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Introduction to Radiology

Introduction to Radiology

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Published by: sarguss14 on Feb 20, 2009
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3B2010Subject: Radiology
Topic: Introduction to Radiology
Date: June 13, 2008
Lecturer: Dra. Irene Bandong
Trans Group: Riz, Alphe, AM
Introduction to Radiology
I. DIANOSTIC X-RAY
X-rays are useful:
-In diagnosis of disease involving ones,
lungs, gut kidneys & gall bladder
-In CT-scan, Mammography

-In detecting congenital, inflammatory, traumatic, degenerative & neoplastic disease

PLAIN STUDY:

-Certain diseases need only plain X-rays for diagnosis e.g. in bone, lungs, intestines, kidneys & gall bladder stones

\ue000RADIO-OPAQUE/ DENSE (white)

Differential Diagnosis:
Infiltrate/ inflammatory process
Mass/tumor
Fluid
Lithiasis
Foreign ody e.g. coin

\ue000RADIOLUCENT- bl a c k; air

Pneumoperitoneum
Pneumothorax
Pneumomediastinum
Pneumopericardium
Tumor

FLUOROSCOPY CONTRAST EXAMINATION
\ue001Contrast(barium/iodi ne)
-is given orally/IV/ other routes depending
upon region (part) under investigation
\ue001Upper gastrointestinal series(UGIS)

-To evaluate the esophagus, stomach, duodenal bulb and the prox small bowel segments

\ue001Smal intestinal Series(SIS)
-To evaluate the small bowel segments
\ue001Barium Enema(BE)
-To evaluate the colonic segments
\ue001IVP
-Intravenous contrast for functional &
structural assessment of kidneys
\ue001Hysterosalpingogram studies
-To evaluate uterus & tubes of infertile women
\ue001Angiogram study
-To evaluate the lumen of blood vessels
II. ULTRASOUND
-based on the same principles involved in the
sonar used
-painless
Advantages

\ue002No radiation risk
\ue002Non-invasive
\ue002Inexpensive
\ue002Painless
\ue002Don\u2019t require contrast material
\ue002Sedation is not required

\ue001Anechoic
- No sound through transmission
\ue001Isoechoic
- With margin
- Sagittal and transverse evaluation
\ue001Echogenic/ Hyperechoic
-Solid:white
-Mass:black
SOLID NODULE VS. CYST
\ue000SOLID NODULE
-Well defined
-Ovoid shape
-With uniform internal echoes
\ue000CYST

-Well defined
-Round or oval shape
-Anechoic
-Enhance through transmission

Limitations of the UTZ
-Large body habitus, obese patients limit

image quality as the overlying adipose tissue
-Have trouble penetrating bone
-Performs very poorly when there is gas
-It is operator-dependent

-There is no scout image as there is with CT
scan and MRI.
-Once an image is acquired there is no exact
way to tell which part of the body was imaged
III. MAMMOGRAPHY
-special type of imaging
-Plays a central role in early detection of
breast cancer because it can show cancer

signs in te breast even years before a patient or physician would be able to feel a breast cancer lump

-Screening mammography can assist in the detection of disease even if a woman has no complaints of symptoms

BENEFITS
-Use for early detection of breast cancers
-Ability to detect small tumors/ non palpable
nodules
and
microcalcifications,
first
indication of breast cancer
LIMITATIONS

-The appearance of an image may be compromised if there is powder on the breasts or undergone breast surgery

-Need to compare the image to views from
previous examinations
-Declines significantly with increasing breast
density with dense breasts
-Breast implants can also impede accurate
mammogram readings
IV. CT SCAN

-Technique that uses X-rays to take many multiple \u201ccross-section\u201d images of the body, which are then assembled into a three- dimensional image by a computer. It is painless

non-invasive
radiological
investigation
Uses of CT Scan
-Detection, measurement, localization, extent
of lesions and its relationship to other organs
-Characterization of borders, composition and
content
-Used for staging tumor
-Locating internal bleeding and organ damage
in trauma patients
-Detecting and staging tumors of various body
parts
-Detecting sources of infection and deep
abscess
-Detecting urinary stone disease without x-ray
dye
-Performing non-invasive blood vessel imaging
(CT angiography)
DISADVANTAGES
-Requires placement of an intravenous line for

IV contrast
-Exposes patient to radiation
-Contrast toxicity or allergy

-Most young children require sedation to
undergo CAT scan
Attenuation Value
\ue001Hyperdense (white)
+1000
calcium
>250
compact bone
30-230
spongy bone
70-90
coagulated blood
50-60
whole blood
\ue001Iso dense
20.70
soft tissue
> 18
exudate
<18
transudate
\ue001Hypo Dense
0
water
-50 to -75
fat
-1000
Air
V. MRI

-Technique that uses a magnetic field and radio waves to take multiple cross-section images of the body, which are then assembled into a three- dimensional image by a computer

-Uses radio frequency waves
-No ionization radiation is used
-Gives multiplanar display (axial, coronal,
sagittal and transverse)
What are the advantages of MRI over CT
Scan?

\ue000No radiation
\ue000NO bony or air artifac
\ue000Multi-section imaging
\ue000High intrinsic contrast
\ue000Specificity & extension of disease is

more accurate
\ue000Few diseases can be diagnosed early
\ue000MRI
can
distinguish
between
proteinaceous or H2O containing mass
\ue000In breast MRI, it can detect ruptured
implant
Limitations:
-Can not be used by people with pacemakers

or other metallic implants
-More expensive than the price for CT
-Not very useful for bones

-Even very slight movement of the part being scanned can cause very distorted images that will have to be repeated

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