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Hannah RAD III > Specialty Imaging PPT > Flashcards

Specialty Imaging PPT Flashcards

1
Q

What is the name of the procedure that examines the CNS structures situated within the vertebral canal?

A

Myelogram

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2
Q

Spinal cord and its _______ structures with the

use of contrast

A

Nerve

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3
Q

Spinal Cord Review

A

Slender, elongated structure

Adult – 18” to 20” long

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4
Q

***Spinal Cord Extends from

A

brain (connects to medullaoblongata @ level of

foramen magnum) to space between _1st & 2nd_vertebra

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5
Q

Spinal Cord ends @

A

L1-L2

Cornus Medullaris

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6
Q

Spinal Cord connects to

A

31 pairs of spinal nerves

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7
Q

***Spinal Cord Most pathology and trauma occur in the

A

Cervical & lumbar areas of the spine

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8
Q

Myelograms are used to identify

A

– Extent
– Size
– Level of pathological process

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9
Q

***Pia mater

A

Inner sheath; adhere closely to spinal cord

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10
Q

***Subarachnoid space

A

Wide space separating arachnoid from pia mater
– Continuous with ventricular system of brain
– Ventricles & subarachnoid space contains cerebrospinal fluid
» CSF produced in ventricles

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11
Q

***Arachnoid

A

Delicate, central sheath

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12
Q

***Dura mater

A

Outermost sheath

– Strong fibrous covering of brain and spinal cord

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13
Q

***Subdural space

A

Separates dura from arachnoid space

– Does not communicate with ventricular system

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14
Q

***What are some of the indications for a myelogram?

A
  • Extrinsic spinal cord compression caused by a herniated disk, bone fragment, cyst or tumor (Most common-HNP)
  • Spinal cord swelling resulting from traumatic injury
  • Identifies narrowing of subarachnoid space
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15
Q

***What are some of the contraindications for a myelogram?

A
  • Blood within CSF
  • Arachnoiditis (inflammation)
  • Increased intracranial pressure
  • Recent lumbar puncture (w/t 2 weeks)
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16
Q

***What contrast agent introduced in late 1970s for myelogram?

A

Water‐soluble

Nonionic Iodinated

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17
Q

***Nonionic & water‐soluble contrast

A

– Provide visualization of nerve roots
– Readily absorbed by body
• _4-5_hours hazy effect; undetectable after 24 hours

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18
Q

Nonionic & water‐soluble contrast good enhancement for

A

CT of spine (follow‐up)

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19
Q

***What type of injection is used for a myelogram?

A

Intrathecal injection

Store intrathecal injection separate from other contrast

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20
Q

***Where is the contrast for a myelogram commonly injected?

A

L2-L3 or L3-L4 interspace

Also @ cisterna magna between C1 & occipital bone

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21
Q

Most commonly used contrast agents for myelogram are

A

– Isovue

– Omnipaque

22
Q

Using ionic contrast may

cause

A

Severe & fatal neurotoxic reactions

23
Q

***Lumbar Myelogram Procedure

A 
Contrast (_9-12 mL) slowly injected
• Angulation of table for distributing contrast
– Erect to Trendelenburg
– Head fully extended
-Patient is monitored for 4 to 6 hours
• Patient’s head and shoulders elevated 30 to 45 degrees
• Bed rest for several hours
– Avoid strenuous activity for 72 hours
24
Q

What are some common complications of a myelogram?

A 
Headache
Nausea/vomiting
Seizure
Allergic reaction
Bleeding
Infection
25
Q

Myelogram Demonstrates

A

– Deformity in subarchnoid space

• Obstruction of passage of contrast within space

26
Q

Myelogram Conus projection

A

– Demonstrates conus medullaris

– AP position with CR @ T12‐L1

27
Q

***What is the name of the procedure for radiography of a joint or joints?

A

Arthrogram

28
Q

Radiologic examination of soft tissue structures of joints after injection of 1 or 2 contrast agents into capsular space

A

– Pneumoarthrography (gaseous)
– Opaque arthrography (water‐soluble iodinated)
– Double‐contrast arthrography (combination)

29
Q

***MRI

A

has reduced number of arthrograms

30
Q

***What are the most frequent sites for an arthrogram to be performed?

A

Knee & shoulder

Hip, wrist & TMJ

31
Q

***Images are taken for arthrogram

A

Fluoroscopy and conventional images

32
Q

What are some common indications for a knee arthrogram?

A
  • Tears of the joint capsule, menisci or ligatments (trauma)

* Baker’s cyst (nontrauma)

33
Q

Purpose of knee arthrogram

A

Demonstrate and assess knee joint &

associated soft tissue

34
Q

***What are indications for a shoulder arthrogram?

A
  • Evaluation of partial or complete tear in rotator cuff or glenoidal labrum
  • Persistent pain or weakness
  • Frozen shoulder
35
Q

***Where is the injection site for a shoulder arthrogram?

A
  • ½ inch inferior and lateral to the coracoid process

* Spinal needle is used due to deep location of capsule

36
Q

Shoulder Arthrogram Procedure

A
  • Single contrast: 10 to 12 mL of contrast

* Double contrast: 3 to 4 mL of contrast along with 10 to 12 mL of air

37
Q

Shoulder Arthrogram Projections

A

– AP (internal/external)
– 30‐degree AP oblique
– Axillary
– Tangenital

38
Q

Shoulder Arthrogram Increasingly performed with

A

MRI

– Injection of gadolinium contrast into joint capsule

39
Q

CT follows double contrast arthrogram

A

Images obtained @ 5‐mm intervals

40
Q

Wrist Arthrogram Indications

A

•– Trauma
– Persistent pain
– Limitation of motion

41
Q

Wrist Arthrogram Contrast is injected

A

– Dorsal wrist @ articulation of radius, scaphoid &
lunate
– 1.5 to 4 mL

42
Q

***Hip Arthrogram

A

Performed most often on children
– Evaluate congenital hip dislocation before &
after treatment

43
Q

***If performed on adults
– Detect loose hip prosthesis
– Confirm presence of infection

A

Cement used to fasten hip prosthesis components
– Barium sulfate added to cement (radiographically visible)
***Use SUBTRACTION technique

44
Q

Injection site of Hip Arthrogram

A

¾” distal to inguinal crease & ¾” lateral to palpated femoral pulse
• Spinal needle

45
Q

***What is the name of the radiologic procedure that examines the nonpregnant uterus, accessory organs and vagina?

A

HSG

46
Q

***What are some indications for an HSG?

A
  • Assessment of female infertility
  • Size, shape and position of uterus & uterine tubes
  • Delinate lesions (polyps, tumor masses or fistulous tracts)
  • Patency of uterine tubes
47
Q

***What are some contraindications for an HSG?

A
  • Pregnancy
  • Acute pelvic inflammatory disease
  • Active uterine bleeding
48
Q

***The HSG examination should be scheduled approximately

A

7 to 10 days after the onset of menstruation.

49
Q

***What position will be the patient be placed in to facilitate the flow of contrast during an HSG?

A

Trendenlenburg

LITHOTOMY position

50
Q

Where should the contrast spill out into when performing an HSG?

A

Peritoneal cavity

51
Q

How much contrast is used to fill the uterine cavity and how much is needed to fill the uterine tubes?

A

4 to 5 ml

Additional 4 to 5 ml for uterine tube patency

Hannah RAD III (25 decks)

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