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BACKGROUND AND TERMINOLOGY The main advantages of CT over conventional radiography are in the elimination of superimposed structures, the ability to differentiate small differences in density of anatomic structures and abnormalities, and the superior quality of the images.
Basic Principles of CT
Basic Principles of CT
referred to as the Z axis. .Basic Principles of CT Each CT slice represents a specific plane in the patient's body. The Z axis determines the thickness of the cross-sectional slice.
depending on the average photon energy of the x-ray beam and the characteristics of the structure in its path.BEAM ATTENUATION X-ray photons pass through or are absorbed or scattered by structures in varying amounts. The degree to which an x-ray beam is reduced is referred to as attenuation .
Objects that have the ability to absorb much.BEAM ATTENUATION Objects that have little ability to attenuate the beam are said to have low attenuation. . Historically. or all. of the beam are said to have high attenuation. Higher attenuation structures are represented by a white or light gray area on the image. lower attenuation structures are represented by a black or dark gray area on the image.
density. The .BEAM ATTENUATION The number of photons that interact with an object depends on the thickness. amount of the x-ray beam that is scattered or absorbed per unit thickness of the absorber is expressed by the linear attenuation coefficient (u). and atomic number of the object.
there must be a sufficient density difference between the two objects. To differentiate an object on a CT image from adjacent objects. . Oral or intravenous administration of a contrast agent is often used to create a temporary artificial density difference between objects.BEAM ATTENUATION Differences in linear attenuation coefficients among tissues are responsible for x-ray image contrast.
000 for air to +1. . ranging from —1.BEAM ATTENUATION Hounsfield units quantify the degree that a structure attenuates an x-ray beam.000 for dense bone.000 HU for naturally occurring anatomic structures. There are 2.
the beam comprises photons with varying energies. This can produce image artifacts.POLYCHROMATIC X-RAY BEAM The x-ray beam used in CT is polychromatic. . That is. The CT detectors cannot differentiate and adjust for differences in attenuation that are caused by low-energy x-ray photons.
Filtering improves image quality by reducing artifacts.POLYCHROMATIC X-RAY BEAM An artifact is an object seen on the image but not present in the object scanned. Filtering the x-ray beam helps to reduce the range of x-ray energies that reach the patient by eliminating the photons with weaker energies. Filtering reduces the radiation dose to the patient .
and if the area to be scanned is large. Thinner slices result in a higher radiation dose to the patient. Scanning procedures are designed to provide the image quality necessary for diagnosis at an acceptable radiation dose. The process in CT by which different tissue attenuations are averaged to produce one lessaccurate pixel reading is called volume averaging or the partial volume effect. VOLUME AVERAGING . Thicker CT slices increase the likelihood of missing very small objects. will produce a huge number of slices.
Reusing raw data to generate new images is called retrospective reconstruction. .VOLUME AVERAGING The process of using raw data to create an image is called image reconstruction. The reconstruction that is automatically produced during scanning is often called prospective reconstruction.
In the 1990s technical developments resulted in helical scanning. . Helical scanners were further improved to incorporate multiple rows of detectors that allowed data for many slices to be acquired with each gantry rotation. which allows for uninterrupted imaging.SCAN MODES Older CT systems operated exclusively in a "stepand shoot" fashion.
This position is characterized by an individual standing erect. Anterior and ventral refer to movement forward (toward the face).Proximal . and cephalic Lateral – Medial. Posterior and dorsal describe movement toward the back surface of the body Superior. cranial. with the palms of the hands facing forward.Distal .IMAGE PLANES Directional terms used in medicine are based on the body being viewed in the anatomic position.
or transverse. Sagittal plane divides the body into right and left sections Midsagittal plane. plane A coronal plane divides the body into anterior and posterior sections.IMAGE PLANES Body planes can be imagined by thinking of large sheets of glass cutting through the body in various ways. or longitudinal. planes Planes that stand perpendicular to the floor are called vertical. & Parasagittal plane . All planes that are parallel to the floor are called horizontal.
.OVERVIEW OF CT OPERATION Detectors record the number of x-ray photons that pass through the patient. The digital data from the DAS are then transmitted to the central processing unit (CPU). Each detector cell is sampled many times per second by the data acquisition system (DAS). The reconstruction process takes the individual views and reconstructs the densities within the slice.
