, -s. Radio!. See linear opacity. sa#{241}nslangle, n. Anal/Radio!. The angle formed spite pathology def. 1, radiologic evidence of
between the right and left main bronchi in a frontal cardiornegaly need not be present.
batwlng distribution, n. RadiO!. A spatial arrange-
ment of radiographic opacities in a frontal radi- chest radiograph. -Synonyms: bifurcation an- cyst, n, -S. 1. Patho! anat. A circumscribed space,
gb, angle of tracheal bifurcation. -Evaluation: A 1 cm ormore in diameter, containing gas or liquid,
ograph that bears a vague resemblance to the
definitive anatomic and radiologic measurement. whose wall is generally thin, weN defined. and
shape of a bat in flight; said of coalescent, poorly
defined opacities that are nearly bilaterally sym- cavIty, n, -lea. 1. PatPiol ens!. A gas-filled space composed of a variety of ceflular elements. 2.
within a zone ofpulmonary consolidation or within Radio!. A circumscribed lucency or opacity within
metric and that are confined to the central one-
to two-thirds of the lungs. (Lesions that produce a mass or nodule, produced by the expulsion of the lung or mediastinurn, 1 cm or more in diam-
a necrotic part of the lesion via the brOnchial tree. eter, that is presumed to represent a cyst in the
such shadows are not necessarily peripheral or
central in location.) -Synonym: butterfly distri- 2. RadiO!. A lucency within a zone of pulmonary pathologic sense. -Qualifiers: 1. foregut (bron-
consolidation, a mass. or a nodule; hence, a chogenic. esophageal duplication); postinfection.
bution. -Evaluation: A radiologic descriptor of
limited usefulness.
lucent area within the lung that may or may not 2. air. -Evaluation: 2. This term is appropriate
contain a fluid level and that is surrounded by a for the description of any thin-walled, gas-con-
blab, n, -a. 1. Patho! anat. A gas-containing space
wall, usually of varied thickness. -Evaluation: 2. taming pulmonary space of uncertain cause
within the visceral pleura of the lung. A form of
An inferred conclusion often used as a descriptor. whose wall is more than 1 mm thick. The term is
pulmonary air cyst. 2. RadiO!. A sharply demar-
The term expresses pathologic anatomy without entirely nonspecific and, if possible, a more spa-
cated, thin-walled lucency contiguous with the
pleura, usually at the lung apex. -Synonyms: causative connotation. It is a useful radiobogic cific term(bleb, bul!a,pneumatocele) is preferred.
type I bubla(Reid), bulla, air cyst. -Evaluation: 2. descriptor; it is not synonymous with abscess,
which may exist without cavitation.
An inferred conclusion, seldom justified by the
circumscribed, adj. Radio!. Possessing a corn-
radiograph alone. Bulla or air cyst is preferred.
belle, n, -as. 1. Patho! anat. a. A sharply demar-
pletely or nearly completely visible border. -
D
cated region of emphysema 1 cm or more in Evaluation: An acceptable descriptor: cf. defined.
diameter. b. An abnormal space within the lung coalescent, adj. Radio!. Joined together; said of dense, adj. Radio!. Possessing density (q.v.). Usu-
multiple opacities joined to form a single opacity, ally used in describing or comparing radiographs
1 cm or more in diameter that may contain only
gas (type II of Reid), or may contain, in addition, but stlH individually identifiable; cf. confluent, or radiographic shadows with respect to their
blood vessels and ruptured alveolar walls (type
composite. -Evaluation: An acceptable descrip- light transmission. -Synonyms: black, heavily
Ill of Reid). Aform ofpulmonary aircyst. 2. Radio!. tor. exposed. -Evaluation: A recommended term ,ri
Any sharply demarcated lucency 1 cm or more in coin lesion, n. Radio!. A sharply defined, circular the context defined. Should not be used in refer-
opacity within the lung. suggestive of the ap- ring to the opacity of an absorber to x-radiation.
diameter within the lung, the wall of which is less
than 1 mm thick. -Qualifiers: small, medium,
pearance of a coin and usually representing a See opaque, opacity.
large. -Synonyms: blab, air cyst; pneumatocele spherical or nodular lesion. -Synonyms: pul- density, n, -Isa. 1. Photom/Radiol. a. The property
monary nodule, pulmonary mass. -Evaluation: of an exposedand processed photographic emul-
is not a proper synonym. -Evaluation: 2. An
inferred conclusion. usually justified by the radi-
A radiologic descriptor, the use of which is to be sion thatdetermines itslight absorptlon/transmis-
condemned. The term coin may be descriptive of siori characteristics; hence: b. The opacity of a
ographic findings. An acceptable term.
butterfly distribution, n. Radio!. See batwing dis- the shadow, but certainly not of the lesion pro- radiographic shadow to visible bight; film black-
thbutlon. (To be distinguished from the use of ducing it. ening. 2. RadiO!. A qualitative expression of the
this term in general medicine to describe the
composite, adj. Radio!. Comprising more than one degree of film blackening usually expressed in
distribution of certain cutaneous lesions.) element; said of a shadow complex made up of terms of the blackening of one film or shadow
multiple contiguous or superimposed elements relative to another. 3. Photom. A quantitative
that may or may not be separately identifiable. expression of the degree of film blackening de-
consolidate, V. 1. To become firm or hard (as by fined as: density = bogio X intensity (incident
C solidifying). 2. To cause to become firm or hard. light)[intensity (transmitted light); optical density.
consolidated, adj. Having become firm or solid; 4. RadiO!. The shadow of an absorber more
calcific, adj. 1. Of or pertaining to deposits of having undergone consolidation. opaque to x-rays than its surround; an opacity or
insoluble calcium salts. 2. Radio! [said of a consolidation, n, -S. 1. Pathophysiol. a. The pro- radiopacity: 5. The degree of opacity of an ab-
shadow). a. Significantly moreopaquethan shad- ness by which air in the lung is replaced by the sorber to x-rays, usually expressed in terms of
ows of soft tissues of comparable thickness and, products of disease rendering the lung solid (as the nature of the absorber (e.g., bone density).
therefore, presumed to represent a calcified tis- in pneumonia). b. The state of pulmonary tissue 6. Phys. The mass of a substance per unit vol-
sue. b. Similar in opacity to shadows of structures so Solidified. 2. Radio!. An essentially homoge- ume. -Synonyms: 1. light absorption. film black-
of comparable thickness that are known to be focus opacity in the lung characterized by little ening. 4. opacity. radiopacity. -Qualifiers: 2.
calcified. or no loss of volume, effacement of blood vessel increased, decreased. 3. increased, decreased,
calcification, n, -S. 1. The state or process of being shadows, and sometimes by the presence of an maximum. 5. air, water, metal, soft tissue, bone,
rendered calcareous by the deposition of calcium air bronchogram (q.v.). Applicable only in an fat; increased, decreased, etc. -Evaluation: In
salts. 2. A calcified structure. Specifically: pul- appropriate clinical setting when the opacity can dots. 1-3, the term refers to a fundamental char-
monary calcification, n. 1. Pathophysiol. a. The with reasonablecertainty beattributed to replace- acteristic of the radiograph. This use is recorn-
process by which one or more deposits of cal- ment of alveolar air by exudate, transudate, or mended. In dots. 4 and 5, the term refers to the
csum salts are formed within lung tissue or within tissue. -Evaluation: 2. An inferred conclusion. A character of an absorber and has an exactly
a pulmonary lesion. b. Such a deposit of calcium useful term when used in strict accord with the opposite connotation with respect to film black-
salts. 2. Radio!. A calcific opacity within the lung definitiOn above. Not to be used with reference ening. Because of this potential confusion, the
that may be organized in the sense of concentric to any homogeneous opacity. term should never be used to mean an opacity
lamination, for example, but which does not dis- contrast medium, n, -Ia. RadiO!. An agent admin- (radiopacity).
play the trabecular organization of true bone. - istered to render the lumen of a hollow structure, diffuse, adj. 1. Widespread. 2. Pathophysioi.
