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Miscellaneous > Intro to Imaging > Flashcards

Intro to Imaging Flashcards

1
Q

XRays

  • How they pass through tissue
  • How they create an image
A

-Depends on energy of Xray & density of tissue; higher density is more likely to absorb Xray

  • Xrays that pass completely through to film = dark spaces –> air
  • Xrays that are blocked & don’t reach the film = white –> metal
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2
Q

5 Basic Radiographic Densities

A 
Air
Fat
Fluid/soft tissue
Bone/mineral
Metal
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3
Q

CT Scan

  • Mechanism
  • Images
  • Contrast dye
  • Uses
A
  • 64 multi-slice CT can produce images quickly
  • Each rotation of the scanner provides a picture of a thin slice of the organ or area “cuts”; saved as a group
  • Contrast dye may be utilized to enhance visualization; PO, IV, rectally e.g P.E
  • CT fluoroscopy can be used to guide a Bx needle or other instrument; used carefully d/t significant radiation
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4
Q

Head CT scan indications

A 
Tumors
Intracranial bleeds
Edema
Skull fx
Vasculature
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5
Q

Spine CT indications

A
  • Cervical, thoracic, lumbar fx (intrarticular fx): can leave spinal collar on
  • Compression fx
  • Dislocation
  • Tumors
  • Abscesses
  • Cysts
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6
Q

Chest CT indications

A 
Lung Ca
P.E
Aneurysm (aortic)
Spread of Ca (METs to lymph nodes)
May/not require contrast
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7
Q

Abdominal CT indications

A 
Cysts/ Abscesses
Infection
Tumors
Aneurysm (AAA)
Enlarged lymph nodes
Foreign objects
Bleeding
Diverticulitis
IBD
Appendicitis (usually seen 1st w/ U/S)
Obstruction
Kidney stones (don't need contrast; can measure)
Pancreatitis
Spleen
Gallbladder, bile ducts (only if U/S unavail)
Adrenals
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8
Q

Pelvic CT indications

A

Usually always ordered in combo w/ abdominal CT
Uterus, ovaries (cysts), fallopian tubes
Prostate gland, seminal vesicles
Arteries, veins

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9
Q

Extremity CT Indications

A 
Fx (non-union type)
Joint effusion
Tumors
Dislocation
Cysts/ abscesses
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10
Q

CT Angiography

  • Images
  • ID points
  • Method
  • Risks
A
  • 2D, 3D pictures of vessels & organs
  • IDs obstruction, embolism, thrombosis, dissection, CAD, vessel stenosis, AV malformation
  • Done by injecting radiopaque dye IV: usually accessed via femoral artery to look at arteries and/or jugular vein to look at veins
  • Risks: allergic rxn (dye), stroke, thrombosis/ embolism, cardiac arrhythmias, kidney damage (dye), hypoTN, pericardial effusion; C/I for people w/ kidney damage (Cr > 1.8) for people w/ dye allergy
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11
Q

Mammography

  • Use
  • Limitations
A
  • Diagnostic/ screening tool to examine breast

- 7 % false (+) rate; called back for further testing: cone down views

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12
Q

Nuclear Medicine Scanning

  • Method
  • Uses
  • Examples
A
  • Small amount of low level radioactive material to produce imagines not well-seen with standard Xrays: via injection or drinking solution several hrs or 1 day before scan
  • Tumors, infections, fx, organ function
  • Whole body scan: bone-related pathologies i.e. stress fx, lesions, infections, METs
  • Myocardial perfusion scan: non-invasive evaluation of CAD (overall risk for an event)
  • Hepatobiliary scan: for gallbladder dz
  • VQ scan: for P.E. (CT angiography preferred)
  • Thyroid scan: usine iodine to eval hyperthyroidism
  • Parathyroid scan: for adenomas
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13
Q

SPECT

  • Method
  • Uses
A
  • Nuclear imaging: radioactive substance + camera that creates 3D pictures
  • Assists in analyzing fxn of internal organs: monitoring brain DOs (dementia, seizures, vascular blockages, encephalitis), CV dz, bone DOs (healing), cancer progression
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14
Q

PET Scan

  • Method
  • Uses: most helpful
A
  • Uses small amts of radioactive material; nuclear med
  • Used to diagnose or treat many dz incl CANCERS, CV dz, G.I, endocrine, neurological DOs
  • Can pinpoint molecular activity w/in body to ID dz in early stages, determine response of pts to interventions: monitoring tumors (esp pulmonary)
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15
Q

