Professional Documents
Culture Documents
Principles of Radiology
Principles of Radiology
INTRODUCTION
The spectrum composing electromagnetic radiation includes gamma rays, UV rays, infra red
and electric waves. X-rays are a part of this gamma ray spectrum emitted by the cosmic system.
Medical X-rays, which are used routinely for diagnostic purposes, are not emitted from any
radioactive material. Instead, they are produced by heating a tungsten or molybdenum cathode
in a vaccumized tube at high temperatures, such that electrons having short wave emit
radiation from the surface of these materials.
This radiation is then raced towards a tungsten anode by a strong electrical current, which
results in abrupt stopping of the X-ray beam and a change in its direction, thereby focusing the
rays on to the part of the body under examination. There after upon penetrating the body, they
cast an impression on the X-ray plate kept under the area of study. This plate is subsequently
processed and an image is generated for medical evaluation.
Since the X-rays have a short wave length, they are invisible to human eyes. Hence the need
to be conscious about the dangerous side effects of X-rays.
The X-rays are composed of particles of energy called photons, which have no mass, no
charge and travel at the speed of light. These photons are called X-ray photons.
HISTORY OF X-RAYS
X-rays were discovered accidentally on the 8th of November 1895, by Wilhelm Conrad Roentgen.
Roentgen was a German physicist from the University of Wurzburg. He was engaged in studying the
behaviour of an electron beam as it passed through a vacuumized tube to strike a tungsten plate. To his
surprise, he observed that, in addition to electrons, certain unknown rays were also produced, which
could penetrate the glass envelope of his apparatus and produce a glow on a distant fluorescent screen.
He was able to photograph the bones of the hand of his wife by placing it over a photographic plate
and then shining the rays on it. Since no name had been given to this kind of radiation, the name
X-ray was given by him.
For his unique discovery, Roentgen was awarded the Nobel Prize in Physics in the year, 1901
The discovery of X-rays provided a new dimension to the advancement of medical and other sciences.
The medical use of X-rays are for both diagnostic and therapeutic purposes. The technique of using X-
rays for imaging body parts is called radiography, for diagnosing disease, radio-diagnosis and for
treatment of disease, radiotherapy.
As a diagnostic tool radiography has proved of immense value in detection of the diseases, fractures
and many other problems in the human body.
Therapeutically, X-rays are used in the treatment of many types of cancers because, the rays can
destroy cancer cell, though the adjacent normal cells also get affected.
PR O PERTIE S O F X-R A YS
X-rays can destroy both normal and abnormal cells. This effect is utilized in the treatment of various cancers
but at the costs of destroying adjacent normal cells as well.
Hence, X-rays are potentially dangerous. On repeated exposures, they cause burns, hair loss, brittle nails,
development of cancers and even genetic mutations. Therefore, adequate protectilve measures must be
taken against repeated exposures to X-rays.
wnerever and whenever possible they should be avoided particularly in children, young people and
pregnant. However, should the need arise, they must be used with adequate precautions to reduce
morbidity and mortality.
Radiography
Method of obtaining X-rays of different body parts is called Radiography. Radiographs are generally obtained
from a single direction if it is the chest or abdomen or from two directions at right angle to each, if it is the
extremities and spine. This gives complete information about the area in question. The term used by
radiologist for this is "views"
The 'view expresses the direction of flow of the X-ray beam. In AP (anteroposterior) view, the rays pass
from the front to back, the latter resting against the X-ray plate. In PA (posteroanterior) view the X-rays pass
from the back to front, the front surface resting against the X-rays plate. The part of the body touching the
X-ray plate (i.e. near the X-ray plate) casts a sharper shadow than the part facing the X-ray tube.
The views can be anteroposterior (AP), lateral or oblique depending on the relationship of the body part
with the X-ray beam. Chest X-rays are usually posteroanterior (PA) views. For visualizing the thoracic spine,
AP view is preferred.
Fluoroscopy is visualizing the body part in real time using X-rays. lt is of special advantage in observing the
movements of the organs (lungs, gastrointestinal tract, diaphragm), flow of administered Contrast through
blood vessels and bowel and in positioning the
subject during the examination.
Fluoroscopy in earlier days was done in a dark room. But now image intensifiers and television monitors are
used which have eliminated the need for darkening the room.
The fluoroscopic image is visualized directly on the fluorescent screen which is covered with a sheet of lead
glass to absorb unwanted X-rays and to protect the fluoroscopist. Now-a-days the conventional fluoroscopic
screen has been replaced by an image intensifier system with the image being projected on an accompanying
television monitor.
The sharpness of the fluoroscopic image is inferior to that of a radiograph but it provides information about
motion and flow which a static X-ray cannot do.
2. Plain Radiography
An X-ray image, obtained directly without using any contrast medium, is called a plain X-ray. It is useful in the
study of normal bones, lungs, normal joints, paranasal air sinuses and gaseous shadows in the abdomen.
Strength: Covers a large area quickly, relatively low X-ray exposure and low cost. Easy accessibility (Figs 10.1 to
10.3).
Weakness: Relatively low resolution and low soft tissue contrast as Compared to CT scans.
3. Contrast Radiography
.
The hollow viscera and solid organs cannot be visualized in plain radiography
due to their having similar soft tissue densities. However, their differences or
contrast can be accentuated by filling such organs or cavities with either a
radiopaque or a radiolucent substance.
Radiography done after artificial accentuation of the contrast density is called
contrast radiography.
The radiopaque compounds used in contrast radiography are:
1. Barium sulphate suspension (emulsion) in water for gastro- intestinal tract
(Figs 10.4 to 10.6).
2. Aqueous solution of appropriate iodine compounds, for urinary and biliary
passages and vascular system.
SPECIAL PROCEDURES
• For viewing the lungs posteroanterior view (PA view) is taken Viscera are
visualised by contrast radiography or by ultrasound.
• Ultrasound is a relatively safe imaging procedure during pregnancy.
• Magnetic resonance imaging is best used to visualize brain and spinal cord.
• Positron emission tomography detects functional changes at an early stage.