Qualifiers: eggshell, popcorn, etc. (q.v.) -Eval- vessel. or viscus more or less opaque than its Widely distributed through an organ or type of
uation: An explicit statement; may be used as a surroundforthe purposeof radiographic imaging. tissue. 3. Radio!. Widespread and continuous
descriptor. A useful term. To be distinguished -Synonyms: contrast agent, opaque medium, Lsaid of shadows and, by inference, of the states
from pulmonary ossification (q.v.). opaque. -Evaluation: The use of contrast or dye or processes producing them). -Synonyms: dis-
calcified, adj. 1. Having undergone calcification; to refer to a contrast medium is to be condemned, seminated, generalized, systemic, widespread. In
containing calcium safts. 2. Radio!. Containing as is the use of the plural form, contrast media, the context of chest radiology, diffuse connotes
calcific shadows. to refer to a single contrast agent. widespread, anatomically continuous, but not
calcify, v. To make or to become stony or calcar- cor pulmonale, n. 1. Patho! anat/Clin. Right ventric- necessarily complete involvement of the lung or
eous by the deposition or secretion of calcium ular hypertrophy and/or dilatation occurring as a other thoracic structure or tissue; disseminated
salts. result of an abnormality of lung structure or func- connotes widespread but anatomically discontin-
cardiac rncisura, n. Radio!. The concavity in the tion. 2. Radio!. Evidence of pulmonary arterial uous involvement; generalized connotes corn-
512 FLEISCHNER SOCIETY GLOSSARY AJR:143, September 1984

plete or nearly complete involvement, whereas [ATS], 1962). 2. Radio!. Hyperinflatlon (q.v.) of (vs.). 2. Radio!. Of or pertaining to any opacity
systemic connotes involvement of a thoracic all or part of one or both lungs. with or without or pattern of opacities presumed to represent
structure or tissue as part of a process involving associated alteration in pulmonary vascular pat- fibrous tissue-Evaluation: 2. An inferred conclu-
the entire body. -Evaluation: 3. A useful and tem, presumed to represent morphologic emphy- sion usually used as a radiobogic descriptor. Ac-
acceptable term. serna; applicable only in an appropriate clinical ceptable if used in strict accordance with the
-v. To spread, to extend in continuity in all sethng and, in the sense of the ATS definition, criteria cited under fibrosis (vs.).
directions. not applicable to spasmodic asthma or cornpen- fIlm, n, -a. RSdiOL 1. The generic term for a radia-
dirty chest, n. Radio!. An appearance of the lungs satory hyperinflation. -Qualifiers: Morpho!. con- hon-recording medium consisting of a photon-
characterized by acompbex ofabnormal shadows tribobular, panlobular, paraseptal, focal-dust, al- sensitive emulsion coated on a flexible cellulose
of wide distribution and varying form and char- veolar duct, paracicatricial, etc.; Clin. local, gen- acetate or Mylar support. 2. A specific radiation-
acter. -Synonym: dirty lung. -Evaluation: A oral, bobar, segmental, senile, compensatory, sur- recording medium coated with an identified emul-
colloquial descriptor so indefinite as to defy ac- gical; mild, moderate, severe, etc. -Synonyms: sion and having particular, predictable imaging
curate definition. To be rejected in favor of more None; overinflation and hyperaeration are not properties. (This film is more sensitive than
precise descriptors. strictly synonymous with emphysema; emphy- that.”) 3. A unit or sheet of such a radiation
disseminate, v. To spread, as seed. sematous lungs are invariably overinflated, but recording medium. 4. A processed radiograph
dissemInated, adj. 1. Widespread; sown as seed. overmnflated lungs are not invariably emphyse- (col!oq).-Evaluation: Film properly refers to the
2. Pathophysiol. Widely but discontinuously dis- matous. -Evaluation: 2. An inferred conclusion unexposed, unprocessed raw material of radi-
tributed through an organ or type of tissue. 3. acceptable only if used in strict accordance with ographic recordings; radiograph properly refers
Radio!. Widespread but anatomically discontin- the definition above. to the exposed, processed product of radi-
uous [said of shadows and, by inference, of the exudate, n, -S. 1. Pathophysiol. a. Highly protelna- ographic recording. The use of film as a synonym
states or processes producing them]. -Eva!ua- 000us fluid that may or may not contain inflam- for radiograph in referring to an exposed and
tion: 3. A useful and acceptable term. matory cells, is derived from the blood, is elabo- processed diagnostic recording is not recoin-
doubling time, n, -a. Radio!. The time in which a rated as part of the inflammatory response of the mended.
pulmonary nodule or mass doubles in volume lung. pleura, or other tissues, and is deposited in -v, -ad, -ing. Radio!. To record or examine
(increases in diameter by a factor of 1 .25): a extravascular tissue spaces and on tissue sur- radiographically; to expose a radlograph.-Syn-
semiquantitative expression of the growth rate of faces. b. An accumulation ofsuch fluid. 2. Radio!. onyms: to x-ray, to radiograph, to expose a ra-
a lesion. -Evaluation: An acceptable term. The A poorly defined opacity in the lung that neither diograph, to record a radiograph-Evaluation:
concept of growth rate is of very limited value as destroys nor displaces its gross architecture; ap- Film in this sense is usually used in contradistinc-
a criterion for distinguishing benign from malig- plicable only to an opacity that, on the basis of tion to screen, to distinguish a radiographic from
nant nodules. clinical or other evidence, can be attributed with a fluoroscopic procedure. Its use is acceptable
reasonable certainty to a pulmonary infection or (particularly in British usage), but to expose a
other inflammatory process. -Evaluation: 2. An radiograph is preferred.
E inferred conclusion usually used as a descriptor. film contrast factor, n. Radio! phys. The slope of
A useful and acceptable term when used in ac- the film characteristic curve (a plot of density vs.
eggshell calcification, n. Radio!. Thin, sharply do- cordance with the definition above. To be distin- bog relative exposure); hence, the rate of change
fined, curvilinear, calcific opacities occurring in guished from transudate. of film blackening (optical density) as a function
the periphery of a lesion or anatomic structure exudation, n. The process by which exudate (vs.) of exposure-Synonyms: film gamma, film gra-
such as a lymph node. -Synonym: curvilinear is formed. dent; these terms are not strictly synonymous
calcification. -Evaluation: An acceptable radio- exudative, adj. Of or pertaining to an exudate. with film contrast factor, but are closely related
logic descriptor. to it in meaning-Evaluation: A fundamental
embolism, n. 1. Pathol. The complete or partial characteristic of a radiographic emulsion.
destruction ofthe lumen ofa blood vessel, usually F filter, n, -s. 1. Radiolphys. A device (usually sheet
an artery, by the sudden impaction of foreign aluminum or copper) placed in the primary x-ray
material carried in the blood stream; cf. infarc- fibrocalcific, adj. Radio!. Of or pertaining to sharply beam for the purpose of preferentially absorbing
lion. 2. Radio!. A complex of radiographic and/or defined, linear, and/or nodular opacities contain- low-energy photons that otherwise would be ab-
scintigraphic abnormalities presumed to repre- ing cabclficalion(s)(q.v.), usually occurring in the sorbed by the patient. 2. A shaped metallic ab-
sent embolism in the pathologic sense. -Evalu- upper lobes and presumed to represent old gran- sorber placed in the primary x-ray beam to atten-
ation: An inferred conclusion that in some cases ubornatous lesions-Evaluation: A widely used uate certain areas of the beam preferentially. See
can be based on radiographic or scintigraphic and acceptable radiobogic descriptor. trough filter-Qualifiers: 1. primary, secondary,
evidence alone. flbronodular,adj. Radio!. Oforpertainingto sharply mherent, added; 2. trough, wedge.
embolizatlon, n. Pathol. The pathologic process by defined, approximately circular opacities, occur- filtration, n. RadiO! phys. The process of attenuat-
which the lumen of a blood vessel is suddenly ring singly or in dusters, usually in the upper rng the x-ray beam preferentially with respect to
obstructed by blood clot or foreign material car- lobes of the lungs and associated with linear photon energy and/or spatial distribution-Qua!-
ried out in the bloodstream. -Qualifiers: thera- opacities and distortion (retraction) of adjacent ifiers: inherent, added, total-Evaluation: A fun-
peutic, referring to the technique by which the structures. A finding usually presumed to repre- damental concept of radiation physics of clinical
lumen of a blood vessel is deliberately occluded sent old granubomatous disease, but no inference iniportance in radiation protection.
