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DPD 2020 > Introduction to radiology > Flashcards

Introduction to radiology Flashcards

1
Q

What is attenuation in x-rays?

A

Absorption of x-ray photons before hitting x-ray plate.

Bone = high attenuation = white.

Soft tissues = intermediate attenuation = shades of grey.

Lungs/air = low attenuation = black.

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2
Q

What is the silhouette sign?

A

Different tissues absorb different amounts of x-ray.

If vessels can’t be seen, or diaphragm, or heart, then something is going on in the lungs- this is the silhouette sign

White lungs

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3
Q

What is CT?

A

Rotation of x-ray tube and bank of detectors (not film) around patient.

Attenuation information directly entered into computer.

Multislice CT is quicker, modern version, can map anatomy really well.

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4
Q

CXR vs CT? Pros and cons

Spatial resolution

Contrast resolution

Anatomical superposition

Radiation dose

A

Spatial resolution is better in CXR than CT. [ability to define separate structures]

Contrast resolution is much better in CT than in CXR.

Anatomical superimposition is a big part of x-ray, but absent in CT so CT better for diagnosis.

Dose of ionising radiation is 100x higher in CT head than CXR, CT chest is 470x higher than CXR, CT whole spine is 715x higher than CXR.

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5
Q

At what dose of radiation do you begin to see changes in blood cells?

A

100mSv.

Remember cumulative dose- each scan adds up

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6
Q

What is the dose of radiation of a chest x-ray?

A

0.014mSv.

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7
Q

What is the dose of radiation of a CT head?

A

1.4mSv. [100 x CXR]

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8
Q

What is the dose of radiation of a CT chest?

A

6.6mSv. [470 x CXR]

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9
Q

What is the dose of radiation of a CT whole spine?

A

10mSv. [700 x CXR]

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10
Q

What is the annual dose of radiation from living in the UK?

A

2.7mSv.

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11
Q

What is the annual dose of radiation from living in the US?

A

6.2mSv.

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12
Q

What is the annual dose of radiation from living in Cornwall?

A

6.9mSv- higher than other areas of UK

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13
Q

What is the dose of radiation from a transatlantic flight?

A

0.08mSv.

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14
Q

What is the dose of radiation from eating 100g Brazil nuts?

A

0.01mSv.

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15
Q

List basic signs in chest imaging

A

Consolidation.

Ground-glass opacification.

Reticulation.

Honeycombing.

Nodules.

Pulmonary air cysts.

Traction bronchiectasis.

Traction bronchiolectasis.

Cysts.

Halo sign.

Reverse halo.

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16
Q

What is consolidation on chest imaging?

What are the causes?

A

Areas of increased density/attenuation

Air displaced from airspaces, replacement by fluid/cells.

Ill-defined/ fluffy shadowing.

Confluent.

Loss of vessel pattern.

Air-bronchograms.

Causes:

Infection/inflammation- pneumonia

tumour (lung cancer, lymphoma)

pulmonary oedema

haemorrhage

aspiration

ARDS

17
Q

What is the ground glass opacification sign on chest imaging?

What are the causes?

A

Partial displacement of air from lungs.

Increased density- doesn’t obscure airways on CT [lack of obstruction of bronchioles not noticed on CXR]

Causes:

Airspace (haemorrhage)

Interstitial (hypersensitivity pneumonitis)

Both (RBILD).

18
Q

A chest x-ray report describes ‘consolidation in the right lower lobe’. This means:

a) there is infection in the right lower lobe
b) the most likely diagnosis is lung cancer
c) there is blood in the airspaces
d) air has been displaced from the right lower lobe
e) the most likely diagnosis is tuberculosis

A

Air has been displaced from the right lower lobe.

19
Q

The radiation dose from a CT chest is:

a) significantly higher than from a chest x-ray
b) significantly lower than form a chest x-ray
c) nearly 500x the dose of a chest x-ray
d) equivalent to the dose from a thoracic MRI examination
e) nearly 700x the dose from a chest x-ray

A

Significantly higher than from a chest x-ray. Nearly 500x the dose of a chest x-ray.

20
Q

Types of radiology

A

Interventional

Non interventional

21
Q

What part of the heart is seen on right side of CXR?

A

Right atrium

22
Q

What part of the heart is seen on left side of CXR?

A

Left ventricle

23
Q

What is this?

A

Azygous vein draining into SCV

24
Q

What sign can be seen during mediastinal lymph node enlargement?

A

Loss of Azygo-oesophageal line

Suggests tumour spread

25
Q

What does consolidation at horizonal fissure indicate?

A

Consolidation of right upper lobe

26
Q

When is a circular consolidation in the lungs a nodule or mass?

A

Nodule <3cm

Mass >3cm

27
Q

What is this?

A

Spiculated nodule

Primary lung cancer

NOT normal part of hilum

28
Q

How are black areas of lung described? What are the causes?

A

Increased lucency/transradiancy

Causes: pneumothorax, bullae, emphysema

29
Q

Features of pleural effusion?

A

Meniscus

Ill defined {and decreasing attenuation of ] superior margin

30
Q

What causes white out and how to differentiate?

A

Collapse- trachea towards, rib crowding[closer together]

Pleural effusion= trachea away

31
Q

What is this?

A

Cannonball lung mets

DPD 2020 (48 decks)

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