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Radiology > OMR > Flashcards

OMR Flashcards

1
Q

What makes up an X-ray film?

A

Emulsion Base

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2
Q

What is the emulsion component of the x-ray film?

A

Consists of * Photon Sensitive Silver Halide Grains * Suspension vehicle

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3
Q

What is the X-ray sensitive part of the X-ray film?

A

Silver Halide Grains

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4
Q

What happens to the silver halide grains when x-rays hit them?

A

A conformation change occurs which will expose an image during development ** chemically altered

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5
Q

What is the base component of the X-ray film?

A

Plastic supporting material

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6
Q

When the silver halide is chemically altered it creates a ____ _______.

A

Latent image

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7
Q

What makes up a film packet?

A

Lead foil backing (only on back side) Paper wrap Dental Film

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8
Q

What is the purpose of the lead foil backing?

A

To absorb stray x-rays

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9
Q

The bump on the film must always be pointing: away or towards the source of radiation?

A

Towards

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10
Q

The bump on the film should be orientated apically or coronally?

A

Coronally

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11
Q

The bump on the packet should be oriented: away or towards the source of radiation?

A

Away - this is the side o the film packet that has the lead foil

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12
Q

If the lead foil is oriented towards the source of radiation what can happen on the film?

A

The film will have crinkly pattern from the lead foil when developed

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13
Q

Size 0

A

Pedo

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14
Q

Size 1

A

Adult anterior

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15
Q

Size 2

A

Adult posterior

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16
Q

Size 3

A

Long posterior

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17
Q

Size 4

A

occlusal

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18
Q

The film speed depends on what?

A

The size of silver halide crystals

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19
Q

Faster the film speed the ______ the size of the silver halide crystals

A

Larger - the larger the crystals the more likely they are to be struck by an x-ray. Requires less radiation

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20
Q

Slower film speed the ______ the size of the silver halide crystals

A

Smaller - image is less grainy but requires more radiation to hit all of the small crystals

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21
Q

What is the silver halide chemically altered to?

A

Metallic silver compound

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22
Q

what is the purpose of the intensifying screens in the cassettes?

A

To use less radiation. Contains earth metals - once exposed by an X-ray the screen releases more photons to expose the film

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23
Q

What is a downside to cassettes?

A

Decreased definition. Panos’ should not be used for diagnostic measures

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24
Q
A
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25
Q

What is radiographic density determined by?

A

By the number of photons that strike the film’s emulsion layer converting silver halid crystals to metallic silver.

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26
Q

What does the metallic silver do?

A

Prevents the transmission of light through the film.

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27
Q

What influences the radiographic density?

A

mA

kVp
exposure time
focal spot to film distance

subject density
subject thickness

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28
Q

What is a grid?

A

Lead strips staggered with radioluscent material

* Helps filter x-rays through to expose the cassette
* incorporated in the cassette case or separate screen

** REDUCES SCATTER (compton, coherent) - reduces fog on radiograph **

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29
Q

what steps are involved in processing an x-ray film?

A
  1. Developer
  2. Wash
  3. Fixer
  4. Wash
  5. Dry
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30
Q

What occures to the film when exposed to the developer?

A

Converts chemically changed (altered) silver halide crystals into metallic silver grains that cover the film.

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31
Q

What happens during the was steps?

A

rinse for 30 sec

removes developer or fixer

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32
Q

What happens when exposing the film to fixer?

A

Removes undeveloped silver halid crystals.
Hardens and shrinks the emulsion layer

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33
Q

When an xray is emitted from the source of radiation it will pass through material or get absorbed by material (radiolucent - radiopaque). The xrays that pass through the material strike the emulsion layer of the film and alter the structure of the silver halide crystal. Where the xrays were absorbed in the material the silver halid crystals remain unchanged. When developing the changed silver halide crystals will be converted into silver metalic grains that remain on the film - the creates the darkness on the image. The unchanged silver halide crystals will be washed off during fixation and the fill will be lighter colored in that region.

A
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34
Q

Does the metalic silver grains create the dark or light portion of the image?

A

Dark

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35
Q

Why is the safelight a infared light?

A

low energy - will take a long time to actually convert a silver halid crystal

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36
Q

For every _____ degrees celsius icreas in temperature the rate of reaction ________?

A

10
doubles

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37
Q

What are the advantages of manual processing?

A

Most economical
Produces the best radiographs

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38
Q

What are the disadvantages of manual processing?

A

Most time consuming

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39
Q

What are the advantages of automatic processing?