by the introduction offoreign objects or materials. concerning the activity of such a lesion is justified fissure, n, -S. 1. Mat. Any cleft or infolding of the
embolus, n. -i. 1. Patho!. A blood clot or mass of on the basis of a single radiograph-Evaluation: surface of a structure; hence, in the lungs, the
foreign material that has been carried in the An inferred conclusion usually used as a radio- mfolding of visceral pleura that separates one
bloodstream and that partly or completely cc- logic descriptor. Its use is not recommended. lobe or part of a lobe from another. a. Interlobar
ciudes the lumen of a blood vessel; Cf. thrombus. fibrosis, n. 1. PotPie!. a. Cellular fibrous tissue or fissures are produced by two layers of visceral
2. Radio!. A lucent defect or obstruction within dense acellular collagenous tissue. b. The pleura. b. Anomalous fissures may be complete
an opacifled vessel presumed to represent an process of proliferation of fibroblasts leading to or incomplete, usually separate segments rather
embolus in the pathologic sense. -Qualifiers: the formation of fibrous or collagenous tissue. 2. than lobes and, in the case of the azygos fissure,
Expressing clinical course: acute, chronic. Ex- Radio!. Any opacity presumed to represent fi- may be formed by two layers of visceral and
pressing nature of embolic material: air, fat, am- brous or collagenous tissue; applicable to linear, parietal pleura. 2. Radio!. A linear opacity normally
niotic fluid, parasitic, neoplastic. tissue, foreign nodular, or stellate opacities that are sharply 1 mm or less in width that corresponds in position
materials (e.g., iodized oil, mercury, talc). Miscel- defined, that are associated with evidence of loss and extent to the anatomic separation of pulmo-
laneous: septic, therapeutic, paradoxic. -Eva!- of volume in the affected part of the lung and/or nary lobes or segments-Qualifiers: minor, ma-
uation: 2. A radiologic conclusion that may appro- with deformity of adjacent structures, and that jor, horizontal, oblique, accessory, anomalous,
priately be based on arteriographic evidence show no change over a period of months or azygos, inferior accessory-Synonym: la. inter-
alone. years. Also applicable with caution to a diffuse lobar septa.-Eva!uation: 2. A specific feature of
emphysema, n. 1. Pathol anat. a. A morbid condi- pattem of opacity if there is evidence of progres- radiobogic anatomy; an appropriate and useful
tion of the lung characterized by abnormally cx- siveboss oflung volumeor ifthe pattern of opacity term.
panded air spaces distal to the terminal bron- is unchanged over time, with or without compen- Flelschner line, n, -a. Radio!. A straight, curved, or
chicle with or without destruction of the air-space satory overmnflation.-Evaluation: 2. An inferred rregular linear opacity that is Visible in multiple
walls (per Ciba Conference, 1959). b. As above, conclusion often used as a radiobogic descriptor. projections; is usually situated in the lower half
but “with destruction of the walls of involved air An acceptable term if used in strict accordance of the lung; is usually approximately horizontal,
spaces specified (per World Health Organiza- with the criteria cited. but may be oriented in any direction; and may or
tion, 1961 , and American Thoracic Society fIbrotic, adj. 1. Pathol. Of or pertaining to fIbrosis may not appear to extend to the pleural surface.
AJR:143, September1984 FLEISCHNER SOCIETY GLOSSARY 513

Such lines vary markedly in length and width; but should not be used with reference to pulmo- of a feeding vessel. Such an opacity is commonly,
their exact pathologic significance is unknown.- nary overinflation with mediastinal displacement. but not exclusively, hump-shaped and pleural-
Qualifiers: In radiologic description, the location, hilum, n, -a. 1. Anat. A depression or pit in that part based when seen in profile; poorly defined and
length. width, and orientation of such a line of an organ where the vessels and nerves enter. round when viewed en face. (Subsequent events
should be specified-Synonyms: None; plate- 2. Radio!. The composite shadow at the root of may establish that the opacity was the result of
like, discoid, and platter atelectasis should not be each lung produced by bronchi, arteries and either hemorrhage or tissue necrosis.) -Syno-
used as synonyms. In the absence of clear his- veins, lymph nodes, nerves, brOnChial vessels, nym: infarction. -Evaluation: 1. Infarct is pro-
tologic evidence of the significance of F. lines, and associated areolar tissue. -Synonyms: ferred to infarction in this sense. 2. An inferred
this inferred identification of such lines with a hilus, -I, lung root. -Evaluation: 2. A specific conclusion, which, in the proper clinical sethng,
form of atelectasis is unwarranted-Evaluation: element ofradiologic anatomy. Hilum and hila are may be based on the radiograph. The word
An acceptable term. The term linearopacity prop- preferred to hilus and hili. -adj. hilar. should not be used in the absenceof a pulmonary
erlyqualified with respectto location, dimensions, homogeneous, adj. Radio!. Of uniform opacity and opacity.
and orientation is to be preferred, however. texture throughout. -Antonyms: inhornoge- -V. -ad. Pathol. To produce an infarct, def. 1
fluffy, adj. Radio![said of opacities]. Poorly defined, neous, nonhomogeneous, heterogeneous. - above.
lacking clear-cut margins; resembling down or Evaluation: An acceptable radiologic descriptor. infarction, n, -a. 1. Pathol physiol. The process of
fluff. -Synonyms: shaggy, poorly defined. - lnhomogeneous is the preferred antonym as a infarct formation. 2. Patho! anat. An infarct.
Evaluation: An imprecisedescriptoroflimited use- descriptor of radiographic shadows. -n. home- bnflhtrate, n, -a. 1. Pathophysiol. a. Any substance
fulness. y. or type of cell that occurs within or spreads
fluid bevel, n. Radio!. The shadow complex pro- honeycomb pattern. n. 1. Patho!. A multitude of through the interstices (interstitium and/or alveoli)
duced by a horizontal x-ray beam traversing a irregular cystic spaces in pulmonary tissue that of the lung, that is foreign to the lung, or that
space containing both gas and liquid or, less are generally lined with bronchiolar epithelium accumulates in greater than normal quantity
often, two liquids of different attenuation char- and have thickened walls composed of dense within it. b. An accumulation of such a substance
acteristics. Hence, a horizontal interface between fibrous tissue, with or without areas of chronic or type of cell. 2. Radio!. a. A poorly defined
zones of relative lucency above and opacity be- inflammation. 2. Radio!. A number of closely ap- opacity in the lung that neither destroys nor dis-
low. -Synonyms: air-fluid level (fluid level is pro- proximated ring shadows representing air spaces places the gross morphology of the lung and is
ferred), gas-fluid level, gas-liquid level. -Evalu- 5-10 mm in diameter with walls 2-3 mm thick presumed to represent an infiltrate in the patho-
ation: A useful and acceptable descriptor. that resemble a true honeycomb; a finding whose physiologic sense. b. Any poorly defined opacity
occurrence implies “end-stage lung. -Syno- in the lung. -Evaluation: Majority: An inferred
nyms: None; coarse reticular pattern and coarse and often unwarranted conclusion used as a
reticulonodular pattem are sometimes used as descriptor. The term is almost invariably used in
G synonyms, but are inaccurate descriptors in this sense 2b, in which it serves no useful purpose,
gas shadow, n. 1. Pathophysiol/Clin. A shadow of context and are not recommended. -Evaluation: and lacking a specific connotation is so variably
such exceptional lucency relative to adjacent an- A radiobogic desctiptorthat has been loosely used used as to cause great confusion. Its use as a
atomic shadows and to the inferred thickness of in the past and, therefore, with imprecise mean- descriptor is to be condemned. Minority: Were
ing. It is recommended that it be used strictly in the term to be used in strict accordance with
the absorber as to exclude the possibility of its
accordance with the dimensional limits cited definition 2a, it would be a useful descriptor to
representing a solid or liquid absorber. -Evalu-
ation: An inferred conclusion appropriately based above, in which case it will have specific signifi- distinguish processes that do not distort lung
on radiographic evidence alone and useful as a canoe. architecture from expanding processes that do.
Hounsfield unit, n, -a. Radio!phys. The unit (‘/ooo) -v. 1. To penetrate the interstices of. 2. To
descriptor.
ground-glass, adj. Radio! [usually with appear- of an arbitrary scale on which the x-ray attenua- spread or cause to spread by infiltration.
hon of air, water, and compact bone are defined infiltrated, adj. 1. Having entered or spread by
ance]. Any extended, finely granular pattem of
pulmonary opacity within which normal anatomic
to be -1000, 0, and +1000, respectively. Each penetration of the interstices of a tissue. 2. Hay-
such unit represents 0.1% difference in attenua- rng undergone infiltration.
details are partly obscured; from a fancied resem-
tion with respect to that of water. Abbr: H. infiltration, n. 1. The process by which substances
blance to etched or abraded glass. -Evaluation:
A nonspecific radiologic descriptor oflimited use- hyperemia, n. 1. Patho!. An excess of blood in a and/or cells spread through lung tissue via its
fulness. part of the body; engorgement. 2. Physiol. In- mterstices without destroying or displacing its
creased blood flow as part of the inflammatory normal architecture. 2. See infiltrate. def. lb.
response. 3. Radio!. Apparent increase in number inflate, v. To expand, to swell with gas.
or caliber of small vessels secondary to an inflam- inflated, adj. Expanded or filled with gas. -Quali-
H matory process. ynonym: pleonemia. -Eva!- tiers: See below.
