CT OF THE HEAD
PATHOLOGIES AND
PROTOCOLS

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INDIAN DENTAL ACADEMY
Leader in continuing dental education
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PATHOLOGIES

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SINUSITIS
Sinusitis is the
name given when
the lining of one or
more of these
sinuses is red,
swollen, and tender,
the ope...
SINUS POLYP

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ORBITAL FRACTURE
Demonstrates a
superior orbital
fracture on the
left with
fragments of
bone extending
toward the
frontal ...
ORBITAL ROOF FRACTURE

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TRIPOD FRACTURE

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The tripod fracture, also called
the zygomaticomaxillary
complex, is composed of a set of
fractures including the lateral
...
Blowout fracture

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MANDIBULAR FRACTURE

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SKULL FRACTURES
• OPEN
• CLOSED

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Although the skull is tough, resilient, and provides excellent protection for the brain, a severe impact or blow can
resul...
OPEN FRACTURECOMPOUND

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CLOSED FRACTURE

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HEMORRHAGE
•
•
•
•

INTRACEREBRAL
SUBDURAL
EPIDURAL
SUBARACHNOID

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INTRACEREBRAL

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SUBDURAL

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SDH
• form of traumatic brain injury in which
blood gathers between the dura (the outer
protective covering of the brain) ...
EPIDURAL

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EDH
• buildup of blood occurring between the
dura mater (the brain's tough outer
membrane) and the skull.

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SUBARACHNOID

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SAH
• is bleeding into the subarachnoid space
surrounding the brain, the area between the
arachnoid membrane and the pia m...
Rupture of an intracranial aneurysm is
the most common cause of nontraumatic
subarachnoid hemorrhage.
90-95% of all intrac...
CEREBRAL INFARCT

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BRAIN CYST

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HYDROCEPHALUS

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ARTERIO-VENOUS
MALFORMATION

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What is a brain AVM?
Normally, arteries carry
blood containing oxygen
from the heart to the brain,
and veins carry blood w...
BRAIN METS

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CVA

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This is a CAT scan of a patient with a bleeding stroke
caused by CAA. The two bright areas represent recent
areas of bleed...
BRAIN INFECTIONS
• MENINGITIS
• ENCEPHALITIS
• ABSCESS

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MENINGITIS

Subdural empyema and diffuse cerebral edema in a patient with
bacterial meningitis (same patient as in Image 1...
ENCEPHALITIS

Encephalitis
Encephalitis is an inflammation (irritation and swelling with presence of
www.indiandentalacade...
BRAIN ABSCESS

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BRAIN TUMORS
•
•
•
•
•
•

ASTROCYTOMAS
GLIOMAS
PINEAL REGION TUMORS
LIPOMA
ACOUSTIC NEUROMA
MENINGIOMA
www.indiandentalaca...
•astrocytomas
Astrocytomas are glial cell tumors that are
derived from connective tissue cells called
astrocytes. These ce...
•Brain stem gliomas
are tumors found in the brain stem. Most brain stem tumors
cannot be surgically removed because of the...
•optic nerve gliomas
Optic nerve gliomas are found in or around the nerves that send
messages from the eyes to the brain. ...
•medulloblastomas
Medulloblastomas are one type of PNET that are found near the
midline of the cerebellum. This tumor is r...
•pineal region tumors
Many different tumors can arise near the pineal gland, a gland which
helps control sleep and wake cy...
GLIOMA

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ACOUSTIC NEUROMA

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ACOUSTIC NEUROMA

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PITUITARY GLAND TUMOR

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CT PROTOCOLS
•
•
•
•
•
•
•
•
•
•

HEAD
HEAD VASCULAR CTA CTV
PITUITARY & SELLA TURCICA
INTERNAL AUDITORY CANAL
ORBITS
PARA...
OML
CML

IOML

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HEAD/BRAIN (ADULT)
SCOUT: LATERAL
FOV -240
LANDMARK: OML – 15 DEG ABOVE OML
SLICE PLANE: AXIAL
I.V. CONTRAST: 100-140 ML 1...
15 DEG AND 20 DEG ABOVE OML

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CT HEAD – LOSS OF BALANCE
SCOUT: LATERAL
FOV -240
LANDMARK: OML – 15 DEG ABOVE OML
SLICE PLANE: AXIAL
I.V. CONTRAST: 100-1...
CT HEAD – SEIZURES -20 DEG TO
OML

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BRAIN ANGIO CTA
SCOUT: LATERAL
LANDMARK: OML
SLICE PLANE: AXIAL
I.V. CONTRAST: 100-140 ML- 3-5 ml /sec -