Phase 3 is image display (show data). Phase 2 is image reconstruction (use data). The CT process can be broken down into three phases: Phase 1 is data acquisition (get data).OVERVIEW OF CT OPERATION Digitized data are then sent to a display processor that converts them into shades of gray that can be displayed on a monitor. .
Review Questions????? 1. Scanogram d. Which is NOT a synonym for the preliminary (or localizer) image taken at the start of a CT examination? a. Scout c. Spiral . Topogram b.
The ability of a system to differentiate. temporal resolution. objects with similar densities is known as a. on the image. b. . low-contrast resolution. high-contrast resolution. spatial resolution. c.Review Questions????? 2. d.
matrix. pixel. b. c. Each two-dimensional square of data that make up the CT image is called a. fragment. d. Review Questions????? 3. voxel. .
576 .048 c. Review Questions????? 4.048. 1. How many pixels are contained in a 1.144 d. 2.024 matrix image? a. 1. 262.024 b.
the phenomenon by which artifacts result when lowerenergy photons are preferentially absorbed. the phenomenon by which an x-ray beam passing through a structure is decreased in intensify or amount because of absorption and interaction with matter. d. b. c. Beam attenuation can be defined as a. Review Questions????? 5. the ability of the detector to capture transmitted photons and change them to electronic signals. leaving only higher-intensity photons to strike the detector array. x-ray energy that is produced from bombarding a substance with fast-moving electrons. .
Review Questions 6. Iodine-filled aorta b. Calcified arteries . Which of the following is a lowattenuation structure? a. Rib c. Trachea d.
50 d. -10 c. 850 . What is the expected Hounsfield measurement? a. An object is slightly less dense than water.Review Questions 7. -940 b.
lodinated contrast material decreases the average photon energy of the x-ray beam. Why does the administration of iodinated contrast media result in an enhanced image? a. b. more photons are absorbed by the patient. which results in an enhanced image." . d. The administration of iodinated contrast material results in a smaller pixel.Review Question 8. lodinated contrast material alters the atomic number of body tissues. In the case of blood vessels it temporarily changes their color from red to blue. thereby increasing spatial resolution. c. hence the name "x-ray dye. lodinated contrast material increases the ability of the enhanced structure to attenuate the x-ray beam. therefore.
9. c. when viewed by the naked eye. The x-ray beam sources for CT produce xray energy that is polychromatic. photons contained in the beam are all of the same wavelength. This means that a. a substance known as polychlorinated biphenyl. the beam exhibits many different colors. the beam comprises photons with varying energies. b. it produces. d. as a by product. .
b. anomaly. d. c. . shadow. An object that appears on the image but is not present in the object scanned is called a (an) artifact. ghost a. 10.
11. c. Which is an advantage of filtering the xray beam? a. Filtering reduces the anode heat load. Filtering the beam prevents energy from being converted to heat. Filtering reduces the radiation dose to the patient . therefore 100% of the energy is converted to x-rays. d. A filtered beam produces images with substantially less quantum mottle. b.
Scan thickness is primarily important for the part it plays in noise reduction. c. b. . the contrast scale. volume averaging. d. a. 12. detector aperture opening.
a thin slice will be necessary to reduce the chance that volume averaging will obscure their appearance on the image. d. 13. The thickest slice available should be used to reduce the radiation dose to the corneas. c. The appropriate slice thickness will vary considerably from patient to patient. Because the auditory ossicles are quite small. A slice thickness of 5 to 7mm is adequate because the structures of interest are not particularly small and the examination is most often ordered as a screening study for asymptomatic patients. each technologist should be free to adjust the slice thickness as he or she deems necessary for the particular patient. b. Therefore. . Which of the following is a logical consideration when determining an appropriate slice thickness for studies of the internal auditory canal? a. You are working with the radiologists to establish examination protocols for your department.
One half the number of all values recorded from the detector array b. The number of HU per pixel is one-tenth the display field of view d. One .the average of all measurements for that pixel c. 4 values for a 512-matrix . Two values for a 256-matrix. 14. How many CT numbers are assigned to each pixel in the image matrix? a.
b. 15. c. d. . Which is another name for raw data? Image data Scan data Reconstructed data Displayed data a.
with elbows bent. 16. down by the sides. raised above the head. palms facing backward and resting on the hips. When in the anatomic position. palms on opposite shoulders. palms facing forward. the arms are a. . palms facing backward. by the sides. crossed over the chest. b. c. d.
c. arrow #1 depicts a (an) a. In Figure 1-1. axial plane. transverse plane. b. coronal plane. 17. sagittal plane. 1 . d.
