Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

2280-CT > outcomes 1, 3, 6- head, neck + spine > Flashcards

outcomes 1, 3, 6- head, neck + spine Flashcards

1
Q

what is the modality of choice when imaging the spine?

A

MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

when is CT superior than MRI for imaging of the spine?

A
  • when evaluating spine for bony abnormalities, or if there is metal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

visualization of _______ _____ is improved by intrathecal administration of CM

A

intradural structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the indication for a spine CT

A

-Disc herniation
-Spinal stenosis
-Spinal infection
- Trauma (fracture, dislocation)
-Intraspinal tumors
- Etc..

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

True or false:
no IV contrast is used when evaluating post-op lumbar spine, inflammatory and
neoplastic lesions

A

FASLE, iv contrast is used for : Post-op lumbar spine, inflammatory and
neoplastic lesions+spinal infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

when is IV contrast used for the spine

A

 IV contrast is only used when specified by the
rad. (Romans says 100ml at 1.5ml/s. scan
when injection is finished)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

is IV contrast administration used for any other pathology like disc lesions, spinal
trauma, congenital anomalies

A

NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

is oral contrast used for the spine?

A

NOOOO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

patient position for the c-spine

A

-supine
-head first
-leaser at glabella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

whats the SFOV for the c-spine

A

just above base of skull to mid T1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what recons + reformates are used from the C-spine

A

-always include a bone window
-reformates= coronal+sagittal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the patient position for the T-spine

A

-supine with knees bent
-FF
-arms above head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

where’s the internal laser light for the T-spine

A

-2 inch above jugular notch- NEED T1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

patient position for the L=spine

A

-supine, knees bent
-FF
-arms raised above head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

where is the internal laser light for a CT of the L-spine

A

-xiphoid process=T9/T10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

where does the scan of the L-spine begin+ stop

A

Scan above L1 to mid Sacrum -all L-spine unless specified

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is prefered for detail of the spine, 3D recons or 2D images

A

more detail is displayed in 2D D images due to anatomical
complexities in the spine. (axial, coronal,
sagittal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the windowing for soft tissue spine

A

350 ww/ 50wl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the windowing for bone spine

A

2000ww/500wl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

True or false:
CT examinations are performed after myelography
to enhance or clarify findings

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the recommended scan delay for between the intrathecal
injection and scanning is recommended.

A

1-3 hours, allow CM to dilute
-CM that is too dense may mask intradural structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

when is intrathecal contrast done

A

in fluoroscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what does a sagittal reformatted CT myelogram revel?

A

Multisegmental severe disc
degeneration
 Disc space height reduction,
 Vacuum phenomenon
 End-plate sclerosis of the lower
lumbar spine
 Thecal sac compressions at the
L3–4 and L4–5 levels (arrows).
b–d | Axial images shows
 Circumscribed severe LSS
(lumbar spinal stenosis) of L3–4
 Typical hourglass constriction
of the thecal sac (arrow)
adjacent to relatively normal
areas.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

why do we perform a CT myelogram

A

 Some patients can not have an MRI
 Demonstrates CSF leaks as well
-widely used for operative planning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is a CT myelogram best suited for

A

-dynamic stenosis
-postoperative leg pain
-severe scoliosis, spondylolisthesiis
-metalic implants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

indications for CTA spine(Angio)

A

-AV fistulas, ATM
-blunt trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is the Iv cm for a CTA spine angio

A

120 mL of cm at 6mL/s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

whats are the 2 sets of scans for CTA spine angio

A

◦ 1st scan (Arterial) scan delay=bolus tracking ROI in aorta
just below diaphragm
◦ 2nd delayed scan immediately after 1st arterial scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the slice thickness and interval utilized for reconstructing a helical T-spine scan on a 16-Detector CT scanner?

A

2.50mm/1.25mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

true or false
MRI provides higher soft tissue sensitivity than CT

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

T or F
For conditions such as spinal stenosis MRI is equivalent to CT

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

In a CT myelogram, the suggested delay between injection and scanning is ?

