As I sit here in lecture trying to make sense of high resolution CT X-ray scans amidst a somnolent backdrop with lights dimmed, I feel a sudden urge to sleep. At the same time, I can't help but think that all these images look virtually the same (ok, not really, but close enough that it's incredibly difficult to distinguish the difference between honeycomb lungs and ground glass lungs that we see in different lung diseases).And then there is the challenge associated with identifying infiltrate in lung X-rays based on opacity (looking for white or gray areas), which the radiologist admits "takes years of experience."
In a normal lung X-ray, the lungs appear as two big black sacs with heart snugly sitting in the middle. The lungs should be filled with air (air turns out to be black, since it does not absorb the X-rays). If there are abnormalities, such as fluid build-up in pneumonia, gray or white areas will appear where fluid is located, since fluid can absorb more X-rays. The trick is playing close attention to details and identifying the abnormal by making sense of the shades of gray.
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