A

Most efficieent film processings

Faster than manual
Produces dry films

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40
Q

What are the disadvantages of autmatic flim processing?

A

Expensive

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41
Q

Do you drain the chemicals down the drain?

A

NO!

Recyle

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42
Q

What are the advantages of digital xrays?

A

Lower patient exposure (reduces by 80 - 85% compared to D-speed film)
Faster
More eco-friendly
Easier storage of images
Can be easily sent to another doctor
Easy retrieval
Enalarge and vary image density
Easy to display radiographs

43
Q

High resolution vs High Contrast

A

The average grayscale of 4 adjacent pixels in a high resolution image is assigned to create one pixel in a high contrast image

Pixels:

4:1

44
Q

What are the disadvantages to digital x-rays?

A

Cost of equipment
Damage to sensors
Uncomfortable sensors
Loss of image
NOT AS FINE AN IMAGE - if film is ideally processed

45
Q

Flim with small grain that is well developed will have the best image.

T or F

A

True - but requires more radiation.

46
Q

What type of digital xray is the sensor?

A

Direct - directly connects with the computer and displays the image

47
Q

What type of digital xray is the phosphor plates?

A

Indirect - the xray exposed a laten image that is scanned. The image is digital and stored on the computer. The Phosphor plates are reusable.

48
Q

What is a photostimulable storage phosphor plate (PSP)?

A

Phosphor plate

49
Q

What in the digital xray converts xrays to light phtons?

A

CSI scintillator

50
Q

What do the light photons strike to create an image? (where light photons are converted into a digital image)

A

CMOS sensor

51
Q

What format is the electronic data saved as?

A

DICOM format - Digital image and communication in Medicine

52
Q

Digital xray constrast resolution.

A

The ability to distinguish different desnities in an image.

Densities are limited by noise
Human eye can detect less gray levels than computer

53
Q

What is spatial resolution?

A

The ability to distinguish fine detail
Film - silver grains 8 microns, Digital - pixel is 20 microns –> Film has more detail
Digital systems allow enlargment of image

54
Q

What is the sensor latitude?

A

The ability to capture a range of exposures.

* Digital and film - similar
* Phospher plate - more latitude

55
Q

PSP systems allow a dose reduction of _____ compared to F speed film

A

50%

56
Q

What are advantages of the pano compared to FMX?

A

Broad coverage of facial bones and teeth
Low radiation does (2.6 microSv vs 15 microSv)
Can be used in patients with trisumus or pts who cannot tolerate intraoral radiography

57
Q

What are disadvantages of a pano?

A

Lower resolution images that do not provide fine detail
Magnification across imas is unequal
Image is superimposition of real, double, ghost images.
Requires careful visualization to decipher
Requires accurate patient positioning to avoid errors
Difficult to image both jaws when pt has severe maxillomandibular discrepancy (CLASS II)

58
Q

What are some limitations of Pano?

A

Linear measurements are undependable
Magnification varies
Horizontal image magnification vareis from .7 to 2 times actual size.

xray beam is not orientated at right anlge to the long axis of anatomical areas or film plane

59
Q

How is the xray head related to sensor in the pano?

A

it is located lower than sensor.

This causes:

* Foreshortening
* Elongation

60
Q

What is the focal trough?

A

A zone that creates sharp images. Designated by the moving source (xray head) and the receptor.
Try to position pt in this trough to get a clear image.
* more narrow in anterior
* more wide in posterior

61
Q

How do you get a clearer image?

A

Position the structure as close to the middle of the focal trough as possible.

* Structures outside of the focal trough are blurred, magnified, reduced in size, or distorted beyond regonition.

62
Q

How do you position the patients anteriors into the focal trough?

A

Patient positioning device - bite block with a slit for anterior teeth to fall into.

63
Q

Panoramic images are inherently distorted in both ____ and _____. Making linear or angular measurement highly unrelieable.

A

Size
Shape

64
Q

What is distortion influenced by?

A

Beam angulation
Xray source to object distance
Path of rotational center
Position of object within the focal trough

65
Q

What happens to the image when the xray source and object of interest have more distance between them?

A

Magnified
Elongation, foreshortening

66
Q

What does a pano indicate?

A

overall evaluation of dentition
Fine detail and sharp image is not essential

67
Q

What does a pano examine?

A

intraosseous pathology – cysts, tumors, infections
Gross evaluations of temporomandibular joints
position of impacted teeth
eruption of permanent dentition
dentomaxillofacial trauma
Developmental disturbances

68
Q

What are ghost images?