uation: An inferred conclusion appropriately used inflation, n. Ptiysio!/Radio!. The state or process of
heart failure, n. 1. Pathophysio!/Cin. Inability of the as a descriptor only in arteriography. - adj. being expanded or filled with gas; used specifi-
heart to satisfy the circulatory needs of the tis- hyperemic. cally with reference to the expansion of the lungs
sues of the body without raising ventricular end- hypertension, n. Clin. Greater than normal systolic with air. -Qualifiers: over- (preferred) or hyper-;
diastolic pressure above 1 2 mm Hg, even though and/or diastolic pressure within the systemic or under- (preferred) or hypo-. ynonyms: aera-
filling pressures may be adequate. 2. Radio!. The pulmonary vascular bed. Generally accepted em- ton, inhalation, inspiration, ventilation. Inflation
presence within the thorax of a complex of signs pirical boundary levels are as follows: systemic connotes expansion with gas or air. Aeration
of pulmonary or systemic venous hypertension arterial h., >1 40 mm Hg systolic, >90 mm Hg connotes the admission of air, exposure to air.
including, but not limited to, cardiomegaly, pul- diastolic; systemic venous h., >12 mm Hg; pul- Inhalation refers specifically to the act of drawing
monary bboodflow redistribution, interstitial and/ monary arterial h., >30 mm Hg systolic, >15 air into the lungs in the process of breathing (as
or alveolar edema, generalized decrease in pub- mm Hg diastolic; pulmonary venous h., >1 2 mm opposed to exhalation); and inspiration with ref-
monary volume, and, in the case of right ventric- Hg. -Evaluation: An inferred conclusion, but ox- erence to breathing, is similar in connotation.
ular failure only, generalized systemic venous cept in the case of systemic arterial hypertension, Ventilation connotes both the intake and expub-
distension. -Qualifiers: Expressing course of it can be approximated with useful accuracy on sin of air from the lungs. -Evaluation: The word
development: acute, chronic. Expressing nature the basis of radiologic evidence. inflation avoids the confusion that surrounds the
of involvement: left, right, biventricular. -Syn- meanings of aeration and ventilation as a result
onyms: cardiac decompensation, cardiac failure, of common misusage. It is the preferred term.
congestive heart failure. -Evaluation: 1. An ac- interface, n. Radio!. The boundary between the
ceptabbe term used in the clinical and pathophys- shadows of two juxtaposed structures or tissues
iobogic sense. 2. An inferred conclusion justified of different texture or opacity. -Synonyms:
by the presence of cited radiographic findings in infarct, n, -S. 1. Patholanat. a. A region of ischemic edge. border, silhouette, junction. -Evaluation:
an appropriate clinical setting. Cardiac decom- necrosis surrounded by hyperemic tissue result- A useful radiologic descriptor.
pensation or congestive heart failure are the pro- meg from occlusion of the region’s feeding vessel, interstitlum, n. l.Anat/Radio!. Acontinuum of loose
ferred terms. usually by an embolus; a complete infarct. b. A connective tissue throughout the lung comprising
hernia, herniation, n. Clin/Patho! anat/Radio!. The region of tissue injury and hemorrhage resulting three subdivisions: (i) the bronchovascular (ax-
protrusion of all or part of an organ or tissue from occlusion of the region’s feeding vessel, lab), surrounding the bronchi, arteries, and veins
through an abnormal opening. -Evaluation: An usually by an embolus; an incomplete infarct. 2. from the lung root to the level of the respiratory
inferred conclusion to be used only within the Radio!. A pulmonary opacity that by virtue of its bronchiole; (2) the parenchymal (acinar). situated
precise terms of the definition. Thus, the word is temporal development and clinical setting is con- between alveolar and capillary basement mom-
appropriate in relation to a diaphragmatic hernia, sidered to result from thromboembolic occlusion branes; and (3) the subpleural, situated beneath
514 FLEISCHNER SOCIETY GLOSSARY AJR:143, September1984

the pleura as well as in the interlobar septa. - Primary: The terminal unit of an acinus; the part discrete pulmonary opacities that are generally
Synonym: interstitial space. -Evaluation: A use- of the lung distal to the terminal respiratory bron- uniform in size and widespread in distribution and
ful anatomic term. The interstitium of the lung is chiole. It comprises alveolar ducts, alveolar sacs, each of which is 2 mm or less in diameter. -
not normally visible radiographically; it becomes alveoli, and their accompanying blood vessels, Synonym: micronodular pattern. -Evaluation: An
visible only when disease(e.g., edema) increases lymphatics, and supporting tissues. 2. Second- acceptable descriptor without causative conno-
its volume and attenuation. -adj. Interstitial. ary: A variable number of acini (usually 3-5) tation.
bounded, in mostcases, bythin connective tissue mucold impaction, n. Pathol/Radiol. A broad linear
septa. -Evaluation: 1. Acinus is the preferred and/or branching opacity (I-, Y-, or V-shaped)
anatomic/physiologic unit of lung structure. 2. caused by the presence of thick, tenacious mu-
K The word lobule when unmodified refers to a cus within a proximal airway (bobar, segmental,
secondary lobule. The concept of the primary or subsegmental bronchus) and usually associ-
Kerley line, n, -5 [usually in the plural]. Radio!. a. lobule as defined has been largely abandoned. ated with airway dilatation. -Evaluation: An in-
A septal line (q.v.). b. A linear opacity, which, bocal, adj. Radio!. Occupying orconfined toa limited ferred conclusion without precise causative con-
depending on its location, extent, and orientation, space within a defined structure; cf. circum- notation. A useful descriptor.
may be further classified as follows: K. A line: An scribed. -Synonyms: localized, focal. -Mto- MiiIer maneuver, n. Physiol. Inspiration against a
essentially straight linear opacity 2-6 cm long nyms: generalized, general, widespread. -Eval- closed glottis, usually, but not necessarily, from
and 1 -3 mm wide, usually situated in an upper uation: An acceptable descriptor. a position of residual volume, for the purpose of
lung zone, that points toward the hilum centrally lucency. n, -lee. Radio!. 1. The capacity to transmit producing transient decrease in intrathoracic
and is directed toward, but does not extend to, light (translucency); hence, by extension, the ca- pressure.
the pleural surface peripherally. K. B line: A pacity to transmit x-radiation. 2. The degree of x-
straight linear opacity 1 .5-2 cm long and 1-2mm ray transmission of an object, usually expressed
wide, usually situated at the lung base and orb- in terms of transmission of one object relative to
ented at right angles to the pleural surface with another. 3. The shadow of an absorber that
which it is usually in contact peripherally. K. C N
attenuates the primary x-ray beam less effec-
lines [always in the plural]: A group of branching, tively than do surrounding absorbers. Hence, in nodular pattern, n. Radio!. A cOllection of innumer-
linear opacities producing the appearance of a a radiograph, any circumscribed area that ap- able, small, roughly circular, discrete pulmonary
fine net, situated at the lung base and represent- pears more nearly black (of greater photometric opacities ranging in diameter from 2 to 10 mm,
ing K. B lines seen en face. -Synonyms: septal density) than its surround. Usually applied to the generally uniform in size, widespread in distribu-
lines, lymphatic lines. Except when it is essential shadows of air or fat when surrounded by more tion, and without marginal spiculation; cf. reticu-
to distinguish A, B, and C lines, the term seota! effective absorbers such as muscle, exudate, etc. bonodular pattern. -Evaluation: An acceptable
line is to be preferred. Lymphatic line is anatom- ynonyms: translucency, transradiancy. - radiologic descriptor without specific pathologic
ically inaccurate and should never be used. - Evaluation: This term, used by analogywith opec- or causative implications. The size of the nodules
Evaluation: A specific feature of pathologic/radio- ity, is acceptable in American usage, although it should be specified, either as a range or as an
logic anatomy. An acceptable but not preferred is etymobogically indefensible. In British usage, average.
term. transradiancy is preferred. nodule, n, -s. 1. Morphol/Gen’l med. Any small,
lucent, adj. Radio!. Capable of transmitting radiant nearly spherical collections of differentiated tis-
energy; specifically, x-radiation. sue. 2. Radio!. Any pulmonary or pleural lesion
lymphadenopathy, n. Clin/Patho! anat/Radiol. Any represented in a radiograph by a sharply defined,
L abnormality of lymph nodes; by common usage, discrete, nearly circular opacity 2-30 mm in di-
usually restricted to enlargement oflymph nodes. ameter. - Qualifiers: Should always be qualified
line, n. Radio!. An extended longitudinal shadow (in
-Synonyms: lymph node enlargement (pro- with respect to size, location, border character-
the lung or mediastinum, an opacity) no greater
ferred), adenopathy. -Evaluation: Lymph nodes istics, number, and opacity. -Synonym: coin
than 2 mm in width; cf. stripe. -Evaluation: A
are not glands. Lymphadenopathy and ado- lesion (q.v.); cf. mass. -Evaluation: A useful
useful term appropriately used in the description
nopathy are, therefore, inappropriate terms and and recommended descriptor to be used in pref-
of radiographic shadows within the mediastinum
any reference to lymph glands is to be con- erence to coin lesion.
