DIAGNOSTIC IMAGING - Image Interpretation Flashcards

This deck will include revision on normal structures on radiographs as well as the steps for interpreting radiographs

1
Q

How would you describe the opacity of metal on a radiograph?

A

Brilliant white

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2
Q

How would you describe the opacity of bone on a radiograph?

A

White

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3
Q

How would you describe the opacity of soft tissue/fluid on a radiograph?

A

Soft gray

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4
Q

How would you describe the opacity of fat on a radiograph?

A

Dark gray

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5
Q

How would you describe the opacity of gas on a radiograph?

A

Black

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6
Q

Identify the anatomical structures on this normal lateral radiograph of the canine abdomen

A
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7
Q

Identify the anatomical structures on this normal lateral radiograph of the feline abdomen

A
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8
Q

Identify the anatomical structures on this normal ventrodorsal radiograph of the feline abdomen

A
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9
Q

How does the appearance of the stomach vary between right and left lateral recumbency?

A

When the patient in lying in right lateral recumbency, any gas in the stomach will rise to the fundus. However, in left lateral recumbency, any gas in the stomach will move to the pylorus

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10
Q

How can you tell the difference between a left and right lateral radiograph of the thorax?

A

The crura of the diaphragm appear to be running in parallel in the right lateral view of the thorax while the crura of the diaphragm appear to be diverging in the left lateral view of the thorax, forming a ‘y’ shape

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11
Q

How can you tell the difference between a ventrodorsal and dorsoventral radiograph of the thorax?

A

For ventrodorsal views of the thorax, the patient is in dorsal recumbency which causes the apex of the heart to fall away from the sternum resulting in the heart appearing longer and narrower. For dorsoventral views, the patient is in sternal recumbency so the heart remains in it’s normal position and therefore is more oval shaped

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12
Q

Identify the following features on this normal right lateral radiograph of the thorax

A
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13
Q

Identify the specific heart chambers on this normal ventrodorsal radiograph of the thorax

A
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14
Q

What size should a normal heart appear on a radiograph of a dog?

A

2/3 height of thorax
1/2-2/3 width of thorax
Take up 3-3.5 intercostal spaces

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15
Q

What size should a normal heart appear on a radiograph of a cat?

A

2/3 height of thorax
1/2-2/3 width of thorax
Take up 2-3 intercostal spaces

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16
Q

Identify the lungfields on this normal right lateral radiograph of the thorax

A
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17
Q

Identify the lungfields on this normal ventrodorsal radiograph of the thorax

A
18
Q

What are the three stages used to approach image interpretation?

A

Recognition
Report
Interpretation

19
Q

Describe the recognition stage of image interpretation

A

During the recognition step of image interpretation you should carry out a systematic seach of the entire image. You can do this through assessing each individual body system or through assessing the image area by area (i.e. left to right)

20
Q

Describe the report stage of image interpretation

A

During the report stage of image interpretation you should identify any abnormalities and describe them

21
Q

What are the seven Roentgen signs that can be used to guide your description of any abnormalities identified during the report stage of image interpretation?

A

Size
Shape/margin
Number (of normal stuctures, number of lesions)
Position/location
Opacity/echogenicity
Internal structure
Function

22
Q

Describe the interpretation stage of image interpretation

A

During the interpretation stage of image interpretation you should generate a structured list of differential diagnoses with any differentials that explain all of the abnormlaities identified ranked higher on the list

23
Q

Describe the pneumonic that can be used to help construct a differential diagnoses list

A

Vascular
Inflammation, Infection
Trauma
Anomaly (congeital)
Metabolic
Idiopathic, Iatrogenic
Neoplasia, Nutritional

Degenerative

24
Q

What are the six components that should be included on an imaging report?

A
  1. Patient and study details
  2. Image quality
  3. Description of image findings
  4. Summary or major abnormalities annd a differentials list
  5. Refined differentials list incorporating other factors (i.e. history, clinical exam, bloods)
  6. Plan further investigations to get a definitive diagnosis or treatment plan based on your findings
25
Q

What are the three most common errors in image interpretation?

A

Search errors
Judgement errors
Analysis errors

26
Q

What are some of the common search errors that you should be aware of for future clinical practice?

A
  • Interpreting the lesion as normal
  • Not assessing the entire image
  • Getting distracted by obvious lesions and terminating the search early
  • Not noticing the absence of a normal structure
27
Q

What are some of the common judgement errors that you should be aware of for future clinical practice?

A
  • Not considering appropriate differentials due to preconceived ideas as to what the diagnosis will be
  • Not reconsidering differentials when presented with new evidence
  • Not recognising breed/species variations
28
Q

What are some of the common analysis errors that you should be aware of for future clinical practice?

A

Generation of incorrect or incomplete differentials Inappropriate further investigations

29
Q

What are the three factors you should look at when assessing radiograph quality?

A
  1. Is the radiograph identified (owner and animal information), dated and labelled (L/R marker)?
  2. Are the exposure factors satisfactory (background, tissue contrast)?
  3. Are the animal and the machine positioned correctly?
30
Q

What are the two circuits of electricity required to take an X-ray?

A

Milliamperes (mA)
Kilovolts (kV)

31
Q

What is controlled by the milliamperes-seconds (mAs) settings in regards to the primary x-ray beam?

A

mAs settings determine the quantity of x-ray photons produced

32
Q

How does decreased milliamperes-seconds (mAs) impact the quality of a radiograph image?

A

Decreased mAs results in the radiograph having a pale background

33
Q

What indicates that the mAs settings are correct in radiography?

A

Background blackening outside of the collimation area indicates that there are enough photons being produced and thus the mAs settings are correct

34
Q

What is controlled by the kilovoltage (kV) settings in regards to the primary x-ray beam?

A

kV settings determine the energy of the x-ray photons as they leave the x-ray tube and thus determine the penetration of the x-ray photons

35
Q

How does increased kilovoltage (kV) impact the quality of a radiograph image?

A

Increased kilovoltage (kV) causes the radiograph image to be overexposed

36
Q

How does decreased kilovoltage (kV) impact the quality of a radiograph image?

A

Decreased kilovolts (kV) decreases the contrast between the different tissue types on the radiograph

37
Q

What indicates that the kV settings are correct in radiography?

A

Contrast between the tissue types on a radiograph indicates that there is optimal photon penetration and thus the kV settings are correct

38
Q

How can the quality of a radiograph be affected when the area of interest is not in the centre of the x-ray beam?

A

This can cause geometric distortion

39
Q

How can the quality of a radiograph be affected when the animal is incorrectly positioned and the area of interest has been obscured?

A

This can mask lesions or can result in normal structures appearing abnormal

40
Q

How can the quality of a radiograph be affected by rotation of the animal?

A

This can result in normal structures appearing abnormal

41
Q

How can the quality of a radiograph be affected by a movement blur?

A

A movement blur can mask subtle lesions