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  • Dr. Roentgen felt the discovery was for the benefit of mankind and not his sole property.
  • Images are classed as projection (whole structure) or tomographic (sectional or slice)
  • The letters(AP) identify the direction the x-ray beam traverses the patient. In this case the x-rays travel from anterior to posterior with the foot placed on top of the film.(AP = Anterior to Posterior)
  • Notice how the projection image superimposes data and does not allow for depth evaluation. This is why x-ray exams typically have 2 projections at 90 degrees. i.e.. AP and Lateral
  • These are the standard planes of section
  • Multiple separate slices are viewed to evaluate the entire data volume
  • An energy source is directed into a volume of tissue and a image is created of the tissue interaction.
  • An X-ray tube is similar to a light bulb with a filament and a current to heat the filament. There is a much higher voltage to direct the electrons from the filament at a target. This collision releases the x-ray radiation that is used to image.
  • These are typical body regions that plain x-ray is used to evaluate.
  • The x-rays can traverse tissue but can only separate the 4 basic densities noted. Water will appear of the same density as soft tissue and cannot be separated. Notice you cannot separate the blood from the heart or aorta.
  • Administering a contrast agent modifies the image to give more information. Typical ones are barium, an inert particulate contrast used in GI tract evaluation and Iodine, a water soluble agent which can be injected into the vascular tree.
  • The contrast agent will outline the structure identifying the wall, determine size and patency or obstruction. The darker density in the colon is air which has been mixed with the barium to better show the wall. Note difference in wall comparing the stomach and colon.
  • Iodine can be injected and is water soluble. In the blood stream, it will outline the vessel and demonstrate anatomy. Iodine is filtered by the kidney and can show information about tissue function.
  • The detectors count the photons that traverse the patient and use this data to assign a density to the tissue. Denser tissue would have fewer photons measured by the detectors. The numerical value determines the tissues density .
  • Here a radioactive drug is administered. The pharmaceutical portion has been created to localize to a type of tissue. The radioactive tag serves to identify the site of accumulation. The CAMERA measures the radiation distribution and maps it to a region.
  • Here the drug used collects in a specific tissue and the radioactivity allows an image and numerical counts of activity. This can be followed over time to see physiology without additional radiation exposure since the isotope has been injected there is no additional exposure for additional images.
  • The ultrasound hand-held probe transmits sound into the body. The absorption and reflection of the sound is used to create the image. The probe functions as the transmitter and receiver.
  • The data is sectional/tomographic. The planes are similar to standard CT planes. Longitudinal planes are sometimes referred to when a pure sagittal section is not obtained. Axial planes may be called transverse.
  • The tissue response to magnetic fields and radio wave stimulation serves as the basis of imaging. The radio wave is the source of the image.

Lecture Presentation Transcript

  • 1. As Clinical Anatomy 1 E-mail: x-ray@med.sc.edu Radiology Website: http:// radiology.med.sc.edu Radiology Department: Basement of Library 733-3295 Francis Neuffer, M.D. U.S.C. School of Medicine 2009 RADIOLOGY Speaker note
  • 2. COURSE GOALS
    • Understand basics of image generation.
    • Relate imaging to gross anatomy.
    • See clinical relationship to basic science.
    • Appreciate constraints and limitations.
    • Develop imaging vocabulary.
  • 3. WHAT IS RADIOLOGY?
    • Medical specialty that supervises and interprets imaging studies.
    • Reports findings to referring physicians.
  • 4. RADIOLOGIST ROLE
    • Separate: Normal from Abnormal
    • Characterize / Describe: Abnormality
    • Determine: Extent (stage) of disease
    • Suggest: Diagnosis / Differential
    • Recommend: Further exams / follow-up
  • 5. X-RAY
    • Discovered and named by
    • Dr. W. C. R öe ntgen at
    • University of W ü rzburg, 1895
    • Awarded first Nobel prize for physics, 1901
    • Did not patent invention
  • 6. PROJECTION -VS- TOMOGRAPHIC IMAGE
  • 7. FOOT AP PROJECTION (ANTERIOR - POSTERIOR) RT
  • 8. LATERAL FOOT
  • 9. TOMOGRAPHIC IMAGES ARE IN A SPECIFIC PLANE SAGITTAL AXIAL CORONAL RT RT
  • 10. CT- HEAD CT REFERENCE FILM Skull / brain RT
  • 11. RADIOLOGY TOOLS X- RAY ULTRASOUND NUCLEAR MEDICINE MAGNETIC RESONANCE COMPUTED TOMOGRAPHY
  • 12. HOW IS IMAGING DONE?