A

1-3 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Scouts of the spine include

A

AP= lateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Before a CT myelogram, it is recommended that a patient

A

roll over once or twice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

T or F
On CT spine protocols the gantry is tilted

A

FALSE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

T or F
The display FOV is much smaller on CT spine protocols compared to abdomen or chest CT

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

T or F
Compared to conventional radiography CT spine has inherently high soft tissue contrast

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

are pathologies often “visible” in the neck region

A

YES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Indications for CT soft tissue of the neck

A
  • Bone:
  • tumors
  • infection
  • trauma
    *-Soft tissue:
  • tumors
  • congenital defects
  • enlargement of
    glands
  • infection
  • abscess
  • vasculature
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

patient prep for CT soft tissue of the neck

A

It is recommended that patients wear loose,
comfortable clothing for the exam.
* Patients will need to remove
▫ dentures, dental appliances
▫ glasses
▫ hearing aids, earrings
▫ Hairpins, wig
▫ any other object that may be in the area of interest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

patient position for CT soft tissue of the neck

A

-supine
-head first
-ask patient to lower shoulders as much as possible
-EXTEND NECK SLIGHTLY= hard palate perpendicular to table or angle gantry parallel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

neck protocol

A

DFOV 18 cm
* Helical mode, most often
* Neck Soft tissue window 450ww/75wl
* Bone window 4000ww/400wl
* Reconstruction slice thickness 2.5mm at 1.25mm
intervals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

is iv contrast enhancement used in the neck

A

YES ALWAYS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what is the goal with CM in the neck

A

Goal is to allow sufficient time for CM to enhance:
▫ Mucosa
▫ lymph nodes
▫ pathological tissue
 While acquiring images with the vasculature opacified

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

is a split bolos used in the neck

A

YES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what is the split bolus that is used for teh neck

A
  • Split bolus is used (total CM injection 125 ml at 2.0 ml/s):
    ▫ First bolus (50mL) given, 2 mins delay
     This allows for structures that are slower to enhance
    ▫ Second bolus (75mL), scan 25 sec delay (arterial phase).
     This allows for all vessels to be fully opacified.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what is the first bolus for in the neck split bolus

A

 This allows for structures that are slower to enhance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what is the second bolus for in the neck spilt bolus

A

 This allows for all vessels to be fully opacified

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

is oral contrast given for CT of soft tissue of the neck

A

Usually none, unless in combo with other exams…
* The entire procedure normally takes 5-10 minutes.
* IV contrast studies may take an additional 10-15 min.
* If oral contrast is required, you will also need an
additional 45-50 minutes prior to the test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what are the 2 types of breathing techniques used for CT of the neck

A
  • Perform modified Valsalva maneuver “puff
    cheeks out” – distends pyriform sinuses
  • Pronounce long “e” during scanning– evaluate
    aryepiglottic folds, and pyriform sinus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what is the possible combination exam for the CT of the neck

A

Combination exam example (C/A/P/N/H – neck done
@95 secs)
* Start with arms up,
* At the end of the pelvic scan the patient lowers arms
down to their sides (being careful not to move their
head)
* Glabella to SC joints if in combo with chest
* Could be done 3ml/sec to compliment C/A/P scan
injection rate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

CTA of the soft tissue of the neck

A
  • Arterial phase
  • Evaluate vessel walls, relationship of lesions & surrounding
    structures, valuable for surgical planning
  • Cerebral catheter angiography (digital subtraction angio) can be
    diagnostic & therapeutic (but more time, $$$ & risk of complications)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what can be the downside to Cerebral catheter angiography (digital subtraction angio) of the soft tissue of the neck?

A

-more time
-more money
-greater risk complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

what are some advantages of the CTA of the soft tissue of the neck

A

Non-invasive
* Widely available
* Time saving (especially with stroke)
* Can combine with brain perfusion studies
* Less expensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

what can be used to evaluate the Circle of Willis
for completeness in 3D

A

-CTA- for neck and head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what is CTV (CT Venography)

A
  • CT venous phase (a modification of CTA)
  • Used to visualize venous anatomy
  • Same protocol, however, acquired in venous
    enhancement phase (longer scan delay 40-50
    seconds for example)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Routine neck CT is preformed with the patient in what position?

A

supine, neck slightly extended

55
Q

Neck studies are most often preformed in which mode

A

Helical

56
Q

Scanning a CT neck too early could result in what going undetected?

A

Certain neoplastic and inflammatory diseases

57
Q

CTA techniques of the neck are taken in…

A

arterial phase

58
Q

CTV techniques of the neck are taken in…

A

Venous phase

59
Q

CTA of the neck is used to accurately measure…

A

Carotid stenosis

60
Q

As per the text book, what is the delay between split bolus injections during a CT neck?

