Radiology Flashcards
When looking at an MRI picture what must you remember?
You are looking at the patient from feet up
the projection might distort the size (AP vs PA)
what are limitations of x rays
2d representation
overlapping structures obstructed
no depth perception
what are good things of x rays
great spatial resolution
immediate results
what is a grey area on an x ray
soft tissues
what is a dark area on an x ray
air. (low density)
what is a white area on an xray
bone/metal
3 fates of xrays
transmitted
absorbed
scattered
trendelenburg body position
lying down with head lower than feet
fowler’s body position
lying down head higher than feet
radiographic density
amount of exposure or blackness on the radiograph
radiographic contrast
difference in density between adjacent area of a radiographic image
spatial resolution
recorded sharpness of structures on the image. clarity, sharpness or detail of an image
what happens when there are 2 structures that are the same density next to each other on an xray
cant see margins they merge together
contrast agent
substance used to increase the contrast between organs/ vessels/ fluids or other structures withn the body that do not have natural inherent contrast with surrounding tissues
why iv contrast
improves sensitivity : detection
improves specificity: characterization
improves certainty
create ct and mri angiograms
advantages of a ct
quick motion not much of a problem grey scale can be manipulated on viewing screen excellent resolution in most areas widely available and cheaper than mri
disadvantages of ct
ionizing radiation
renal function must be evaluated if contrast is used
some patients are allergic to iodine contrast
mri t1
csf dark
tr and te are short
mri t2
csf white
tr and te are long
advantages of mri
nonionizing
better soft tissue contrast
extremely versatile - can use variety of sequences fo rvisualizing specific tissue
disadvantages of mri
longer time for sequences more expensive images cant be manpulate gantry narrow - claustrophobia no metal noisy
transverse orientation (ultrasound)
probe marker towards patient’s right
sagittal orientation (ulrasound)
probe marker towards patients head
xray pros
easy, available less than 30 min 1-3 rad cheap
xray cons
often nondiagnostic
limited
mri pros
high sensitivity and specificity
best for soft tissue contrast
30-60 min
no radiation
mri cons
motion sensitive safety issues claustrophobia availibility expensive
ct pros
fast
available
relatively motion resistant
30-60 min
ct cons
3-4 rads
expensive
ultrasound pros
no radiation
cheap
30-45 mn
fast, reliable, safe
ultrsound cons
limited in obesity
nuclear medicine pet/ct pros
targets specific tumors/disease
nuclear medicine pet/ct cons
limited availability hours-days costly nonspecfic 3-4 rads
xray densities black
gas
xray densities dark grey
fat
xray densities light grey
soft tissue/ fluid
xray densities light white
bone/calcification
xray densities pure white
metal
anechoic
absence of echoes
looks dark
hypoechoic
less echogenic than surrounding tissues
light grey
isoechoic
same echogenicity as surrounding tissues
see no difference
hyperechoic
more echogenic than surround tissues
looks lighter
which use ionizing radiaton
xray / ct
nuclear med
pet
which use nonionizing radiation
ultrasound
mri
odontoid
dens
jefferson fracture
break in multiple places
burst fracture of atlas
hangman fracture
between superiot and nferior facets
hyperextension
facet orientation cervical
oblique nearly horizontal facets
thoracic facet orientation
nearly vertical
lumbar facets orientation
nearly vertical
where does spinal cord end
l3
os terminate
tip of dens doesn’t fuse
has smooth margin
os odontoideum
doesn’t ctabilize c1 c2
doesnt fuse body and dens of c2
type ii odontoid fracture
base of odontoid
sharp margins
three things to line up looking at radiographs
anterior vertebral line
posterior vertebral line
spinolaminar line
scotty dog nose
trasnverse process
scotty dog eye
pedicle
scotty dog front leg
nferior articular facet
scotty dog ear
superior articular facet
scotty dog neck
pars nterarticularis
scotty dog body
lamina