Ultrasound

  • Method
  • Benefits
  • Imaging of choice
A
  • High freq. sound waves to visualize soft tissue: muscle, blood vessels, internal organs
  • No radiation, can be done bedsite (starting a central line, PICC line; fluid evaluation)
  • Test of choice for: gallbladder dz, DVT, soft tissue FBs & cysts, hemoperitoneum, pericardial tamponade, cardiac valve/pump fxn, fetal development, uterine/ovarian dz, arterial blood flow (femoral, subclavian), breast cysts
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16
Q

MRI

  • Method
  • Common uses

-NOTHING METALLIC CAN BE IMAGED

A
  • Magnetic field pulses to develop pictures or organs/ structures: NO RADIATION; takes longer
  • Common in orthopedics for tendon, ligament, meniscus, muscle injury; evaluating arthritis, tumors, stress rxns, stress fx/ infection in bones; CAN be used in pregnancy
  • In spine: disc dz, nerve impingement, stenosis, abscesses/tumors
  • Aneurysm, cerebral hemorrhage, nerve injury; damage d/t stroke
  • Used with contrast to ID obstruction in blood flow through vessels, dissection, aneurysm, AV malformation (MRA)
  • Tumors of breast, lung, abd, ovaries/uterus
17
Q

Fluoroscopy

  • Method
  • Risk
  • Uses
A
  • Uses Xray to obtain REAL TIME images of internal structures (can move limb around)
  • Biggest risk = radiation exposure
  • Barium enemas/ swallow tests, orthopedic surgery (fx fixation/ reduction) angiography, feeding tube placement, pacemaker/defibrillator/resynchronization device implantation
18
Q

Radiation Dosage, effect

  • Highest risk modalities
  • Consequences
A
  • CT scan & upper G.I. barium swallow with SBF = 2 biggest doses of radiation
  • 5 CT studies of head, neck, chest, abdomen across pt’s lifetime exposes pt to ~50mSv = associated increased cancer risk; dosing is cumulative
  • 1,000-10,000 mSv: radiation sickness –> death
19
Q

Contrast

  • Function
  • Routes
  • Uses
  • Risks, reactions
A

-Produces bright white outline of structure
-IV or PO
-Barium Sulfate: oral/ rectal contrast for tract imaging
-IV contrast (usually iodinated):
Angiography/Venography; urography, visualizing changes in tissue on CXR, CT, MRI
-Risk of severe reactions: C/I for pts w/ shellfish allergy; MC for IV contrast; RENAL FAILURE can be exacerbated, BUN/CRT w/ calculated CrCl is needed before contrast can be given!!
-Reaction types: laryngeal edema (stridor) anaphylaxis, severe hypotension, cardiac arrest; transient renal failure

20
Q

Ordering Tests

  • Tips
  • Appropriateness Criteria
A
  • Know what you’re looking for before ordering it; if it won’t change your plan, don’t order it!!
  • American College of Radiology provides evidence-based guidelines for appropriate imaging tests for each circumstance
  • Call radiologist for guidance PRN
21
Q

Extremity Fxs

  • 7 involving diaphysis
  • 4 involving epiphysis
A
  • Transverse
  • Oblique
  • Spiral
  • Comminuted (>2 pieces, irregularly-shaped)
  • Segmental (>2 pieces, similarly-shaped sections)
  • Torus (cortex didn’t allow fx to break through – kids)
  • Greenstick (only one cortex is broken)
Avulsed
Impacted
Displaced
Angulated
Rotated -- should be described in relation to proximal portion of bone
22
Q

Hip Fractures

  • 2-4 parts
  • 6 major types
A
  • Subcapital neck fx: just underneath head
  • Transcervical neck fx: right through surgical neck
  • Intertrochanteric fx: right through both trochanters
  • Subtrochanteric fx: below both
  • Greater trochanteric fx
  • Lesser trochanteric fx – evulsion (tx as tolerated)
23
Q

Proximal Tibial Fractures

-6 major types

A
  • Type I (wedge/ split) easiest to fix using screws
  • Type II: split depression
  • Type III: central depression (screws, plates etc.)
  • Type IV: medial condyle (comminuted)
  • Type V: biocondyler
  • Type VI: biocondylar with shaft involvement
24
Q

Pediatric Fractures

-SUDAC and Types I-V

A

-Shifted (tender at growth plate) = type I
Up (above plate) = II
Down (below plate) = III
Across (both above and below plate) = IV
Compressed (plate obliterated) = V

Miscellaneous (6 decks)

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