A

2 min.

61
Q

indications for a CT scan of the head

A

Stroke
 TIA
 hemorrhage
 trauma
 Acute neuro changes
 tumors
 AVM
 thrombosis
 aneurysm
 headache/seizures
 mass/lesion /hearing loss
 Unknown/Surprises…parasites etc…

62
Q

patient position for CT of the head

A

 Supine, head placed in head holder,
immobilize head.
 Rare, if coronal is needed patient can extend
chin & drop head back if possible or patient may be
prone (which requires a special holder).
 Typically head first into the gantry.
 Patients orbitomeatal line or better still
the supraorbital meatal line should
be parallel with gantry. (tilt gantry or
tuck the chin down)

63
Q

Why does recent practice in CT favour having slices
of the brain/head to be parallel to the supraorbital
meatal line? (Rather than the OML)

A

To reduce the radiation exposure to the lens of the eye.

64
Q

what type of scan is the routine brain scan

A

axial scan- Scan just below base of skull to just above vertex

65
Q

what type of scan is the skull base(posterior fossa)

A

axial-Foramen magnum through petrous ridge

66
Q

what type of scan is the temporal bones ct scan

A

axial scan
 Just below mastoid process to just above petrous ridge
(DFOV10cm, include entire mastoid, IAC & external auditory canal)

67
Q

what is the sella ct scan

A

– 99% performed in MRI- axial in CT
 Below sellar floor through dorsum sellae (DFOV 14cm)

68
Q

what artifact is often see in the images of the posterior fossa

A

beam-hardening

69
Q

what is the routine slice thickness for the head

A

1.25mm

70
Q

what type of scanning is used for CTA’s

A

helical scanning

71
Q

why is IV contrast used in the head

A

IV contrast used for infection,
neoplasm…

72
Q

soft tissue of the brain for slices in post fossa

A

160ww/40wl

73
Q

soft tissue of the brain for slices in post fossato vertex

A

100ww/30wl

74
Q

what is the bone and blood ww + wL for the head/brain

A

bone= 2500/400wl
blood=200ww/60wl

75
Q

T or F
Scans of the head usually start at the base of the skull and continue superiorly to the vertex

A

TRUE

76
Q

T or F
A head holder may be used for both CT head scans as well as neck scans

A

True

77
Q

T or F
A head sponge on the scan table may be used in place of a head scoop or holder?

A

TRUE

78
Q

is Suspended breath is necessary for a CT of the head

A

NO its not

79
Q

Cross sectional slices of the brain should be parallel to the …

A

SOML

80
Q

Why do recent practices favour using the supraorbital meatal line for CT heads?

A

Protects the lens of the eye

81
Q

Beam Hardening is common through which area

A

Posterior fossa

82
Q

How may this beam hardening in the posterior fossa be reduced?

A

decrease slice thickness, and increase KVP

83
Q

ICH will appear hyperdense to normal brain tissue for approximately

A

3 days

84
Q

What is the DFOV for a routine CT head?

A

23

85
Q

What is the scan location for a CTV head?

A

Just below skull base to just above vertex

86
Q

The anatomy demonstrated in CT head images predominately is determined by

A

Angle of gantry

87
Q

What is the scan range for a T-spine?

A

Above T1 to below T12

88
Q

A patient requires a CT myelogram. Which department will inject the contrast?

A

Fluoroscopy

89
Q

Why would a patient require a myelogram?

A

CSF leak

90
Q

What slice thickness are C-spine images acquired with a helical scan type reconstructed to?

A

2.5mm

91
Q

What interval thickness are C-spine images acquired with a helical scan type reconstructed with?

A

1.25mm

92
Q

What is a indication for an enhanced CT Spine?

A

Spinal infection

93
Q

What IV contrast protocol is used for routine spine CT according to Roman’s?

A

100 ml at 1.5 ml/s, scan when injection is finished

94
Q

When bolus tracking for a CT spine IV injection, the ROI should be placed where?

A

in the descending aorta, just below diaphragm

95
Q

A CT Sinuses scan is often a roadmap used by surgeons for

A

endoscopic surgery

96
Q

Sinus screening in CT is not intended as a/an….

