Imaging MT

Question 1

Which modality is best for ovarian mass?

Answer 1

Ultrasound because quick, cost effective, high resolution, time resolution.
Next step- CT scan for metastasis
MRI- character of spread

Question 2

Which is best modality for initial assessment?

Answer 2

Antenatal- Non invasive, quick, see foetal heartbeat and measure lengths.
Ultrasound then MRI for problems

Fluid accumulation looks same density

Question 3

Modality for assessment of paediatric brain?

Answer 3

Ultrasound baby’s brain- because fontanelles haven’t fused so can scan
CT scan if child’s fallen, MRI- children will be moving, but non-ionising radiation. Only used for non-acute

Question 4

Modality for renal calculi?

Answer 4

Kidney calcului- posterior attenuation dark (shadow) because of kidney stone (white) ultrasound for stone
Dilation renal pelvis problems for X-ray
Perinephric fat stranding-oedema within fat around kidneys- would use CT

Question 5

Modality for gall stones?

Answer 5

Gallstones- acoustic shadows, ultrasound calcified object will have shadows
ERCP-fluoroscopic study- removing gallstone
Black air in gallbladder, quite indistinct and oedema around gallbladder- choleocystitis
MRCP- before ERCP, noninvasive high resolution, tell where gallstones are.
Ultrasound, then MRCP and ERCP otherwise surgeons just take out gallbladder

Question 6

Modality for back pain?

Answer 6

Back pain Fracture: CT then MRI. Don’t do X-ray, because too much shadowing
Any neurology then MRI i.e cancer, soft tissue impinging, TB

Question 7

Modality for suspected fracture?

Answer 7

Scaphoid fracture, Base of thumb hurts.
Not always visible on X-ray, hence MRI, can see oedema and sharp cut off
CT used for operative planning, where to put pins

Question 8

Advantages and disadvantages of X-ray?

Answer 8

X-ray: quick and cheap, non invasive, live studies fluoroscopy
Radiation(low dose), resolution, composite shadowing

Question 9

Advantages and Disadvantages of CT?

Answer 9

CT: Very quick, cheap, contrast for bleeding, fluid, anatomical structures
High radiation dose, distorted images if moving individual

Question 10

Advantages and Disadvantages of MRI?

Answer 10

MRI: soft tissue radiation, functional, contrast

Getting to stay still, long, expensive (needs to be kept cold), not good for bones

Question 11

Ultrasound Advantages and Disadvantages?

Answer 11

USS: Relatively high resolution, fast, cheap, live test at bedside and contrast
User dependent, in high BMI people hard to get pictures, not good if bone in front