To interpret a chest X-ray, it is necessary to know normal anatomy and possible anatomical deviations as well as diseases or pathologies of the heart, lungs, mediastinum (middle section of the chest cavity), lungs and pleura (thin tissue that lines the inside of the chest cavity). It is best to take a systematic approach, working from the inside out of the film, according to the Radiology Assistant.
Where the lung borders the heart, diaphragm and other structures, the silhouette is important because it can be displaced or obscured by disease. Opacity can be used to diagnose a mass or pneumonia, depending on how sharply it is defined, according to the University of Virginia. There are three possible locations for a mass in the thoracic cavity, including intraparenchymal, pleural and extra-pleural.
The radiologist needs to know the structures within the mediastinum and the lobes of the lungs as well as their margins, says the University of Virginia. If a mass or pneumonia appears, the radiologist must know which part of the lung and which organ within the mediastinum are involved.
The University of Virginia also notes that it is imperative to know the anatomy of the bronchi. Familiarity with the vasculature or blood vessels of the lungs is useful for understanding the anatomy of the chest.