A

high radiation dose method

97
Q

T or F
Clinical indications of recurrent or chronic sinusitis are done with IV contrast

A

true

98
Q

T or F
Indications of recurrent or chronic sinusitis are scanned in the direct coronal or axial & reformatted to coronal plane

A

true

99
Q

T or F
Other clinical indications for sinuses CT may require IV contrast

A

true

100
Q

CT angiography has advantages over traditional angio …the biggest advantage is

A

time saving

101
Q

CTA occurs during what phase

A

arterial phase

102
Q

Carotid and vertebral _________ may be accurately measured in CTA’s

A

stenosis

103
Q

CTA’s can evaluate

A

vascular lesions
dissections
occlusions

104
Q

T or F
Facial bones CT is done in helical scans

A

true

105
Q

What is the focus of sinus CT anatomically

A

Frontal, ethmoid, sphenoid, and maxillary sinuses as well as nasal passages, turbinates, and septum

105
Q

Facial bones CT scan axis is parallel to the

A

IOML

105
Q

What are the benefits of Sinus CT

A

Screening is inexpensive, low radiation, and accurate

105
Q

What is the more common scan plane for sinuses: Coronal or Axial

A

Axial supine

106
Q

What is the scan range for sinuses

A

From above the frontal sinus to below the hard palate including from mid sella through frontal sinus

107
Q

How do you position a patient for sinuses

A

Supine (sometimes prone), extend the chin and drop head as far back as possible in a special head holder.
Align hard palate perpendicular to the table (OML line) OR angle the gantry if not possible

108
Q

Do you use CM for sinuses

A

no

109
Q

What are you trying to demonstrate in chronic sinusitis coronal axial image

A

air-fluid level

110
Q

What is the preferred modality for imaging of the face

A

CT. It is most sensitive for fracture detection

111
Q

What is a disadvantage of CT imaging for the face

A

It has potential to miss a subtle tooth fracture along the axial plane

112
Q

What are some indications for a non-enhanced face ct

A

facial fractures and soft tissue injury

113
Q

What are some indications for an enhanced ct scan of the face

A

Infection and masses

114
Q

Is face CT axial or helical

A

Helical: crucial to make accurate reconstructions!

115
Q

If contrast IS used, will it be single or split bolus in the neck

A

split

116
Q

How will some techs opt to position patient

A

angle gantry parallel to the IOML

117
Q

What type of scan is routine brain according to romans

A

Axial (step and shoot)

118
Q

What is included in a scan of the head

A

Skull base: Foramen magnum through petrous ridges
Temporal bones: just below mastoid process to just above petrous ridges
Sella: below sellar floor through dorsum sellae

119
Q

Why are beam hardening artifacts often seen in images of posterior fossa

A

Because the skull base is so dense

120
Q

How might artifacts be reduced for skull artifacts?

A

thinner slices

121
Q

At what rate may someone hand inject CM for a head CT

A

~1ml/s

122
Q

What must every study include for the spine

A

AP and lateral scouts

123
Q

What is improved by administering intrathecal CM

A

Intradural structures

124
Q

How do you position a patient for T-spine

A

Q
How do you position a patient for T-spine

A
Feet first, supine, sponge under the knees, arms over head

125
Q

What is the start and end location for T-Spine

A

Just above T1 to just below T12 (UNLESS specific levels specified)

126
Q

What is the most frequently used initial exam( modality) for imaging intracranial hemorrhage stroke (ICH)

A

CT

127
Q

where does density loss start at

A

Density loss starts at the periphery of the hematoma; portions
become isodense. Progresses to become completely hypodense

128
Q

what is the timeline for when is ICH hyperdense

A

4-10 days

129
Q

What is the timeline for when is ICH isodense

A

11days to 6 months

130
Q

what is the timeline for ICH stroke to be hypodense to normal

A

Hypodense to normal brain tissue after 6 months

131
Q

when should t-PA be administered to be affective for acute ischemic stroke

A

To be effective, t-PA must be administered within 3
hours of the first signs of stroke.
This means that the stroke victim must be transported
to the hospital, diagnosed, and administered the t-PA
treatment before the 3-hour window has expired…or
have the stoke ambulance come to them 

132
Q

what contraindications t-PA therapy

A

ICH contraindicates t-PA therapy.

133
Q

what is done to differentiate ischemic stroke from hemorrhagic stroke

A

A noncontrast CT of the brain is routinely performed to
differentiate ischemic stroke from hemorrhagic stroke.

134
Q

when is CM used for a stroke

A

CM is used to assess the state of cerebral circulation
and tissue, and secondarily, to assess the underlying
disease.

2280-CT (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions