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Introduction to Radiology

Introduction to Radiology

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02/01/2013

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3B2010

Subject: Radiology Date: June 13, 2008

Topic: Introduction to Radiology 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

-based on the same principles involved in the sonar used -painless

Advantages  No radiation risk  Non-invasive  Inexpensive  Painless  Don’t require contrast material  Sedation is not required    Anechoic No sound through transmission Isoechoic With margin Sagittal and transverse evaluation Echogenic/ Hyperechoic Solid: white Mass: black

 RADIO-OPAQUE/ DENSE (white)
Differential Diagnosis: Infiltrate/ inflammatory process Mass/tumor Fluid Lithiasis Foreign ody e.g. coin

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 RADIOLUCENT- black; air Pneumoperitoneum Pneumothorax Pneumomediastinum Pneumopericardium Tumor
FLUOROSCOPY CONTRAST EXAMINATION  Contrast (barium/iodine) -is given orally/IV/ other routes depending upon region (part) under investigation  Upper gastrointestinal series (UGIS) -To evaluate the esophagus, stomach, duodenal bulb and the prox small bowel segments  Smal intestinal Series (SIS) -To evaluate the small bowel segments  Barium Enema (BE) -To evaluate the colonic segments  IVP -Intravenous contrast for functional & structural assessment of kidneys  Hysterosalpingogram studies -To evaluate uterus & tubes of infertile women  Angiogram study -To evaluate the lumen of blood vessels II. ULTRASOUND

SOLID NODULE VS. CYST  SOLID NODULE -Well defined -Ovoid shape -With uniform internal echoes  CYST -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 “cross-section” images of the body, which are then assembled into a threedimensional 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  Hyperdense (white) +1000 calcium >250 compact bone 30-230 spongy bone 70-90 coagulated blood 50-60 whole blood  Iso dense 20.70 soft tissue > 18 exudate <18 transudate  Hypo 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?  No radiation  NO bony or air artifac  Multi-section imaging  High intrinsic contrast  Specificity & extension of disease is more accurate  Few diseases can be diagnosed early  MRI can distinguish between proteinaceous or H2O containing mass  In 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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