TOPIC 3

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Merges the xray technology images in a computer

ctscan

Xray beams moves in an arc motion surrounding the patient

ctscan

Computer reconstruct the images based on the position of the scanner and how much radiation is absorbed

ctscan

This allows the computer to determine the type of tissue in the specific area

ctscan

CT scan is more sensitive than conventional radiography

true

Volume effect: the compiter applies the average values in a specific area, making it less specific in the borders of different tissue boundaries

ctscan

Attenuation

ctscan

Xrays are emitted and detected at an angle and is measured by how much of the radiation has passed thru or absorbed

attenuation

Mathematical algorith allows the reconstruction of the human body

ctscan

Attenuation is measured in

hounsfield units, ct number

Bone

high density tissue

Lungs

low density tissue

Absorbs the radiation to a greater degree, and a reduced amount is detected by the scanner on the opposite side of the body

high density tissue

Absorbs the radiation to a lesser degree, and there is hreater signal detected by the scanner

low density tissue

Black to white substance according to hounsfield value

air, fat, water, blood, bone

Study values

Parts of ctscan

gantry, data acquisition system, operator console

Xray source, collimators and detectors are found in what part of CT scan

gantry

Different forms of CT

3D, myelogram, conebeam

Combines CT with contrast material

myelogram

Employs a large cone shaped beam matched with flat panel detectors

conebeam

Results in high speed scans with lower radiation

conebeam

Human eye can detect ___ shades of gray vs _____ shades by the computer

32, 256

Displaying all hundered of gray shades may appear as one shade in the human vision

true

Computers cannot be manipulated to choose the radiodensities to be displayed

false

bone window

soft tissue window

Introduction of ________ dye allows enhancement of tissues

radiofluorescent

Radiofluorescent dye

intravenous for cardiovascular system and tumors, oral contrast for bowel and digestive system

Passage thru the urine for CT urogram

intravenous for cardiovascular system and tumors

Ctscan with contrast

angiogram, urogram, barium swallow, stonogram

Radiofluorescent dye

contrast

Uses radiooharmaceuticals for the diagnosis of diseases based in physiological or functional changes of the tissue

nuclear imaging

Pharmaceutical moves and concentrates in the speicifc organ and the computer measure the about of gamma radiation emitted in the same area

nuclear imaging

Nuclear imaging consists of two parts

pharmaceutical, radionuclide

Targets specific organ

pharmaceutical

Emits the gamma ray

radionuclide

Lung and thyroid scans

static

Seen in bone scans

whole body

Cardiac, hepatobiliary and gastric studies

dynamic

Used to detect perfusion in bone, cardiac, brain and liver

SPECT

Measures the metabolism (low or high) to detect tumors

pet scans

Used in CNS disorders, dementia and cardiac blood flows

pet scans

PET Scan

positron emission tomography scan

PET uses ______ as tracers.

drugs

Tracers may be swallowed, inhaled or injected. Tracers accumulate in areas of low activities.

first true second false

Conjunction of CTScan or MRI =

better imaging diagnosis and location

Show up as bright spots on PET scans because they have a HIGHER metabolic rate than do normal cells

cancer

In terms of cancer, PET scans may be useful in:

detecting, revealing whether it has spread, checking if treatment is working, find recurrence

PET scans must be interpreted carefully because noncancerous conditions can look like cancer, and some cancers do not appear on PET scans

true

Solid tumors appear on PET scans:

brain, cervical, colorectal, esophageal, head and neck, lung, lymphoma, melanoma, pancreatic, prostate, thyroid

Body is made up of watee

mri

Different tissues have different amounts of hydrogen ions

mri

Magnets are used to spin the hydrogen ions

mri

When magnet is turned off, protons gradual return to their normal state

mri

Details of the body is determined by how long it take to return to their normal state

mri

Measures the energy emitted by the hydrogen atom where they are stimulated by radiofrequency

mri

Alignment of the protons by external magnetic fields

longitudinal magnetization

Altering the alignment of the protons

transverse magnetization

Realignment and decay

release of energy absorbed during alignment

Return to longitudinal magnetization

The faster the recovery, the shorter the t1, the stronger the signal

Relaxation of the transverse magnetization

The slower the decay, the stronger the signal

Different tissues have the same decays

false

shorter TR and TE times, fat gives high signal intensity, provides images of good anatomical details, water gives low signal intensity

water are slow to give up energy hence high signal intensity, long TE and TR times, fat gives up energy easily hence low signal intensity, valuable in detecting inflammation

Contast in MRI

gadolinium, excellent in soft tissue details = tumor, stroke, bleeds

WHITE T1

fat protein rich fluid

T2 white

water content— inflammation, tumor, hemorrhage, infection

Intermediate T1

gray spinal matter, darker than white

Intermediate T2

white spinal matter, darker than gray

Dark T1

bone, air, water content

Dark T2

bone, air, fat

Shows high signal intensity on T1; low to moderate intensity in T2

acute hemorrhage

Shows moderate to high signal intensity on both T1 and T2

subacute hemorrhage

Shows variable signal intensity on T1; high signal intensity on T2

chronic hemorrhage

Increase freewater content of tissues display

inflammation

decreased signal intensity on T1, increased signal intensity on T2

inflammation

Associated with rheumatoid arthritis

proliferated synovium

Intermediate to high signal intensity

proliferated synovium

Often associated with infiltration of the substance of the muscle by fat and fluid

muscle atrophy

Increased signal intensity on both T1-T2

muscle atrophy

High free water content

soft tissue tumors

Low signal intensity on T1, high signal intensity on T2

soft tissue tumor

Various signal intensifies depending on the tissue from which they arise and whether they are osteogenic or osteolytic in nature

bone tumor

Displayed as straight or serpiginous (worm-like) lines of low signal intensity on both T1 and T2

bone tumor

Surrounded by marrow edema, which exhibits low signal intensity on T1 but high signal intensity on T2

acute fracture

Display as bone bruises

stress fracture

Low signal intensity on T1, high signal intensity on T2 before a fracture line is visible

stress fracture

Uses soundwaves to get a picture of the body

ultrasound

Requires little to no preparation

ultrasound

Harmless to fetus and children

ultrasound

No radiation needed

ultrasound

Used to study movement of material in the body

doppler

Special uses of ultra sound

guide needles during biopsy, identify blood flow, others

Ultrasound runs between

2-5 mhz

Non invasive, dependent on the skill and interpretation of sonologist

ultrasound

Transducer is placed on the skin with intervening gel. Fingers are on the side of the transducer to guide the transducer while scanning.

ultrasound

100

Ultrasound relies on the attenuation of the different tissue:

absorption, reflection, refraction, scatter

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