8. Consolidation |
|
“.” if N/A |
HOMOGENEOUS |
0 |
8. |
PATCHY |
1 |
|
9. Nodule details (Specify only if answer to questions 2–7 includes “4”) |
|
|
a. Number |
|
9a. |
SOLITARY |
0 |
|
MULTIPLE |
1 |
|
b. Size |
|
9b. |
MILIARY (<2 mm) |
0 |
|
SMALL (2–3 mm) |
1 |
|
MEDIUM (>3–5 mm) |
2 |
|
LARGE (>5 mm) |
3 |
|
c. Calcification |
|
9c. |
NON-CALCIFIED |
0 |
|
CALCIFIED |
1 |
|
BOTH |
2 |
|
10. Cavity details (Specify only if answer to questions 2–7 includes “5”) |
|
|
a. Number |
|
10a. |
SOLITARY |
0 |
|
MULTIPLE |
1 |
|
b. Size |
|
10b. |
SMALL (<2 cm) |
1 |
|
MEDIUM (2–5 cm) |
2 |
|
LARGE (>5 cm) |
3 |
|
c. Wall thickness |
|
10c. |
THIN (≤1 mm) |
0 |
|
MODERATE (1–3 mm) |
1 |
|
MARKED (>3 mm) |
2 |
|
d. Fluid levels |
|
10d. |
ABSENT |
0 |
|
PRESENT |
1 |
|
e. Intracavitary bodies |
|
10e. |
ABSENT |
0 |
|
PRESENT |
1 |
|
11. Predominant location of the findings on the radiograph as a whole? |
|
|
a. Distribution |
|
11a. |
FOCAL DISEASE |
0 |
|
DIFFUSE DISEASE |
1 |
|
b. If focal disease |
|
11b. |
UPPER LOBE |
0 |
|
MIDDLE LOBE |
1 |
|
LOWER |
2 |
|
c. Centrality of diffuse |
|
11c. |
CENTRAL |
0 |
|
PERIPHERAL |
1 |
|
UNIFORM |
2 |
|
d. Symmetry |
|
11d. |
BOTH |
0 |
|
RIGHT |
1 |
|
LEFT |
2 |
|
12. Cardiac silhouette |
|
12. |
NORMAL |
0 |
|
ENLARGED |
1 |
|
UNINTERPRETABLE |
2 |
|
13. Mediastinal position |
|
13. |
MIDLINE |
0 |
|
SHIFTED RIGHT |
1 |
|
SHIFTED LEFT |
2 |
|
14. Mediastinal size |
|
14. |
NORMAL |
0 |
|
WIDENED |
1 |
|
MASS |
2 |
|
15. Hilar elevation |
|
15. |
NONE |
0 |
|
RIGHT |
1 |
|
LEFT |
2 |
|
BOTH |
3 |
|
16. Is hilar/mediastinal lymphadenopathy present? |
|
16. |
NO |
0 (Go to 17) |
|
YES |
1 (Go to 16a) |
|
a. Location? |
|
16a. |
BOTH |
0 |
|
RIGHT |
1 |
|
LEFT |
2 |
|
17. Pleural abnormalities |
|
|
a. Apical cap? |
|
17a. |
NO |
0 |
|
YES |
1 |
|
b. Pleural thickening |
|
17b. |
ABSENT |
0 |
|
RIGHT |
1 |
|
LEFT |
2 |
|
BOTH |
3 |
|
c. Effusion |
|
17c. |
ABSENT |
0 (Go to 18) |
|
RIGHT |
1 (Go to 17d) |
|
LEFT |
2 (Go to 17d) |
|
BOTH |
3 (Go to 17d) |
|
d. Effusion size |
|
17d. |
SMALL (Less than one lung zone) |
0 |
|
MODERATE (between 1 and 2 lung zones) |
1 |
|
MASSIVE (>2 lung zones) |
2 |
|
e. Effusion type |
|
17e. |
FREE |
0 |
|
LOCULATED |
1 |
|
f. Pneumothorax |
|
17f. |
ABSENT |
0 (Go to 18) |
|
RIGHT |
1 (Go to 17g) |
|
LEFT |
2 (Go to 17g) |
|
BOTH |
3 (Go to 17g) |
|
g. Pneumothorax size |
|
17g. |
SMALL (less than 1/3 of the hemithorax) |
0 |
|
MODERATE (2/3 of hemithorax) |
1 |
|
MASSIVE (>2/3 of hemithorax) |
2 |
|
18. Radiological extent of disease: |
|
18. |
NORMAL |
0 |
|
MINIMAL |
1 |
|
MODERATELY ADVANCED |
2 |
|
FAR ADVANCED |
3 |
|
19. Radiological impression of parenchyma |
|
19. |
Normal parenchyma |
0 |
|
Lobar pneumonia |
1 |
|
Bronchopneumonia |
2 |
|
Interstitial pneumonia |
3 |
|
Collapse/atelectasis |
4 |
|
Fibrosis |
5 |
|
Fibrocavitary pneumonia |
6 |
|
Cavitary pneumonia |
7 |
|
Miliary TB pattern |
8 |
|
Solitary pulmonary nodule |
9 |
|
Mass |
10 |
|
Emphysema |
11 |
|
Pleural effusion/disease |
12 |
|
Pneumothorax |
13 |
|
Pulmonary cardiovascular disease |
14 |
|
Bronchiectasis |
15 |
|
Others, specify |
16 |
|
20. Likelihood of TB |
|
20. |
Probable (findings consistent with TB) |
0 |
|
Possible (atypical findings) |
1 |
|
Unlikely (findings not consistent with TB) |
2 |
|
Unable to assess |
3 |
|
21. Radiological diagnosis |
|
21. |
Normal |
0 |
|
Pulmonary tuberculosis |
1 |
|
Extrapulmonary tuberculosis |
2 |
|
Bacterial pneumonia |
3 |
|
Pneumocystis pneumonia |
4 |
|
Pulmonary Kaposi's sarcoma |
5 |
|
Lymphoma |
6 |
|
Lymphocytic interstitial pneumonia |
7 |
|
Other |
8 (Specify in 21a) |
|
a. Specify other |
|
|
22. Radiologist |
|
22. |
OR/HNK |
0 |
|
HNK/MK |
1 |
|
OR/MK |
2 |
|