Advanced imaging Flashcards
What are the two types of advanced imaging?
Computer tomography
Magnetic resonance imaging
Which spinal problems would you use CT?
Spinal trauma
bone tumours
Which spinal problems would you use MRI?
Method of choice for all other spinal problems that don’t include bone
What are the limitations of radiography in spinal imaging?
Superimposition of structures 2D image of 3D objects lack of soft tissue visualisation Myelography often necessary (Time-consuming, risk seizures, neurological deterioration)
When is radiography recommended in spinal problems?
Routine radiography may be recommended as you may not need advanced imagery
What spinal problems can radiography highlight?
Spinal fractures and luxations congenital malformations neoplasm infection discospondylitis at an advanced stage Degenerative disc disease and secondary discal herniation will require further imaging
What does myelography do and how is it achieved?
Injection of non-ionic water soluble iodinated contrast medial into the subarachnoid space
Outlines the path of the spinal cord
injection can be cisternal or lumbar
What can be classified with the use of myelography?
Spinal lesions
Extradural or intradural
Extramedullary or intramedullary
Leaves black patch on the image
What is computer tomography?
X-ray based cross-sectional technique
Patient placed on a table inside a ring containing the x-ray tube and some detectors
An x-ray source rotates around the patient.
Information is re-constructed slices/cross-sectional images of the patient
Data displayed in shades of grey
Myelography (Idionated contrast) can be used intravenoulsy for better delineation of some lesions)
What are the advantages of CT?
Slightly better soft tissue contrast Cross-sectional imaging (Small details, laterilisation of lesions) Reconstructs in different windows Reconstructs in 2D and 3D images Good spatial resolution Sedation or GA
What are the disadvantages of CT?
Sometimes require myelography ( to assess intradural or intramedullary lesions)
Expensive
uses ionising radiation
What is MRI and how does it work?
Magnetic resonance imaging
Based on magnetic field and radiowaves
(Patient placed in a strong magnetic field, coil emits and received radiowaves)
Cross-sectional imaging
What is CT useful at analysing?
Spinal trauma neoplaisa intervertebral disc disease Degenerative discs become mineralised Right versus left herniation can be determined Discospondylitis
What are the advantaged of MRI?
Superior soft tissue contrast
no ionising radiation
fluid can be differentiated from muscles, spinal cord and brain
Ideal for CNS imagery
What contrasting agent may be used with MRI?
Intravenous injection of gadolinium-based contrast