15 - 20 SEC DELA...
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PITUITARY AND SELLA TURCICA
SCOUT: LATERAL
LANDMARK: OML
SLICE PLANE: CORONAL & AXIAL
I.V. CONTRAST: 100-140 ML
BREATH HOL...
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IAC
SCOUT: LATERAL
LANDMARK: IOML
SLICE PLANE: CORONAL & AXIAL
I.V. CONTRAST: 100-140 ML FOR ACOUSTIC NEUROMA OR HEARING L...
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SCANNED
DFOV
20 CM

RECON:
R & L SIDE
DFOV
10 CM
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ORBITS
SCOUT: LATERAL
LANDMARK: IOML

DFOV
15CM

SLICE PLANE: CORONAL & AXIAL
I.V. CONTRAST: 100-140 ML MASS OR VISUAL DIS...
OPTIC NERVE PROTOCOL

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PATIENT CAN’T ASSUME
PRONE POSITION

SUPINE-CORONAL

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DENTAL ARTIFACT OMISSIONMULTIANGULATION

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FACIAL BONES
SCOUT: LATERAL
LANDMARK: IOML
SLICE PLANE: CORONAL & AXIAL
I.V. CONTRAST: 100-140 ML MASS 2 cc/sec

65 SEC DE...
FACIAL BONES

INCLUDE MANDIBLE!!!!!!

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PNS
SCOUT: LATERAL
LANDMARK: OML

DFOV
15 CM

SLICE PLANE: CORONAL & AXIAL
I.V. CONTRAST: 100-140 ML MASS 2 cc/sec

65 SEC...
TMJ
SCOUT: LATERAL
LANDMARK: OML
SLICE PLANE: CORONAL & AXIAL
I.V. CONTRAST: NONE
BREATH HOLD: NONE
SLICE THICKNESS: 1 - 2...
SCANNED
DFOV
20 CM

RECON:
R & L SIDE
DFOV
10 CM

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DENTAL

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STEREOTACTIC

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Stereotactic system use
•
•
•
•

Biopsy of intracranial lesions
Aspiration of cysts
Laser microsurgery
Aspiration of brain...
Thank you
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Leader in continuing dental education

www.indiandentalacademy.com
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Head pathologies and protocols /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.


Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078

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Head pathologies and protocols /certified fixed orthodontic courses by Indian dental academy