. the ability of the detector to capture transmitted photons and change them to electronic signals.Beam attenuation can be denned as 1MB | a. d. x-ray energy that is produced from bombarding a substance with fast-moving electrons. b. leaving only higher-intensity photons to strike the detector array. the phenomenon by which an x-ray beam passing through a structure is decreased in intensify or amount because of absorption and interaction with matter. c. the phenomenon by which artifacts result when lowerenergy photons are preferentially absorbed.
DATA ACQUISITION Data are acquired when x-rays pass through a patient to strike a detector and are recorded. The major components used for data acquisition are those contained in the gantry and the patient table. .
The gantry can be tilted to adjust the scan plane . Gantries vary in total size as well as in the diameter of the aperture.GANTRY Components are mounted in the gantry on a rotating scan frame. Typical aperture size ranges from 70 to 90 cm.
Gantry Early scanners used cables to rotate the gantry frame. The development of slip rings permits the gantry frame to rotate continuously. . This required the gantry to rotate in one direction and then stop to change direction and rotate in the opposite direction. making helical scan methods possible.
They are located within the gantry. The power capacity of the generator is listed in kilowatts (kW). Generators produce high voltage and transmit it to the x-ray tube.Generator High-frequency generators are used in CT. . The power capacityof the generator determines the range of xposure techniques available.
Generators produce high kV to increase the intensity of the resulting x-ray beam. This increases the penetrating ability of the beam and reduces the patient dose. A high kV setting also allows a lower mA setting, which helps to reduce the heat load on the x-ray tube. Cooling mechanisms housed within the gantry help to reduce temperature fluctuations that could affect system performance.
The x-ray tubes used in CT are a modification of a standard rotating anode tube.
CT tubes often contain more than one size focal spot. Small focal spots improve spatial resolution but, because they concentrate heat onto a smaller portion of the anode, they cannot tolerate as much heat.
Anode heat capacity is measured in million heat units (MHU).
Anode heat dissipation rate is measured in thousand heat units (KHU).
Filtering the x-ray beam helps to reduce the range of x-ray energies that reach the patient by removing the lower energy x-rays.Filtration Filters are used to shape the x-ray beam. They reduce the radiation dose to the patient and help to reduce image artifact. .
corresponding to the thinner areas of a patient's anatomy. These reduce the beam intensity at the periphery of the beam. .Filtration Different filters are used when scanning the body than when scanning the head Bow tie filters are often used to scan the body.
Because they act on the x-ray before it passes through the patient they are also called prepatient collimators. Reducing the scatter improves contrast resolution and decreases patient dose. Source collimators affect slice thickness by narrowing or widening the x-ray beam. .Collimator Collimators restrict the x-ray beam and reduce scatter radiation.
Collimator Some CT systems also use predetector collimation. . These act on the x-ray after it has emerged from the patient and before it strikes the detector. Their purpose is to prevent scattered radiation from reaching the detectors. These are sometimes referred to as postpatient collimators.
each of which measures the intensity of transmitted x-ray radiation along a beam projected from the x-ray source to that particular detector element. . A detector array comprises detector elements situated in an arc or a ring.Detectors Detectors collect information regarding the degree to which each anatomic structure attenuates the x-ray beam.
Detectors The number of detector cells that collect data is controlled by the selection of scan field size. each with their own advantages and disadvantages . Detectors can be made from different substances.
Detectors The optimal characteristics of a detector are: High detector efficiency-defined as the ability of the detector to capture transmitted photons and change them to electronic signals .
persistent flash of scintillation that must be taken into account and subtracted before image reconstruction .Detectors The optimal characteristics of a detector are: Low. or no. afterglow-defined as a brief.
and scatter rejection. geometric efficiency. . scintillator (solid-state types) or charge collection (xenon types) efficiency.Detectors The optimal characteristics of a detector are: High scatter suppression High stability Detector efficiency is dependent on the stopping power of the detector material.
geometric efficiency.Detectors Efficiency Detector efficiency is dependent on the stopping power of the detector material. . scintillator (solid-state types) or charge collection (xenon types) efficiency. and scatter rejection.