(e.g., anteriorjunction line)orlung(e.g., interlobar
damned.
fissures).
linear opacIty, n, -*5. Radio!. A shadow resem-
bling a line; hence, any elongated opacity of 0
approximately uniform width. -Qualifiers: The M
length, width, anatomic location, and orientation oligemia, n. 1. Physio!. Less than normal blood flow
of such a shadow should be specified. -Syn- marking, n, -S [usually in the plural]. Radio!. A to the lungs or a part thereof. 2. Radio!. General
onyms: line, line shadow, linear shadow, band vague descriptor variously used with reference or local decrease in the apparent width of visible
shadow. Band shadow and line shadow have to: (1) the shadows produced by normal pulmo- pulmonary vessels, suggesting less than normal
been used by some to identity elongated shad- nary blood vessels; (2) the shadows produced by blood flow. -Qualifiers: acute, chronic, local,
ows more than 5 mm wide and less than 5 mm a combination of normal pulmonary structures general. -Synonym: reduced blood flow. -
wide, respectively. Linear opacity qualified by a (blood vessels, bronchi, etc.), or (3) abnormal Evaluation: An inferred conclusion appropriately
statement of specific dimensions is to be pro- pulmonary shadows of no specific characteristics based on the radiographic appearance and usu-
ferred. -Evaluation: Ageneric radiologicdescnp- of significance. -Synonyms: opacity, [usually] ally used as a descriptor. An acceptable term. -
tor of great usefulness. The term includes a va- linear opacity. - Qualifiers: The type, dimen- adj.OligemiC.
riety of linear shadows whose anatomic location, sions, and anatomicdistribut,on of such shadows opacIty. n. -bee. Radio!. 1. ImpervIousness to ra-
orientation, and dimensions imply their specific should be specified (e.g., bronchovascular, tra- dent energy; specifically, x-rays; the capacity to
anatomic or pathologic significance (e.g., septal becular). The term should not be used without attenuate an x-ray beam. 2. The degree of x-ray
lines). Unear opacity is to be preferred to more qualification. -Evaluation: When used alone, a attenuation produced by an absorber, usually
specific anatomic or pathologic terms (e.g., dis- vague descriptor of no value; not recommended. expressed in terms of the attenuation of one
cold atelectasis), unless the true nature of the With proper qualifIcation, the term is acceptable, absorber relative to another. 3. The shadow of
shadow is known or can be inferred with reason- but opacity or shadow is usually to be preferred. an absorber that attenuates the x-ray beam more
able certainty. mass, n, -es. 1. Morpho!/Gen’lmed. Any cOllection effectively than do surrounding absorbers.
bobar, adj. Anat/Radiol. Of or pertaining to a lobe. of tissue differentiated from surrounding tissues. Hence, in a radiograph, any circumscribed area
lobe, n, -5. 1. Mat/Radio!. One of the principal 2. Radio!. Any pulmonary or pleural lesion repro- that appears more nearly white (of lesser photo-
divisions of the lungs (usually three on the right, sented in a radiograph by a discrete opacity metric density) than its surround. Usually applied
two on the left) each of which is enveloped by greater than 30 mm in diameter (without regard to the shadows of nonspecific pulmonary colbec-
visceral pleura except at the lung root and in any to contour, border characteristics, or homogene- tions of fluid, tissue, etc., whose attenuation cx-
area of developmental deficiency where a fissure ity). but explicitly shown or presumed to be cx- coeds that of the surrounding aerated lung. -
is incomplete. 2. Radio!. One of the principal tended in all three dimensions. -Qualifiers: Synonym: 3. radiopacity; cf. density. -Evalua-
divisions of the lungs (usually three on the right, Should always be qualified with respect to size, tion: 3. An essential and recommended radiobogic
two on the left) that are separated in whole or in location, contour, definition, homogeneity, opac- descriptor. In the context of radiologic reporting,
part by pleural fissures. ity, and number. -Synonyms: None; of. nodule. radiopaque is acceptable but appears redundant,
lobular, adj. Anat. Of or pertaining to a pulmonary -Evaluation: 2. A useful and recommended do- particularly since radio- does not serve to distin-
lobule. scriptor. guish between the opacity of an absorber to x-
lobule, n, -a. Mat. A unit of lung structure. 1. mlliary pattern, n, -a. Radio!. A collection of tiny rays and opacity of a radiographic shadow to
AJR:143, September 1984 FLEISCHNER SOCIETY GLOSSARY 515

visible light rays. Radiopaque is preferred in But- opacity of uncertain significance, presumed to wide, commonly projected on the tracheal air
ish usage, nevertheless. Density (q.v.) should represent diminished volume in part of the lung shadow and usuaNy slightly concave to the right.
never be used in this context. seen end-on. -Synonyms: platter, linear, or dis- it is produced by the shadows of the right and
opaque, n, -S. Radio!. That which is opaque (Webs- cold atelectasis. -Evaluation: An inferred con- left pleurae in intimate contact between the aer-
ter). Specifically, a contrast medium that is clusion, usually not subject to proof and often atod lungs. It represents the plane of contact
opaque to x-rays. -Synonyms: contrast me- unwarranted. Its use as a descriptor is not rec- between the lungs posterior to the esophagus
diem, contrast agent, contrast material. -Eval- ommended. Linear opacity, planar opacity, etc. and anterior to the spine; hence, in contrast to
uation: A concise and acceptable term. Contrast are preferred. the anterior junction line, it may extend both
medium, agent, and material are preferred, how- pleonemla, n. 1. Physiol. Increased blood flow to above and below the suprastemal notch and may
ever. NB.: The terms contrast and contrast me- the lungs or a part thereof. 2. Radio!. General or be seen above and/or below the azygos and
dia (when referring to a single agent) are colbo- local increase in the apparent width of visible aortic arches. -Synonyms: posterior mediastinal
quial, grammatically incorrect, and should not be pulmonary vessels, suggesting greater than nor- septum, posterior mediastinal line. -Evaluation:
used. -adj. Radio!. Impervious to x-rays. - mel blood flow. -Synonyms: hyperemia, in- A specific feature of radlologic anatomy. to be
Synonym: radlopaque. -Evaluation: Opaque and creased blood flow. -Evaluation: An inferred preferred to the synonyms.
radiopaque are both acceptable terms; opaque is conclusion appropriately based on the radi- posterior tracheal stripe, n. Radio!. A vertically
preferred. See opacity. ographic findings alone. Because pleonemia oriented, linear opacity ranging in width from 2 to
ossific, adj. Of or pertaining to bone. serves to distinguish increased blood flow of 5 mm, extending from the thoracic inlet to the
ossification, n, -5. The state or process of being other causes from increased blood flow resulting bifurcation ofthetrachea and visible only in lateral
ossified. Specifically: pulmonary ossification, n. from inflammation (hyperemia), it is the preferred radiographs of the chest. It is situated between
1. Pathophysiol. a. The process by which tra- term in this sense. -adj. pbeon.mlc. the air shadows of the trachea and the right lung
becubar bone is formed within lung tissue. b. The pneumatocele, n, -s. 1. Pathol anat. a. A thin- and is formed by the posterior tracheal wall and
state in which trabeCUlar bone exists within the walled. gas-filled space within the lung, usually contiguous mediastinal interstitial tissue. -Syn-
lung tissue. c. A mass orfocus of trabecular bone occurring in association with acute pneumonia onym: posterior tracheal band. -Evaluation: A
occurring in lung tissue. 2. Radio!. Cabciflc opac. (most commonly of staphybococcal origin) and specific feature of radiologic anatomy. Posterior
ities within the lung that represent trabecular almost invariably transient. b. A form of pulmo- tracheal stripe is preferred to posterior tracheal
bone; applicable to disseminated calcific opacities nary air cyst. 2. Radio!. An approximately round, band.
