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DIAGNOSTIC IMAGING > Final 1 > Flashcards

Final 1 Flashcards

1
Q

List 10 indicators for when to order diagnostic imaging.

A
  1. Trauma
  2. Unexplained weight loss
  3. Hx of malignancy
  4. Night pains
  5. Inflammation or arthritis
  6. Nero-motor problem
  7. Fever of unknown origin (FUO)
  8. Failure to respond to therapy
  9. Deformity
  10. Abnormal blood findings
  11. Medico-legal implications (must take imaging before surgery)
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2
Q

What is conventional tomography?

Is it used much?

A

NOT a CT;
It is a type of tomography that moving X-rays images around the body allows for focal clarity.

Not widely used

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3
Q

What is the difference in appearance between a plain x-ray and conventional tomography?

A

Plain X-ray does not show bone destruction on a small scale.

Conventional tomography can be seen in axial slices from the moving camera and film.

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4
Q

Which imaging plane is commonly used in computed tomography (CT)? Can more than one imaging plane be demonstrated with CT?

A

Axial

Yes; however the resolution is then decreased

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5
Q

What is the difference between CT soft tissue and bone window?

A

Soft Window better visualization of soft tissues.

Bone Window better visualization of the fine details of the osseous structures.

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6
Q

What is the appearance of bone in a soft tissue window?

A

Bone appears white or light grey

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7
Q

What is the appearance of bone in a bone window?

A

cortex being light/white and the medullary being semitransparent.

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8
Q

Does CT utilize the theory of attenuation (absorption of x-rays)?

A

Yes

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9
Q

Which is more sensitive in the differentiation of tissue densities, CT or plain X-ray?

A

CT, because it can image the soft tissues contrast.

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10
Q

What is the appearance of fat on CT vs. MRI?

A

CT fat is black, similar to air

MRI T1-> fat is white
MRI T-2-> fat is dark/grey

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11
Q

By what routes can CT contrast material be administered?

A
  1. Orally-> GI contrast (Barium)
  2. IV-> organs outside GI
  3. Rectally-> GI
  4. Myelographically in subarachnoid space-> spinal cord & brain (CNS)
  5. Intra-articular->Joint space
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12
Q

How does MRI acquire images?

A

hydrogen ions;

This released energy is what captures the image or difference in densities that portray an image that we see.

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13
Q

What does a T1 weighted MRI image look like compared to a T2 weighted image? What structures are high signal (white) vs. low signal (dark) on each weighting?

A

T1=> fat appears white bc=>fat sensitive weighted imaging.
*CNS fluid appears darker.

T2=> fluid appears light/white bc this is a water weighted imaging.
*Fat will appear darker/grey

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14
Q

Which modality would best demonstrate dehydration (desiccation) of the nucleus pulposis, CT or MRI?

A

MRI T2 imaging because it is a water weighted imaging.

If dehydration=> lack of water would appear dark.

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15
Q

Which modality would best demonstrate an intervertebral disc herniation, CT or MRI?

A

(MRI) T2 imaging, bc gelatinous fluid in disc is 80% water.

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16
Q

What is the contrast called that is sometimes used with MRI and why is it used?

A

Gadolinium=> Infections, tumors soft tissues and vasculature

17
Q

Where is the contrast material placed in myelography?

A

subarachnoid space

18
Q

What modality besides plain film radiography is myelography often used with?

A

CT=> b4 a surgery

19
Q

When is myelography utilized?

A

Pre-surgery or when an MRI or CT is not available or contraindicated.

Also in examining lesions, disc herniation, tumors, osteophytes and inflammation.

20
Q

What is a “hot spot” in bone scan?

A

Bone destruction, bright white spot or hot spot on the bone scan.

21
Q

When might SPECT scan be useful?

A

For localizing a lesion and/or confirming a fracture in the pars interarticularis.

22
Q

When might PET scan be useful?

A

Accessing treatment success or tumor localization,

23
Q

When might discography be useful?

A

To document a specific disc lesion or pain and to access disc integrity

24
Q

When might diagnostic ultrasound be useful?

A
  1. Thyroid gland
  2. Heart
  3. Gallbladder/gallstones
  4. Kidney/kidney stones
  5. Pregnancies/fetus
  6. Observe scrotum and prostate
  7. Evaluate blood flow
  8. Help Dx CA or infection
  9. Guide needles for aspirating tumor biopsy or for treatment
25
Q

Which modality would be most appropriate to evaluate an intervertebral disc protrusion?

A

MRI because you can use T2 weighted

26
Q

Which modality would be most appropriate to evaluate a stress fracture?

A

Bone scan

27
Q

Which modality would be most appropriate to confirm or rule out an occult fracture or questionable fracture initially discovered on plain x-ray?

A

Normally a bone scan would be best; however, the X-ray is able to see the fracture so an MRI T1 weighted

28
Q

Which modality would be most appropriate to evaluate avascular necrosis?

A

MRI T2-absence of blood (water)

If appears black => Necrosis.

29
Q

Which modality would be most appropriate to evaluate most chest and abdomen pathologies?

A

CT because it is quick and the patient can hold their breath

30
Q

What are the relative radiation doses for each imaging modality discussed?

A
  1. MRI has no ionizing radiation
  2. Ultrasound no ionizing radiation
  3. X-ray- less than what you get in air travel
  4. SPECT- similar to that which is experience in environment in 1 year time period.
  5. Bone Scan ionizing radiation that is highest in bladder
  6. PET scan ionizing radiation
  7. Pyelography small dose of ionizing radiation, but is also used with CT
  8. CT uses ionizing radiation, but is kept low
  9. Discography uses low dose fluoroscopy and used in conjunction with X-ray or CT
31
Q

Know your imaging planes (i.e. axial, coronal, sagittal).

A

Axial-middle of the body (Top & Bottom)
Coronal- front from back
Sagittal- right from left

32
Q

Which 2 modalities expose Pt’s to no radiation

A

MRI & Ultra Sound

33
Q

Which of these have lower radiation rates?

X-ray or Nuclear Medicine (PET,SPECT, Bone Scan)

A

X-ray

34
Q

Which modality has a relative radiation rate similar to which is experienced in environment in 1 yr?

A

SPECT

35
Q

Which modality has a relative radiation rate similar to which is experienced in air travel?

A

X-ray

36
Q

What is SPECT?

A

3-D pictures. SPECT scan produces images that show how your organs work.

37
Q

Myelography is used with which 2 Modalities?

A

CT & X-rays

38
Q

Myelography is used to examine what?

A

Pathologies of the Spinal Cord

  1. Spinal Cord injuries
  2. Cysts
  3. Tumors
  4. lesions
  5. disc herniation
  6. Inflammation
  7. osteophytes

DIAGNOSTIC IMAGING (7 decks)

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