A

Typically blurred, magnified, and located oposite the antomic structure at a higher level due to upard inclination of the xray beam.

69
Q

How do you minimize ghost imaging?

A

Proper Positioning
Remove any metal

70
Q

What is proper positioning during a pano?

A

Feet flat on the ground
Centered
Head tilted down slightly
Pt biting on bite block to separate teeth
Pt should lift tongue to the roof of the mouth - creating a tongue space

71
Q
A
72
Q

What is the Frankfort plane and what is it used for?

A

Line from the Tragus - Infraorbital foramen

Paralle to floor when taking pano

73
Q

When a pano is underxposed what can be done to fix?

A

increase kVP

cannot increase exposure time on panos

74
Q

Flattened panos (lack smile curve) are bad because?

A

The palate and ghost image of the palate obscures the tips of the roots.

75
Q

How can you tell if the pts head is twisted in a pano?

A

One condyle may be magnified compared to another
More vertebrae show on the image on one side

76
Q

What was used before cone beam imaging to capture images similar to cone beam images?

A

Ceph images and different positioning

77
Q

What are some other extraoral radiogrpahy?

A

Comuted Tomography (CT)
Magnetic Resonance Imaging (MRI)
Positron Emission Tomography (PET)

78
Q

An MRI uses ionizing radiation. T or F

A

FALSE!

79
Q

What is a CT scan?

A

Combines the use of xray wth computer technology to produce cross-sectional images of the body

80
Q

What can CT scans produce?

A

Clear, detailed images of all structures (bone, muscle, fat and organs) in the part of the body examined

81
Q

What is cone beam imaging?

A

emit an xray beam shaped like a con rather than a fan (CT machines).
After this beam passes through the patient the remnant beam is captures on an amorphous silicon flat panel or image intensifier/charge-couple-devide (CCD) detector.

82
Q

What component is used to measure a cone beam image?

A

Voxels - similar pixels except in 3D format

83
Q

Why use cone beam?

A

Dental implants
Orthodontic planning
degenerative changes
lower widsdom teeth - nerve canal
infectios, cysts, or tumors

84
Q

What is the effetive dose range for cone beam imaging?

A

6 - 477 microSv

85
Q

What is the volume of a cone beam image?

A

The location and how much of the structure you are trying to get an image of.

86
Q

What are the different imaging modes?

A

ultra low dose, low dose, high resolution

87
Q

There is freedom to select the correct dosage and image quality ratio for the cone beam. T or F

A

True

88
Q

What is an ultralow dose?

A

14.7 less than a pano

89
Q

What is the effective does of a panoramic image>

A

21 microSv

90
Q

Smaller voxel size requires _____ radiation.

A

More

* need more radiation to ensure a voxel is targeted (similar to crystals in a film)

91
Q

The voxel size, FOV, and radiation dose depend on one another. T or F

A

True

92
Q

Larger the FOV the _____ radiation is needed

A

MORE

93
Q

If you are taking an image with a SMALL FOV at high resolution than _______ radiation is needed.

A

LESS - decreased FOV will influence this

94
Q

If you are taking an image with a LARGE FOV with low resolution than _______ radiation is required.

A

MORE - FOV is larger therefore need more radiation to expose everything.

95
Q

If you are taking an image with a LARGE FOV and HIGH resolution than you need ________ radiation.

A

MORE - both FOV and small voxels require more radiation.

96
Q

Can you scan plaster models and impressions with planmeca?

A

YES!

97
Q

What is the benefits of scanning models?

A

Requires less storage for orthodontics

Ortho treatment planning, follow up
Surgical guid manufacturing

98
Q

What is the dose range for ultra low resolution?

A

14 microsSv –> 21 microSv

99
Q

What are the purpose of the filters of digital radiography?

A

Optimize the gray scale
Eliminating “noise” through smoothing
Sharpening image detail
Extracting features (information)

100
Q

How many shades of gray does a digital sensor pick up compared to the human eye?

A

16,000 vs 64

101
Q

When decresing the brightness of a gray scale what happens to the pixels?

A

The grayscale of all the pixels decrease equally

There are more blacks and more whites. More grays are assigned to black or white. Will make an image more black and white looking

102
Q

By adjusting the gray scale to a new white and black (more whites) what can happen to an image of a penny?

A

brings out the detail in the penny

Refining the gray scale will lead to more detail being observed

103
Q

What are some quality controls with developing film?

A

Replenish xray solutions
Check temperatures
Check quality of films
Log of retakes
Check for dark room light leakage
Check exposure settings
Calibration of xray machines

Radiology (5 decks)

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