that (1) display morphologic characteristics of transient lucency within the lung that is usually primary complex, n. 1. Pathol. The combination of
frabectiar bone (i.e., trabeculation and a defined associated with, arid adjacent to, a zone of re- a focus of pneumonia produced by a primary
cortex) or, more often, (2) occur in association solving pulmonary consolidation that is presumed mfection (e.g., tuberculosis or histoplasmosis)
with a lesion known histologically to produce to represent a pneumatocele in the pathologic with granubomas in the dralnrng hilar or medias-
trabectilar bone within lung (e.g., mitral stenosis). sense. -Evaluation: 2. An inferred conclusion. tinal lymph nodes. 2. Radio!. a. The combination
-Synonyms: ossific nodulation, ossific nod- An acceptable descriptor only if used in accord- of one or more irregular pulmonary parenchymal
ube(s). -Evaluation: 2(i). A primary radiobogic ance with the precise definition. opacities of variable extent and location assumed
diagnosis. 2(2). An inferred conclusion. In either pneumomedlastlnum, n. 1. Patho!. A state char- to represent consolidation with enlargement of
case, a useful radiobogic term; to be distinguished acterized by the presence of gas in mediastinal the draining hilar or mediastinal lymph nodes; an
from pulmonary calcification. tissues outside the esophagus and tracheobron- appearance assumed to represent an active in-
ossified, adj. Having been changed into bone. chial tree. 2. Radio!. The presence ofone or more fection. b. The combination of a small, sharply
ossify, v. To change into or form bone. gas shadows within the mediastinum that do not defined parenchymal opacity(often calcified) with
correspond in position and contour with gas in calcification of the &alning hilar or mediastinal
the esophagus or tracheobronchial tree. -Qua!- lymph nodes; an appearance usually regarded as
p ifiers: spontaneous, traumatic, diagnostic. - evidence of an inactive process. -Synonyms:
Synonym: mediastinal emphysema. -Evalua- Rankecomplex. Ghon complex. Primary complex
parasplnal line, n, -s. Radio!. A vertically oriented tion: A diagnostic conclusion appropriately based is to be preferred to Ranke complex, which is
interface usually seen in a frontal chest radi- on radiologic findings alone. Pneumomediastinum acceptable but rarely used, and Ghon complex,
ograph to the left and rarely to the right of the is preferred to mediastinal emphysema. which represents an inappropriate use of the
thoracic vertebral column. It extends from the pneumonia. n, -s. 1. Pathol. Infection of lung par- eponym and is unacceptable. -Evaluation: A
aortic arch to the diaphragm and represents con- enchyma and/or interstitium. 2. Radio!. COnSOIi- useful inferred conclusion.
tact between aerated lung (of a lower lobe) and dation or any ofvarious otherforms of pulmonary profusion, n. Radio!. I. A qualitative expression of
adjacent mediastinal tissues. On the left, the opacification presumed to represent pneumonia the number of small opacities per unit area or
anatomic interface is situated posterior to the in the pathologic sense. -Synonym: pneumoni- zone of lung. 2. In the ILO/1980 classification of
descending aorta, and its radiographic shadow is tis. -Qualifiers: Expressing temporal course: radiographs of the pneumoconioses. the quaIl-
usually seen between the left lateral margins of acute, chronic. Expressing type of pulmonary flora 0 through 3 subdIvide the profusion of small
the aorta and spine. -Synonyms: left paraspinal involvement: airspace, bobar, interstitial, broncho- rounded and small irregular opacities into four
pleural reflection, left paraspinal interface. - (pneumonia plus bronchitis). Expressing cause: major categories. These may be further subdi-
Evaluation: A specific feature in radiobogic anat- bacterial, viral, fungal. mycoplasma. -Evalua- vided to provide a 12 point scale: -/0,0/0,0/1;
omy. Either of the synonyms cited is preferred to tion: An inferred conclusion; pneumonia is the 1/0,1/1,1/2;2/1, 2/2, 2/3; 3/2, 3/3, 3/k.
paraspinalline, inasmuch as the shadow, in fact, preferredgeneric term. pseudocavlty, n, -lee. Radio!. Any shadow corn-
represents an interface, not a line. pneumoperlcardium, ni. Pathol. A state charac- plex that has the appearance of a gas-containing
parenchyma, n. 1. Anat. The gas-exchanging part terized by the presence of gas within the pericar- spacewithin a zoneofconsolidation, a pulmonary
of the lung consisting of the alveoli and their dial space. 2. Radio!. The presence of gas within mass, or a nodule when, in fact, no such space
capillaries, estimated to constitute about 90% of the pericardium; visible only where the gas exists; hence: 1. A central lucency within a nodule
total lung volume. 2. Radio!. The lung exclusive shadow is seen in profile: laterally in the frontal or mass that is proved by computed tomography
of visible pulmonary vessels and airways. - view, anteriorly or posteriorly in the lateral projec- or pathologic examination to represent lipid. 2.
Evaluation: A useful anatomic concept. An ac- tion. -Evaluation: A diagnostic conclusion ap- An apparently circumscribed lucency created by
ceptable radiologic descriptor. -adj. parenchy- propriately based on radiobogic findings alone. the confluence of shadows of normal anatomic
matous. pneumothorax, n, -aces. 1. Pathol. A state char- structures, most commonly ribs and pulmonary
phantom tumor, n, -s. Radio!. The shadow pro- acterized by the presence of gas within the vessels, that does not, in fact, represent a cavity.
duced by a local COlleCtiOn of fluid in one of the pleural space. 2. Radio!. The presence of a gas -Synonyms: 2. composite shadow, spurious
interbobarfissures, usually possessing an elliptical shadow between the peripheral margin of the cavity. -Evaluation: 1. An inferred conclusion,
configuration in one projection (e.g.. the lateral) lung (visceral pleura) and the chest wall, cia- sometimes used as a descriptor. The term is
and a round configuration in the other (e.g.. the phragm, or mediastinum(parietal pleura). -Qual- without causative connotation. Its use is not rec-
frontal view). It is commonly caused by cardiac ifiers: spontaneous, traumatic, diagnostic, ten- ommended.
decompensation and usually disappears after ap- sion. -Evaluation: A diagnostic conclusion ap- pulmonary blood flow resthbution, n. 1. Physiol.
propriate therapy. -Synonyms: vanishing tumor, propriately based on radiobogic evidence alone. Any departure from the normal distribution of
pseudotumor. -Evaluation: A diagnostic conclu- popcorn calcification, n. Radio!. A cluster of blood flow in the lungs, whether physiologic or
sion that can only be inferred from a single radi- sharply defined, irregularly lobulated, calcific pathologic. 2. RadiO!. Narrowing and reduction in
ograph, but may be explicit by the presence of opacities suggesting the appearance of popcorn. the number of visible pulmonary vascular shad-
serial radiographs. In the latter case, it is an -Evaluation: An acceptable descriptor. ows in one or more lung regions associated with
acceptable radiobogic descriptor. posterior junction line, n. Radio!. A vertically oil- corresponding widening and increase in the num-
plateilke atelectasls, n. Radio!. A linear or planar ented, linear or curvilinear opacity about 2 mm bar of Visible pulmonary vascular shadows in the
516 FLEISCHNER SOCIETY GLOSSARY AJR:143, September 1984

remaining lung regions. -Evaluation: An inferred chiectasis (usually reliable). hibar bifurcation 5.: small superimposed nodules. In common usage,
conclusion, often used as a descriptor and appro- vascular vs. extravascubar hilar enlargement (urn- the reticular and nodular elements are dimen-
priately based on radiographic evidence alone. ited usefulness). hllum overlay 5.: cardiomegaly sionally of similar magnitude. -Qualifiers: fine,
pulmonary edema, n. 1. Pathophysiol. The accu- vs. antenormediastinal mass(limited usefulness). medium, coarse. -Evaluation: An acceptable
mulation of fluid in the interstitial compartment of melting Ice s.: pulmonary infarction (limited use- radiobogic descriptor without specific pathologic
the lung with or without associated alveolar filling. fulness). moon 5.: see crescent a. 1-2-3 s.: wnplications.
