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► Med - Radiology > Ch.11 - CT: Understanding the Basics and Recognizing Normal Anatomy > Flashcards

Ch.11 - CT: Understanding the Basics and Recognizing Normal Anatomy Flashcards

1
Q

CT - Chest - IV contrast usually NOT used:

A
  1. Evaluation of diffuse infiltrative lung diseases using HRCT.
  2. Confirmation of the presence of a nodule suspected from conventional radiographs.
  3. Detect pneumothorax/pneumomediastinum.
  4. Calcium scoring for the coronary arteries.
  5. Known allergies to contrast or renal failure.
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2
Q

CT - Abdomen - IV contrast used:

A
  1. Evaluate for the presence of and/or to characterize a mass and to stage or follow up malignancies.
  2. Trauma.
  3. Abdominal pain (eg appendicitis).
  4. Detect aortic aneurysm or dissection.
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3
Q

CT - Abdomen - IV contrast usually NOT used:

A
  1. Virtual colonoscopy.

2. Search for a ureteral calculus.

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4
Q

CT - When ORAL CONTRAST is used:

A
  1. Most cases of NON traumatic abdominal pain.
  2. IBD.
  3. Abdominal or pelvic abscess.
  4. Locate the site of bowel perforation, including fistulae.
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5
Q

Imaging of abdomen/pelvis - Conventional radiography - Uses:

A

Primarily used for screening in abdominal pain.

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6
Q

Imaging of abdomen/pelvis - Conventional radiography - Advantages:

A
  1. Availability.
  2. Cost.
  3. Patients tolerate procedure well.
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7
Q

Imaging of abdomen/pelvis - Conventional radiography - Disadvantages:

A
  1. Lower sensitivities.

2. Ionizing radiation.

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8
Q

Imaging of abdomen/pelvis - US - Uses:

A
  1. Primary imaging mode for gallbladder and biliary tree.
  2. Screening for aortic aneurysm.
  3. Identification of vascular abnormalities and flow.
  4. Detection of ascites.
  5. Primary imaging mode for the female pelvis.
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9
Q

Imaging of abdomen/pelvis - US - Advantages:

A
  1. Availability.
  2. Cost.
  3. No ionizing radiation.
  4. Patients tolerate procedure well.
  5. Portable.
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10
Q

Imaging of the abdomen/pelvis - US - Disadvantages:

A
  1. Operator dependent.

2. More difficult to interpret.

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11
Q

Imaging of the abdomen/pelvis - CT - Uses:

A

Diagnostic modality of choice for most abdominal abnormalities, including trauma.

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12
Q

Imaging of the abdomen/pelvis - CT - Advantages:

A
  1. Availability.
  2. Cost.
  3. High spatial resolution and image reconstruction.
  4. Evaluates multiple organs systems simultaneously.
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13
Q

Imaging of the abdomen/pelvis - CT - Disadvantages:

A
  1. Ionizing radiation.
  2. Contrast reactions.
  3. Inability to use IV contrast in renal insufficiency.
  4. Patient weight and size may exclude scanning.
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14
Q

Imaging of the abdomen/pelvis - MRI - Uses:

A
  1. Problem solving for difficult diagnoses.
  2. Extension of known disease into surrounding soft tissues (staging).
  3. Vascular anatomy.
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15
Q

Imaging of the abdomen/pelvis - MRI - Advantages:

A
  1. Soft tissue contrast.
  2. No ionizing radiation.
  3. No iodinated contrast.
  4. Image reconstruction.
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16
Q

Imaging of the abdomen/pelvis - MRI - Disadvantages:

A
  1. Cost.
  2. Availability.
  3. Longer scan times.
  4. Claustrophobia.
  5. Monitoring issues in acutely ill patients.
  6. Patient weight and size may degrade or exclude scanning.
  7. Incompatible with aneurysm clips, pacemakers, etc.
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17
Q

By convention, air is assigned a Hounsfield number of?

A

-1.000.

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18
Q

Bone is assigned a Hounsfield number of?

A

400-600.

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19
Q

Fat is?

A

-40 to -100.

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20
Q

Water is?

A

0.

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21
Q

Soft tissue is?

A

20-100.

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22
Q

IV contrast materials available today are?

A

Non ionic + Low osmolar solutions –> High in IODINE –> Opacify the tissues with high blood flow.

23
Q

Mild side effects of iodinated contrast agents?

A
  1. Feeling of warmth.
  2. Nausea.
  3. Vomiting.
  4. Local irritation at the site of injection.
  5. Itching.
  6. Hives.
    Usually require NO TREATMENT.
24
Q

In about …-…% of ALL PATIENTS, severe and idiosyncratic reactions to contrast can occur that can produce intense bronchospasm, laryngeal edema, circulatory collapse, and very rarely, death.

A

0.01-0.04%.

25
Q

What is the probability to die from a contrast agent?

A

1/200.000 to 1/300.000.