  1. 1. CT OF THE HEAD PATHOLOGIES AND PROTOCOLS www.indiandentalacademy.com
  2. 2. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  3. 3. PATHOLOGIES www.indiandentalacademy.com
  4. 4. SINUSITIS Sinusitis is the name given when the lining of one or more of these sinuses is red, swollen, and tender, the opening is blocked, and the sinus is at least partially filled with fluid (mucus and/or pus). www.indiandentalacademy.com
  5. 5. SINUS POLYP www.indiandentalacademy.com
  6. 6. ORBITAL FRACTURE Demonstrates a superior orbital fracture on the left with fragments of bone extending toward the frontal lobe. There was no evidence of an optic canal fracture. www.indiandentalacademy.com
  7. 7. ORBITAL ROOF FRACTURE www.indiandentalacademy.com
  8. 8. TRIPOD FRACTURE www.indiandentalacademy.com
  9. 9. The tripod fracture, also called the zygomaticomaxillary complex, is composed of a set of fractures including the lateral orbital wall, inferior orbital floor, and the zygomatic arch. www.indiandentalacademy.com
  10. 10. Blowout fracture www.indiandentalacademy.com
  11. 11. MANDIBULAR FRACTURE www.indiandentalacademy.com
  12. 12. SKULL FRACTURES • OPEN • CLOSED www.indiandentalacademy.com
  13. 13. Although the skull is tough, resilient, and provides excellent protection for the brain, a severe impact or blow can result in fracture of the skull and may be accompanied by injury to the brain. Some of the different types of skull fracture include: Simple: a break in the bone without damage to the skinLinear or hairline: a break in a cranial bone resembling a thin line, without splintering, depression, or distortion of boneDepressed: a break in a cranial bone (or "crushed" portion of skull) with depression of the bone in toward the brainCompound: a break in or loss of skin and splintering of the bone. Along with the fracture, brain injury, such as subdural hematoma (bleeding) may occur. www.indiandentalacademy.com
  14. 14. OPEN FRACTURECOMPOUND www.indiandentalacademy.com
  15. 15. CLOSED FRACTURE www.indiandentalacademy.com
  16. 16. HEMORRHAGE • • • • INTRACEREBRAL SUBDURAL EPIDURAL SUBARACHNOID www.indiandentalacademy.com
  17. 17. INTRACEREBRAL www.indiandentalacademy.com
  18. 18. SUBDURAL www.indiandentalacademy.com
  19. 19. SDH • form of traumatic brain injury in which blood gathers between the dura (the outer protective covering of the brain) and the arachnoid (the middle layer of the meninges). www.indiandentalacademy.com
  20. 20. EPIDURAL www.indiandentalacademy.com
  21. 21. EDH • buildup of blood occurring between the dura mater (the brain's tough outer membrane) and the skull. www.indiandentalacademy.com
  22. 22. SUBARACHNOID www.indiandentalacademy.com
  23. 23. SAH • is bleeding into the subarachnoid space surrounding the brain, the area between the arachnoid membrane and the pia mater. www.indiandentalacademy.com
  24. 24. Rupture of an intracranial aneurysm is the most common cause of nontraumatic subarachnoid hemorrhage. 90-95% of all intracranial aneurysms are located in the carotid system. The anterior communicating artery is the most common site (30%), followed by the posterior communicating artery (25%) and the middle cerebral artery (20%). www.indiandentalacademy.com
  25. 25. CEREBRAL INFARCT www.indiandentalacademy.com
  26. 26. BRAIN CYST www.indiandentalacademy.com
  27. 27. HYDROCEPHALUS www.indiandentalacademy.com
  28. 28. ARTERIO-VENOUS MALFORMATION www.indiandentalacademy.com
  29. 29. What is a brain AVM? Normally, arteries carry blood containing oxygen from the heart to the brain, and veins carry blood with less oxygen away from the brain and back to the heart. When an arteriovenous malformation (AVM) occurs, a tangle of blood vessels in the brain or on its surface bypasses normal brain tissue and directly diverts blood from the arteries to the veins www.indiandentalacademy.com
  30. 30. BRAIN METS www.indiandentalacademy.com
  31. 31. CVA www.indiandentalacademy.com
  32. 32. www.indiandentalacademy.com
  33. 33. This is a CAT scan of a patient with a bleeding stroke caused by CAA. The two bright areas represent recent areas of bleeding into the brain. Both areas are in the outer part of the brain that is characteristic for CAAwww.indiandentalacademy.com related strokes.
  34. 34. BRAIN INFECTIONS • MENINGITIS • ENCEPHALITIS • ABSCESS www.indiandentalacademy.com