    • IONIZING RADIATION
    • X-ray, CT, Nuclear Medicine
    • SOUND WAVES
    • Ultrasound
    • MAGNETIC FIELDS / RADIO WAVES
    • Magnetic Resonance
  • 13. X- RAY
    • High Energy Photon
    • --Kilo Electron Volts
    • Ionizing Radiation
    • Exposes Film / Detector
    • Projection Data
  • 14. X-RAYS PLAIN FILM RADIOGRAPHY
    • Chest
    • Mammography
    • Abdomen
    • Spine
    • Extremities & Joints
    • Skull
  • 15.
    • Air
    • Soft Tissue
    • Fat
    • Bone
    X - RAY --- FOUR BASIC DENSITIES
  • 16. CONTRAST RADIOGRAPHY
    • Injection, ingestion, or other placement of opaque material within the body.
    • Improves visualization and tissue separation.
    • Can demonstrate functional anatomy and pathology.
  • 17. UPPER GI --(GASTRO INTESTINAL ) BARIUM ENEMA RECTAL BARIUM CONTRAST WITHOUT CONTRAST-plain or scout film STOMACH COLON ORAL BARIUM CONTRAST
  • 18. INTRAVENOUS PYELOGRAM – IVP INTRAVENOUS IODINE CONTRAST ARTERIOGRAM INTRAARTERIAL IODINE CONTRAST WITHOUT CONTRAST-plain or scout film
  • 19. COMPUTED TOMOGRAPHY
    • HIGH ENERGY PHOTON
    • IONIZING RADIATION
    • EXPOSES DETECTOR
    • TOMOGRAPHIC DATA
  • 20. SCAN LEVEL CT EXAMPLE RT
  • 21. NUCLEAR MEDICINE
    • High Energy Photon
    • Ionizing Radiation
    • --Radiopharmaceutical
    • Exposes Detector
    • Projection Data
    • Dynamic / Physiologic
  • 22. NUCLEAR MEDICINE EXAMPLES
    • Hepatobiliary
    • Renal
    • Bone
  • 23. ULTRASOUND
    • Sound Wave - high Frequency
    • No Ionizing Radiation
    • Transmitter / Receiver
    • Tomographic Data
  • 24. ULTRASOUND EXAMPLES
    • Gallbladder
    • Kidney
    • Obstetrics
  • 25.
    • Hydrogen Protons In a Magnetic Field
    • Radio Wave Signal Transmission
    • No Ionizing Radiation
    • Tomographic Data
    MAGNETIC RESONANCE
  • 26. MAGNETIC RESONANCE EXAMPLES
    • Brain
    • Spine
    • Knee
    RT
  • 27.
    • Multiple Choice - Identify
    • Labeled Images
    • From Digital Film Sets And
    • Lecture Images
    RADIOLOGY EVALUATION
  • 28. HOSPITAL LINGO X- Ray Plain Film Scout Film Radiograph Computed Tomography Cat Scan CT Nuclear Medicine Nuc Med Ultrasound Sono Sonogram Magnetic Resonance MR MRI You will hear and see these abbreviations used frequently in the medical community.
  • 29. SUMMARY
    • TOMOGRAPHY- VS- PROJECTION IMAGES
    • SECTION PLANES
    • AXIAL
    • CORONAL
    • SAGITTAL
    • IMAGE GENERATION OF:
    • Nuclear Medicine
    • Computed Tomography
    • Ultrasound
    • X-ray
    • Magnetic Resonance
  • 30. OH… THE MANY USES OF MODERN IMAGING? KING TUT NUC MED STUDY OF A HORSE’S _____!