26
Q

Chest CT - IV contrast used (7):

A
  1. CTPA.
  2. Evaluation of the mediastinum or hila for mass or adenopathy.
  3. Detect aortic aneurysm or dissection.
  4. Evaluate blunt or penetrating trauma.
  5. Characterize pleural disease (metastases, empyema).
  6. CT densitometry of pulm. masses.
  7. Evaluate the coronary arteries.
27
Q

Chest CT - IV contrast usually NOT USED (5):

A
  1. Evaluation of diffuse infiltrative lung diseases using HRCT.
  2. Confirmation of the presence of a nodule suspected from conventional radiographs.
  3. Detect pneumothorax/pneumomediastinum.
  4. Calcium scoring for the coronary arteries.
  5. Known allergies to contrast or renal failure.
28
Q

Abdomen and pelvis CT - IV contrast used (4):

A
  1. Evaluate for the presence of and/or to characterize a mass and to stage of follow up malignancies.
  2. Trauma.
  3. Abdominal pain (appendicitis).
  4. Aortic aneurysm/dissection.
29
Q

Abdomen and pelvis CT - IV contrast NOT USED (2):

A
  1. Virtual colonoscopy.

2. Search for a ureteral calculus.

30
Q

When ORAL contrast is used?

A
  1. Most cases of NON TRAUMATIC abdominal pain.
  2. IBD.
  3. Abdominal or pelvic ABSESS.
  4. Bowel PERFORATION + FISTULAE.
31
Q

Which are the 7 key levels to study every chest CT?

A
  1. 5-vessel level.
  2. Aortic arch level.
  3. Aortopulmonary window level.
  4. Main pulmonary artery level.
  5. High cardiac level.
  6. Low cardiac level.
  7. The fissures.
32
Q

5-vessel level - At this level, you should be able to identify?

A
  1. Lungs.
  2. Trachea.
  3. Esophagus.
33
Q

5-vessel level - Blood vessels?

A

The VENOUS structures tend to be more ANTERIOR than the arterial.

34
Q

5-vessel level - The brachiocephalic veins lie?

A

Just POSTERIOR to the sternum.

35
Q

5-vessel level - From the patient’s R–>L, the visible arteries may include?

A
  1. The innominate artery.
  2. Left common carotid.
  3. Left subclavian arteries.
36
Q

Aortic arch level - At this level you should be able to identify?

A
  1. SVC.
  2. Aortic arch.
  3. Azygos.
37
Q

Aortic arch level - To the … of the trachea will be the SVC.

A

TRACHEA.

38
Q

Aortopulmonary window level - You should be able to identify?

A
  1. Ascending/Descending aorta.
  2. SVC.
  3. Uppermost aspect of the LEFT PULMONARY ARTERY.
39
Q

What do we call the aortopulmonary window?

A

In most people, there is a space visible just underneath the arch of the aorta but above the pulmonary artery –> The aortopulmonary window.

40
Q

Why is the aortopulmonary window an important landmark?

A

Because it is a favorite location for ENLARGED LYMPH NODE TO APPEAR.

41
Q

Main pulmonary artery level - You should be able to identify?

A
  1. The main + right + left pulmonary arteries.
  2. R+L bronchi.
  3. Bronchus intermedius.
42
Q

Main pulmonary artery level - The left pulmonary artery …?

A

Is HIGHER than the RIGHT and appears as if it were a continuation of the main pulmonary artery.

43
Q

Main pulmonary artery level - The right pulmonary artery …?

A

Originates at a 90 degrees angle to the main pulmonary artery + crosses to the right side.

44
Q

Main pulmonary artery level - The right main bronchus …?

A

Will appear as a circular, air-containing structure –> Will become TUBULAR as the right UPPER lobe bronchus comes into view.

45
Q

Main pulmonary artery level - There should be nothing but … posterior to the bronchus intermedius.

A

Lung tissue.

46
Q

Main pulmonary artery level - The left main bronchus …?

A

Will appear as an air-containing circular structure on the left.

47
Q

High cardiac level - At this level you should be able to identify:

A
  1. LA.
  2. RA.
  3. Aortic root.
  4. RV outflow tract.
48
Q

The normal relationship between the pulmonic and aortic valves can be remembered by the acronym “PALS”?

A

Pulmonic valve Anterior Lateral, and Superior to the aortic valve.

49
Q

Low cardiac level - At this level you should be able to identify:

A
  1. RA.
  2. RV.
  3. LV.
  4. Pericardium.
  5. Interventricular septum.
50
Q

What is the so-called triple scan?

A

For patients who present with ACUTE CHEST PAIN –> Ultra-fast CT for simultaneous evaluation of:

  1. CAD.
  2. Aortic dissection.
  3. Pulm. thromboembolic disease.
51
Q

Liver and spleen in abdominal CT?

A

The LIVER should always be DENSER than or EQUAL to the density of the spleen on non contrast scans.

52
Q

On early contrast-enhanced scans, the spleen may be …?

A

Inhomogenous in its attenuation –> Should disappear over the course of the next several minutes.

53
Q

Vicarious excretion of contrast?

A

If the kidneys are NOT functioning properly, contrast is excreted through alternative pathways (bile, bowel) –> Vicarious excretion.

54
Q

CT - Chest - IV contrast used:

A
  1. CTPA.
  2. Evaluation of the mediastinum or hila for mass or adenopathy.
  3. Detect aortic aneurysm or dissection.
  4. Evaluate blunt or penetrating trauma.
  5. Characterize pleural disease –> Metastases, empyema.
  6. CT densitometry of pulm. masses.
  7. Evaluate coronary arteries.

► Med - Radiology (31 decks)

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