  35. 35. MENINGITIS Subdural empyema and diffuse cerebral edema in a patient with bacterial meningitis (same patient as in Image 18). Obtained 1 week after Image 18, this contrast-enhanced CT scan shows www.indiandentalacademy.com diffuse cerebral edema and lacunar infarcts in the thalamus.
  36. 36. ENCEPHALITIS Encephalitis Encephalitis is an inflammation (irritation and swelling with presence of www.indiandentalacademy.com extra immune cells) of the brain, usually caused by infections.
  37. 37. BRAIN ABSCESS www.indiandentalacademy.com
  38. 38. BRAIN TUMORS • • • • • • ASTROCYTOMAS GLIOMAS PINEAL REGION TUMORS LIPOMA ACOUSTIC NEUROMA MENINGIOMA www.indiandentalacademy.com
  39. 39. •astrocytomas Astrocytomas are glial cell tumors that are derived from connective tissue cells called astrocytes. These cells can be found anywhere in the brain or spinal cord. Astrocytomas are the most common type of childhood brain tumor. www.indiandentalacademy.com
  40. 40. •Brain stem gliomas are tumors found in the brain stem. Most brain stem tumors cannot be surgically removed because of the remote location and delicate and complex function this area controls. Brain stem gliomas occur almost exclusively in children; the group most often affected is the school-age child. The child usually does not have increased intracranial pressure, but may have problems with double vision, movement of the face or one side of the body, or difficulty with walking and coordination www.indiandentalacademy.com
  41. 41. •optic nerve gliomas Optic nerve gliomas are found in or around the nerves that send messages from the eyes to the brain. They are frequently found in persons who have neurofibromatosis, a condition a child is born with that makes him/her more likely to develop tumors in the brain. Persons usually experience loss of vision, as well as hormone problems, since these tumors are usually located at the base of the brain where hormonal control is located. These are typically difficult to treat due to the surrounding sensitive brain structures. www.indiandentalacademy.com
  42. 42. •medulloblastomas Medulloblastomas are one type of PNET that are found near the midline of the cerebellum. This tumor is rapidly growing and often blocks drainage of the CSF (cerebral spinal fluid, which bathes the brain and spinal cord), causing symptoms associated with increased ICP. Medulloblastoma cells can spread (metastasize) to other areas of the central nervous system, especially around the spinal cord. A combination of surgery, radiation, and chemotherapy is usually needed to control these tumors www.indiandentalacademy.com
  43. 43. •pineal region tumors Many different tumors can arise near the pineal gland, a gland which helps control sleep and wake cycles. Gliomas are common in this region, as are pineal blastomas (PNET). In addition, germ cell tumors, another form of malignant tumor, can be found in this area. Tumors in this region are more common in children than adults, and make up 3 to 8 percent of pediatric brain tumors. Benign pineal gland cysts are also seen in this location, which makes the diagnosis difficult between what is malignant and what is benign. Biopsy or removal of the tumor is frequently necessary to tell the different types of tumors apart. Persons with tumors in this region frequently experience headaches or symptoms of increased intracranial pressure. Treatment depends on the tumor type and size. www.indiandentalacademy.com
  44. 44. GLIOMA www.indiandentalacademy.com
  45. 45. ACOUSTIC NEUROMA www.indiandentalacademy.com
  46. 46. ACOUSTIC NEUROMA www.indiandentalacademy.com
  47. 47. PITUITARY GLAND TUMOR www.indiandentalacademy.com
  48. 48. CT PROTOCOLS • • • • • • • • • • HEAD HEAD VASCULAR CTA CTV PITUITARY & SELLA TURCICA INTERNAL AUDITORY CANAL ORBITS PARANASAL SINUSES TMJ FACIAL BONES DENTAL STEREOTACTIC www.indiandentalacademy.com
  49. 49. OML CML IOML www.indiandentalacademy.com
  50. 50. HEAD/BRAIN (ADULT) SCOUT: LATERAL FOV -240 LANDMARK: OML – 15 DEG ABOVE OML SLICE PLANE: AXIAL I.V. CONTRAST: 100-140 ML 1-1.5 ML/SEC, TUMOR, METS - 5 MIN DELAY SLICE THICKNESS: 5 x 5 mm START LOCATION: FORAMEN MAGNUM END LOCATION: VERTEX FILMING: BONE & SOFT TISSUE www.indiandentalacademy.com DFOV 25