Specifically, the accumulation of water, protein, pulmonary sarcoidosis (unreliable; misleading). righttracheal stripe. n. Radio!. A vertically oriented
and solutes (transudate) usually due to (1) ri- rabbit ear s.: bronchioboalveolar cell carcinoma linear opacity 2-3 mm wide that extends from
creased pressure in the microvascular bed; (2) (unreliable). scimitar s.: partial anomalous pub- the thoracic inlet to the right tracheobronchial
increased microvascular permeability; or (3) im- monary venous return (reliable). sIlhouette s.: angle in the frontal radiograph. It is situated be-
paired lymphatic drainage. Also, the accumula- presence and localization of intrathoracic lesion tween the air shadow of the trachea and the right
tion of water, protein, solutes, and inflammatory (reliable). tall 5.: see rabbit ear s. (unreliable). lung and is formed by the right tracheal wall and
cells(exudate)in response to inflammation of any water lily 5.: see camabote s. (reliable). Wester- contiguous mediastinal interstitial tissue and ad-
type (e.g., infection, hypersensitivity, trauma. or mark s.: pulmonary embolus(usually reliable). - jacent pleura. -Synonyms: right paratracheal
circulating toxins). 2. Radio!. An inferred conclu- Evaluation: Signs are seldom as specific as their stripe or band. -Evaluation: A specific feature of
sion applicable to a pattern of opacity (often authors believe, and their meanings are often radiographic anatomy.
bilaterally symmetric and perihibar in distribution) confused through frequent misuse. Many are un-
believed to represent alveolar filling and/or inter- reliable(e.g., rabbit ear)or totally erroneous (e.g.,
stitial thickening when associated findings and/ 1-2-3 sign of sarcoidosis). With the exception of
or history suggest one of the processes enumer- a few generally recognized and usually reliable S
ated above. ualifiers: I. Interstitial edema: signs (scimitar, silhouette, Westermark), the use
pulmonary edema confined to the interstitial corn- of signs as descriptors is not recommended. segment, n, -s. Anat/Radiol. One of the Principal
partments of the lung; initially the bronchovas- Specific description of the individual finding is anatomic subdivisions of the lobes of the lung
cuber interstitial space and its continuum, subse- preferred. (usually 10 on the right and 9 on the left); a lobar
quently the alveolar wall interstitial space. Alveo- residual, n. Radio!. Any nonspecific opacity of un- subdivision served by a major branch of the bobar
lar edema: pulmonary edema involving the alveoli certain cause believed to represent an inactive bronchus. -Qualifier: bronchopulmonary.
as well as the interstitial space. Synonyms: 2. process. -Synonym: scar. -Evaluation: An in- segmental, adj. Mat/Radio!. Of or pertaining to a
Wet lung, boggy lung. moist lung. drowned lung. termed conclusion. The term is vague, grammati- segment.
-Evaluation: An inferred conclusion often used cally incorrect (residuum is the noun), and should septal line, n, -s [usually in the plural]. Radio!. A
as a descriptor. A useful and acceptable term be rejected in favor of more precise diagnostic generic term for fine, linear opacities of varied
when used in an appropriate clinical setting. The statements. distribution produced by the interstitium between
synonymous terms are colloquialisms to be -adj. Of or pertaining to a residue or remainder. pulmonary lobules when the interstitium is thick-
avoided. resolution, n. 1. Radio.! phys. a. A quantitative ened by fluid, dust deposition, cellular material,
pulmonary perfusion, n. 1. Physiol. The passage expression of the number of punctate or linear etc. -Synonyms: Kerley lines (q.v.), lymphatic
of blood through the vessels of the lung or a part absorbers that can be recorded as perceptibly lines; of. interlobar septum. Septa! lines is the
thereof. 2. Radio!. Any radiologic evidence of discrete shadows per unit distance across a ra- preferred term; Kerley lines is acceptable, partic-
pulmonary blood flow in the physiologic sense. It diographic receptor; usually expressed in line ularly when one seeks to identity a particular type
may be explicit (in the case of pulmonary angiog- pairs per millimeter. (Metallic wires are usually of septal line (e.g., Kerley B lines). Lymphatic
raphy) or inferred (in the case of conventional used as test objects for such measurements.) b. lines is anatomically an inaccurate term and
radiography). -Synonym: pulmonary blood flow. The characteristic of a radiographic receptor sys- should not be used in this context. -Evaluation:
-Evaluation: a physiologic conclusion that can tern that expresses its ability to record closely A specific feature of pathologic radiobogic anat-
properly be based on, or inferred from, radiobogic approximated absorbers as discrete shadows. c. omy. often inferred. A recommended term.
evidence alone. A useful and recommended term. The spatial frequency response of a radiographic shadow, n, -s. Radio!. 1. In clinical radiography,
system, usually expressed in terms of its modu- any perceptible discontinuity in film blackening
laden transfer function (MTF). d. A measure of ascribable to the attenuation of the x-ray beam
R the “fidelity of the imaging system. -Synonym: by a specific anatomic absorber or lesion on or
resolving power. -Evaluation: Resolving power within the body of the patient. An opacity or
radiographic contrast, n. Radio! phys. 1. The dif- is technically the correct term, but by virtue of bucency. 2. A similar discontinuity in any other
ference in optical density between two specified bong usage, resolution is acceptable in this sense. diagnostic visual representation of the remnant
shadows (usually adjacent) in a processed radi- 2. Pathol/Radiol. The process by which a lesion, energy in an x-ray beam after its passage through
ograph. 2. The resultant of film contrast and specifically aconsolidation, clears. It may becom- the body of the patient (e.g.. a fluoroscopic im-
subject contrast. -Evaluation: A fundamental plete or partial. -Evaluation: An explicit diagnos- age, a CAT display, etc). -Qualifiers: The term
concept of radiologic physics, useful in a clinical tic statement appropriately based on serial radi- should always be qualified as precisely as possi-
context as one determinant of radiographic qual- ographs. ble with respect to size, contour, location, opacity
Ity. respiratory failure, n. Physic!. A pathologic state (lucency), etc. -Evaluation: A useful and rec-
radiographic quality, n. 1. Radio!. An expression resulting from impaired respiratory function and ommended descriptorto be used only when more
of the acceptability of a diagnostic radiograph to characterized by an arterial Po below 60 mm Hg specific identifiCatiOn is not possible.
the interpreter; a subjective evaluation. 2. Radio! or an arterial Pco above 49 mm Hg, in a subject shaggy heart, n. Radio!. A heart whose border is
phys. An expression of the correspondence be- at rest at sea level. -Qualifiers: acute, chronic. partially effaced by multiple small, irregularly dis-
tween the physical characteristics of a radiograph -Synonym: pulmonary insufficiency. -Evalua- tributed opacities produced by any of several
and some predefined standards, usually with re- tion: A useful term in its clinical and physiologic pathologic processes affecting the paracardiac
spect to contrast, resolution, and density; an usage that should never be used as a radiobogic parts of the lungs and/or pleura. -Evaluation:
objective evaluation. -Synonym: film quality. - descriptor. It is preferred to pulmonary insuffi- This term is an imprecise radiologic descriptor, to
Evaluation: A useful concept, but only in a loose, ciency. be used with caution.
qualitative sense. The term defies precise quan- retbcular pattern, n, -s [usually in the singular]. sIlhouette sign, n. Radio!. 1. The effacement of an
titative definition and is not in either sense an Radio!. A collection of innumerable small linear anatomic soft-tissue border by consolidation of
expression of the diagnostic usefulness of a ra- opacities that together produce an appearance the adjacent lung or accumulation of fluid in the
diograph. resembling a net. -Qualifiers: fine, medium, contiguous pleural space. 2. A sign of the con-
radlologic sign, n, -s. Radio!. A shadow or shadow coarse. -Synonym: Small irregular opacities (in formity and, hence, of the probable adjacency of
complex said to be reliable evidence of a specific the lLO/1980 classification of pneumoconioses). a pathologic opacity to a known structure; useful
pathologic state, process, or relation. A list (in- -Evaluation: A recommended descriptor. It has in detecting and localizing a consolidation along
complete) of specific signs, their reputed signifi- no pathologic connotation and should not be the axisofthe x-ray beam. -Evaluation: A widely
cance, and their reliability is as follows: broken used as a synonym for interstitial disease of the accepted and useful radiologic descriptor. It
bough 5.: peripheral bronchial occlusion (highly lung. The synonymous term smallirregular opec- should be noted that the finding, in fact, involves
unreliable). camabote 5.: echinococcus cy5t (reli- ities should be restricted to the radiographic char- the loss of a silhouette.
abbe). continuous diaphragm s.: pneumomedias- acterization of pneumoconiosis. small irregular opacity, n, -lee [usually used in the
tinum (usually reliable). crescent 5.: intracavitary reticubonodular pattern. n, -s [usually in singular]. plural]. Radio!. 1. Small pulmonary opacities that
mass; hydatid cyst, fungus ball, etc. (reliable cvi- Radio!. A collection of innumerable small, linear defy classification in terms of simple geometric
dence of an intracavitary mass but not specific and micronodularopacities that together produce descriptors, that are often poorly defined, and
with respect to cause). gloved finger s.: bron- a composite appearance resembling a net with that in large numbers produce an appearance
AJA:143, September1984 FLEISCHNER SOCIETY GLOSSARY 517

resembling a net. 2. In the ILO/1980 classification tramline shadow, n, -s [usually in plural]. Radio!. an acceptable radiologic descriptor.
