Radiology Flashcards
CXR dx
all forms of PULMONARY complaints
PA= posteroanterior
best choice when CXR is chosen, STANDING patient
AP films
UNSTABLE patient– too sick to stand for PA
AP films often done with…
portable CXR equipment
CXR in ICU setting
AP film
Pleural effusion imaging
- lateral CXR
2. decubitus film– freely mobile and forms a layer on side of XR
widening of mediastinum
dissection THORACIC aorta
cannot tell between pneumonia infiltrate and effusion
DECUBITUS XR
best initial imaging for TB
apical lordotic films
apical lordotic films
ALMOST NEVER the right answer
whenever a apical lordotic film MIGHT be done, instead do…
CT chest
determining precise location of an infiltrate on PA
Lateral CXR
best initial test for effusion
lateral CXR
abdo X ray
ileus or SBO– multiple air fluid levels
abdo X ray for kidney stones
NOOOOOOOOOOO not accurate
abdo X ray for free air under the diaphragm
NOOOOOOOOOOO because cannot visualize the top of the diaphragm
what imaging if perforated the bowel
upright CXR, NOT abdo Xray
best initial test for osteomyelitis
BONE XRAY–elevation of periosteum
skull XRAY
NOT the best initial test
NOT the most accurate test for anything!!!
non-contrast CT indications
- head trauma
- stroke
- BLEEDING– any form- including SAH
CT scan with contrast
- cancer
- infection
best initial test for any form intracranial mass lesion
CT with contrast
NB considerations for head CT with contrast
- don’t order if severe renal failure
- hydrate with saline, possibly use bicarb or NAC with mild renal insufficiency
- stop metformin prior to using contrast
2 methods of contrast for ado CT
IV or ORAL
indications for abdo CT
- retroperitoneal structures– pancreas
- appendicitis and other intra-abda infections
- masses within ado organs: liver and spleen
- MOST accurate test for: nephrolithiasis (no contrast), and diverticulitis
most accurate test for kidneys stones
CT WITHOUT WITHOUT WITHOUT contrast
CT chest
- hilar nodes: sarcoidosis
- mass lesions: cancer
- cavities
- interstitial lung disease– parenchymal lung disease
- pulmonary emboli- spiral CT or CT angiogram
CT and bone
NOT the best initial
NOT the most accurate
MRI most accurate test of….
ALL CNS diseases
exception of MRI for CNS diseases, being most accurate test…
EXCEPT FOR HAEMORRHAGE
MRI with contrast
- infections
- cancer
Best test for MS
MRI
best test for posterior fossa lesion
MRI
best test for brainstem
MRI
best test for pituitary lesions
MRI
best imaging orbits and sinuses
MRI
best test osteomyelitis
MRI
osteomyelitis imaging
- best initial= bone Xray
2. most accurate= MRI
best imaging for spinal cord and vertebral lesions
MRI
most accurate test for cancer and infection
ALWAYS ALWAYS ALWAYS BIOPSY
US indications
- gallbladder - stones
- renal disease
- gynae organs
- prostate evaluation (Transrectal)
most accurate imaging of pancreatic lesions– esp in head of pancreas
endoscopic US
most accurate imaging of pancreatic and biliary ductal disease
endoscopic US
most accurate test for gastrinoma LOCALIZATION
endoscopic US
HIDA scan
cholecystitis
bone scan
= SENSITIVITY-MRI
- NOT as specific as MRI
METASTASES FROM CANCER
gallium scan
fever of unknown origin
gallium=
iron metabolite, transported on transferrin– thus taken up by infection and cancer (since both have more iron)
indium scan
fever of unknown origin
indium scan better than gallium scan with…
assessing the abdomen, since that can be obscured in gallium scanning
indium scan=
tagged WBC’s, reinfected to see where the localize to detect infection
V/Q scan
low probability scans– 15% STILL HAVE A CLOT
high probability scans– 15% do NOT have clot
V/Q or spiral CT for imaging of PE
spiral CT
mUGA or nuclear ventriculography
ejection fraction