.Detector Efficiency The optimal characteristics of a detector are: The geometric efficiency of a detector refers to the amount of space occupied by the detector collimator plates relative to the surface area of the detector.
Detector Efficiency The optimal characteristics of a detector are: Capture efficiency refers to the ability with which the detector obtains x-ray beams that have passed through the patient. .
Detector Efficiency The optimal characteristics of a detector are: Absorption efficiency refers to the number of photons absorbed by the detector and is dependent on the physical properties of the detector face .
Detector Efficiency The optimal characteristics of a detector are: Response time is the time required for the signal from the detector to return to zero so that it is ready to detect another x-ray event. .
Detectors High Detector efficiency Efficiency Geometric Capture Efficiency Absorption Efficiency .
.Detectors The dynamic range is the ratio of the maximum signal measured to the minimum signal the detectors can measure.
they are less expensive to produce. and are highly stable. All new detectors are of the solid-state crystal variety. Solid-state detectors are also called scintillation detectors because they use a crystal that fluoresces when struck by an x-ray photon. .Detectors Detectors can be made from a solid-state crystal or from xenon gas-filled chambers. Xenon gas detectors are much less efficient thansolid-state detectors. somewhat easier to calibrate. However.
Solid-state detectors are more sensitive to fluctuation in temperature and moisture than the gas variety. Older solid-state detectors produced a brief afterglow. . Solid-state detectors are very efficient.Detectors A photodiode transforms the light energy into electrical energy. absorbing nearly 100% of the photons that reach them.
and placement of the detector elements affect the amount of scatter radiation that is recorded. . Detector spacing is measured from the middle of one detector to the middle of the neighboring detector. shape.Detectors The size. It accounts for the spacing bar placed between each detector element.
Detectors The size of the detector opening is called the aperture. A small detector is important for good spatial resolution and scatter rejection .
and sends the signal to the computer. .Detector Electronics The data-acquisition system (DAS) measures the number of photons that strike the detector. The DAS is positioned in the gantry. converts the information to a digital signal. near the detectors.
. analog signals from the detector must be converted into a digital format. This task is accomplished by the: Analog-to-Digital converter (ADC).Detector Electronics To be useful for the CT system computer.
sample rate.Detector Electronics Detectors are sampled many times. as many as 1. Image artifacts can occur if the sampling rate is too low.000 times per second by the DAS. . or sampling frequency. (Data Acquisition System) The number of samples taken per second is known as the sampling rate.
b. Which of the following components is NOT housed within the gantry? Three-phase generator High-frequency generator Slip rings Xenon gas detectors a.Review Questions 1. c. . d.
. c. kilowatts (kW).Review Questions 2. million heat units (MHU). d. The power capacity of the generator is listed in milliamperes (mA). a. b. thousand heat units (KHU).
A device used to shape the x-ray beam. A device that restricts the x-ray beam emerging from the gantry to thin ribbons .Review Questions Which of the following describes a slip ring device? 3. A brush-like apparatus that provides continuous electrical power and electronic communication across a rotating surface c. thereby reducing the radiation dose to the patient and reducing image artifact d. A recoiling system cable used to rotate the gantry frame b. a.
Review Questions 4. b. Which is a disadvantage of a small focal spot size? Reduced spatial resolution Reduced detector efficiency Increased penumbra Reduced heat capacity a. c. d. .
The ability of the tube to withstand by-product heat is called heat capacity. . thermal potential. thermal transference. d. a. b. c. heat dissipation.Review Questions 5.
Bow tie filter c. what is the object marked x called? a. In Figure. Focal spot d. Detector X-ray tube x . Collimator b.Review Questions 6.
d. Regarding the detectors in the CT system. or b. c. detector spacing and aperture.Review Questions 7. geometric efficiency is controlled primarily by: a. type of photodiode used filtration. detector material (solid-state crystals xenon gas chambers). .
c. . d.Review Questions 8. b. Which of the following is a characteristic of xenon gas detectors? Low efficiency Sensitive to temperature and moisture May exhibit afterglow Also called scintillators a.
Review Questions 10. c. b. Which component of the CT system converts the electric signal supplied by the detectors into a digital format? Photodiode Array processor Display processor Analog-to-digital converter a. . d.
c. d.Review Questions 1. b. Which of the following components is NOT housed within the gantry? Three-phase generator High-frequency generator Slip rings Xenon gas detectors a. .
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