of radiographs of the pneumoconioses, the qual- Parallel or slightly convergent linear opacities that vasoconstrictlon, n. 1. Physio!. The narrowing of a
iflers s, t, and u subdivide such opacities into suggest the planar projections of tubular struc- muscular blood vessel by contraction of its mus-
three categories on the basis of their greatest tures and that correspond in location and orion- ole layer. 2. Radio!. Local or general reduction in
thickness: s, up to 1.5 mm; t, I .5-3 mm; and u, tation to elements of the brOnchial tree. They are the caliber of visible pulmonary vessels that is
3-10 mm. -Synonym: reticular pattern. -Eval- generally assumed to represent thickened bron- presumed to result from decreased blood flow
uation: A term to be used specifically to describe chial walls. (Such shadows are of possible path- produced by contraction of muscular pulmonary
radiographic manifestations of the pneumoco- obogic significance only when they occur outside arteries. -Qualifiers: hypoxic, reflex. -Anto-
nioses. Reticular pattern is preferred when refer- the limits of the hilar shadows where bronchial nym: vasodilation. -Evaluation: In the interpro-
ring to nonpneumoconiotic disease. walls may be seen in the normaL) -Synonyms: tation of conventional radiographs, an inferred
small rounded opacity, n, -lee [usually used in the thickened bronchial wails, tubular shadows conclusion appropriately based on radiographic
plural]. Radio!. 1. Innumerable small pulmonary (q.v.). -Evaluation: A radiologic descriptor, the signs that are usually reliable. In the interpretation
nodules ranging in diameter from bare visibllity use of which is not recommended. Linear opaci- of angiograms, an explicit radiographic conclu-
up to 10 mm. 2. In the lLO/1980 classification of ties properly qualified with respect to size, loca- sion. The term is not synonymous with oligernia.
radiographs of the pneumoconioses. the quail- tion, and Orientation 5 tO be preferred. Oligerniais a sign ofvasoconstriction, a functional
flersp, q, and r subdivide the predominant opac- trough filter, n. 1. Radio! phys. Any x-ray filter and potentially reversible process; it also applies
Ities into three diameter ranges: p. up to 1 .5 mm; traversed by a longitudinal zone of diminished to wreversible vessel narrowing. as in emphy-
q, 1 .5-3 mm; and r, 3-1 0 mm. -Synonym: thickness. 2. Radio!. An x-ray filter designed to some.
nodular pattern. -Evaluation: A term to be used attenuate preferentially those parts ofthe primary vasodllatatbon, n. 1. Physiol. The widening of the
specifically to describe radiographic manifesto- beam that will traverse the lungs of the patient in lumen of a muscular blood vessel by relaxation
tions of the pneumoconioses. Nodular pattern is the exposure of a frontal chest radiograph. of its muscle layer. 2. Radio!. The local or general
preferred when referring to nonpneumoconiotic tubular shadow, n, -s. Radio!. 1. Paired, parallel or increase in the width ofvisibbe pulmonary vessels
disease. slightly convergent linear opacities presumed to resulting from increased pulmonary blood flow
stripe, n, -S. Radio!. An extended longitudinal, corn- represent the walls of a tubular structure or do- -Synonym: vasodilation. -Evaluation: In the
posite opacity 2-5 mm wide; cf. line, band vice (e.g., a bronchus, vessel. or chest tube, seen interpretation of conventional radiographs, an in-
shadow, linear opacity. -Evaluation: An ac- in profile). 2. An approximately circular opacity ferred conclusion to be expressed with caution,
ceptable descriptor when used with reference to presumed to represent the wall of a tubular struc- since apparent widening of pulmonary vascular
radiographic shadows within the mediastinum. ture or device seen en face. -Qualifiers: Bron- shadows may. in fact, be due to perivascular
subject contrast, n. Radio! phys. 1. Quantitative: chial walls are usually not identifiable radiograph- edema, neoplasm, etc. In the interpretation of
The ratio of the intensities of the remnant radia- ically unless thickened; arterial walls, unless cal- angiograms, an explicit conclusion.
ben, including scatter, emerging from two spool- cified. These qualifiers are, therefore, almost es- ventilate, v. Physiol. I. To circulate air into and out
fled absorbers in the path of an x-ray beam. 2. sential to their description. -Synonyms: tramline of any closed space. 2. Specifically, to introduce
Qualitative: The difference in attenuation of dif- shadow, thickened bronchial wall. -Evaluation: fresh air and expel stale air from the lungs by
ferent absorbers resulting from differences in A common radiobogic descriptor, but dearly a physiologic or mechanical means. 3. To provide
their physical densities, effective atomic num- misnomer to be avoided. Shadow of a tubular with a patubous opernng for the circulation of air.
bars, and path lengths. -Evaluation: A funda- structure is acceptable if the anatornic signifi- -Qualifiers: hyper-; hypo-.
mental concept of radiologic physics. cance of a shadow is truly obscure; otherwise, ventilated, adj. 1. Having had fresh air admitted
subse9ment, n, -s. Anat/Radiol. A unit of pulmo- thickened bronchial wail or Calcified arterial wail and stale air expelled by physiologic or mechan-
nary tissue that is supplied by a bronchus of is to be preferred. ical means. -Qualifiers: hyper-; hype-.
lesser order than a segmental bronchus, but turner. n, -s. 1. A swelling or morbid enlargement. ventilation, n. Physio!/Radio!. 1. The dynamic acts
which islarger than a lobule. 2. Pathol anat/Radio!. Literally, a mass. -.Syn- of inhaling fresh air and exhaling stale air. 2. The
subsegmental, adj. 1. Anat/Radiol. Of or pertaining onym: mass. -Evaluation: A useful descriptor. movement of air into and out of the lungs. 3.
to a subsegment. 2. Radio!. Of or pertaining to Mass is preferred. The term does not differentiate Inspiration and expiration. -Qualifiers: hyper-
any pulmonary shadow, smaller than a segment between a neoplastic and a nonneoplastic mass; (preferred) or over- ; hype. (preferred) or under-.
and larger than a lobule, presumed to represent its use as a synonym for neoplasm is to be -Synonyms: breathing. respiration; cf. aeration,
a subsegment in the anatomic sense. -Evalua- condemned. inflation. 4. Physic!. Oxygenation of the blood,
tion: An acceptable radiologic descriptor. specifically in the act ofrespiration. -Evaluation:
A useful term if properly used. The term always
wnplies a blphasic dynamic process of admission
and expulsion; hence, cannot be assessed from
T V a single static image. Not to be used synony-
tension, adj. 1. The state of being stretched or Valsalva maneuver, n. Physiol. Forced expiration
rnously with aeration and inflation.
strained. 2. Physiol/Med. A state characterized against a closed glottis, usually but not neces-
by cardiorespiratory functional impairment sarily from a position of total lung capacity. A
caused by pneumo- or hydrothorax. 3. Radio!. maneuver used to produce transient increase in
The accumulation
in an amount sufficient
of gas or fluid in a pleural space
to cause compression of
intrathoracic
vascular
pressure.
prominence, n. Radio!. Real or apparent
x
the ipsilateral lung, markedly enlarge the herni- increase in the caliber and/or number of pubmo- x-ray quality, n. Radio! phys. The effective energy
thorax, depress the hemidiaphragm, and displace nary vessels beyond the expected range, which, or spectral distribution of an x-ray beam. 1. Usu-
the medistinum to the opposite side; applicable in view of the wide range of normal, does not ally expressed in terms of half-value layer (HVL)
only in the presence of clinical cardiorespiratory necessarily imply a pathologic departure from in mm of aluminum. 2. Often implied, but not
embarrassment. -Evaluation: An inferred con- normal. ynonyms: increased vascularity, vas- explicitly defined, by a statement of the peak
clusion to be used only as specified in the defi- cular engorgement, pulmonary hyperemia, put- voltage applied to the x-ray tube. -Synonym: x-
nition. In fact, tension in relation to pneumothorax monary plethora, pulmonary pleonemia. These ray beam quality. -Evaluation: A fundamental
exists only during the expiratory phase of the terms all represent inferred conclusions and are physical measurement useful clinically in spool-
respiratory cycle, since pleural pressure on inspi- not, therefore, strictly synonymous with vascular lying and comparing radiographic systems and
ration is usually subatmospheric. The word prominence. Each is applicable only in specified techniques. The practice of expressing x-ray
should not be used in the term tension cyst, which circumstances and each must be used with care. quality in terms of beam hardness is to be
does not satisfy the criteria cited above. -Evaluation: The term vascular prominence is avoided.