  51. 51. 15 DEG AND 20 DEG ABOVE OML www.indiandentalacademy.com
  52. 52. CT HEAD – LOSS OF BALANCE SCOUT: LATERAL FOV -240 LANDMARK: OML – 15 DEG ABOVE OML SLICE PLANE: AXIAL I.V. CONTRAST: 100-140 ML 1-1.5 ML/SEC, TUMOR, METS - 5 MIN DELAY SLICE THICKNESS: 2 x 2 mm POSTERIOR FOSSA 5 x 5 mm THE REST START LOCATION: FORAMEN MAGNUM END LOCATION: VERTEX FILMING: BONE & SOFT TISSUE www.indiandentalacademy.com DFOV 25
  53. 53. CT HEAD – SEIZURES -20 DEG TO OML www.indiandentalacademy.com
  54. 54. www.indiandentalacademy.com
  55. 55. BRAIN ANGIO CTA SCOUT: LATERAL LANDMARK: OML SLICE PLANE: AXIAL I.V. CONTRAST: 100-140 ML- 3-5 ml /sec - 15 - 20 SEC DELAY CTA 30 SEC DELAY CTV BREATH HOLD: NONE SLICE THICKNESS: 1-2 MM START LOCATION: BELOW SELLAR FLOOR END LOCATION: 4-5 CM ABOVE SELLA RECON: 50% OVERLAP FILMING: 3 D RECON www.indiandentalacademy.com DFOV 18
  56. 56. www.indiandentalacademy.com
  57. 57. www.indiandentalacademy.com
  58. 58. www.indiandentalacademy.com
  59. 59. www.indiandentalacademy.com
  60. 60. PITUITARY AND SELLA TURCICA SCOUT: LATERAL LANDMARK: OML SLICE PLANE: CORONAL & AXIAL I.V. CONTRAST: 100-140 ML BREATH HOLD: NONE SLICE THICKNESS: 1-1.5 mm FILMING: BONE & SOFT TISSUE www.indiandentalacademy.com DFOV 12
  61. 61. www.indiandentalacademy.com
  62. 62. www.indiandentalacademy.com
  63. 63. www.indiandentalacademy.com
  64. 64. www.indiandentalacademy.com
  65. 65. IAC SCOUT: LATERAL LANDMARK: IOML SLICE PLANE: CORONAL & AXIAL I.V. CONTRAST: 100-140 ML FOR ACOUSTIC NEUROMA OR HEARING LOSS 65 SEC DELAY BREATH HOLD: NONE SLICE THICKNESS: 1-2 MM, 1MM THROUGH CANAL, 2 MM PETROUS BONE START LOCATION: CORONAL: P. SEMI-CIRC. CANAL, AXIAL: F. MAGNUM END LOCATION: CORONAL: THROUGH PETROUS BONE AXIAL THROUGH PETROUS BONE FILMING: BONE & SOFT TISSUE www.indiandentalacademy.com
  66. 66. www.indiandentalacademy.com
  67. 67. www.indiandentalacademy.com
  68. 68. SCANNED DFOV 20 CM RECON: R & L SIDE DFOV 10 CM www.indiandentalacademy.com
  69. 69. ORBITS SCOUT: LATERAL LANDMARK: IOML DFOV 15CM SLICE PLANE: CORONAL & AXIAL I.V. CONTRAST: 100-140 ML MASS OR VISUAL DISTURBANCE 2 CC/SEC 65 SEC DELAY BREATH HOLD: NONE SLICE THICKNESS: 2-3 MM START LOCATION: CORONAL: SPH. SINUS, AXIAL: TOP OF MAX. SINUS END LOCATION: CORONAL: ANTERIOR GLOBE AXIAL:UPPER ORBITAL RIM FILMING: BONE & SOFT TISSUE www.indiandentalacademy.com
  70. 70. OPTIC NERVE PROTOCOL www.indiandentalacademy.com
  71. 71. PATIENT CAN’T ASSUME PRONE POSITION SUPINE-CORONAL www.indiandentalacademy.com
  72. 72. DENTAL ARTIFACT OMISSIONMULTIANGULATION www.indiandentalacademy.com
  73. 73. www.indiandentalacademy.com
  74. 74. FACIAL BONES SCOUT: LATERAL LANDMARK: IOML SLICE PLANE: CORONAL & AXIAL I.V. CONTRAST: 100-140 ML MASS 2 cc/sec 65 SEC DELAY SLICE THICKNESS: 2-3 MM START LOCATION: CORONAL: EAM AXIAL: S. MENTI END LOCATION: CORONAL: ANTERIOR GLOBE AXIAL: SUPERIOR ORBITAL MARGIN FILMING: BONE & SOFT TISSUE www.indiandentalacademy.com DFOV 20 CM
  75. 75. FACIAL BONES INCLUDE MANDIBLE!!!!!! www.indiandentalacademy.com
  76. 76. PNS SCOUT: LATERAL LANDMARK: OML DFOV 15 CM SLICE PLANE: CORONAL & AXIAL I.V. CONTRAST: 100-140 ML MASS 2 cc/sec 65 SEC DELAY BREATH HOLD: NONE SLICE THICKNESS: 3 - 5 MM START LOCATION: CORONAL: BEHIND SPHENOID SINUS AXIAL: BOTTOM OF MAX. SINUS END LOCATION: CORONAL: THROUGH FRONTAL SINUS AXIAL: THROUGH FRONTAL SINUS FILMING: BONE & SOFT TISSUE www.indiandentalacademy.com
  77. 77. TMJ SCOUT: LATERAL LANDMARK: OML SLICE PLANE: CORONAL & AXIAL I.V. CONTRAST: NONE BREATH HOLD: NONE SLICE THICKNESS: 1 - 2 MM START LOCATION: CORONAL: POSTERIOR TO JOINT AXIAL: POSTERIOR TO JOINT END LOCATION: CORONAL: THROUGH THE ENTIRE JOINT AXIAL: THROUGH THE ENTIRE JOINT FILMING: BONE & SOFT TISSUE www.indiandentalacademy.com
  78. 78. SCANNED DFOV 20 CM RECON: R & L SIDE DFOV 10 CM www.indiandentalacademy.com
  79. 79. DENTAL www.indiandentalacademy.com
  80. 80. STEREOTACTIC www.indiandentalacademy.com
  81. 81. www.indiandentalacademy.com
  82. 82. www.indiandentalacademy.com
  83. 83. www.indiandentalacademy.com
  84. 84. Stereotactic system use • • • • Biopsy of intracranial lesions Aspiration of cysts Laser microsurgery Aspiration of brain abcess www.indiandentalacademy.com
  85. 85. Thank you www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com

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