Session Two Flashcards

1
Q

How do X-Rays work?

A

X-rays are form of electromagnetic radiation
X-rays travel through the body and are absorbed in different amounts by different tissues, depending on the radiological density of the tissues they pass through.
- E.g. Bones readily absorb x-rays, therefore produce high contrast
- x-rays travel more easily through less radiologically dense tissues (e.g., fat, muscle and air-filled cavities)

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2
Q

What are advantages of X-Rays?

A

Cost-effective
Readily available
Non-invasive
Good bony (osseous) detail
Easily accessible
Fast and Convenient

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3
Q

What are disadvantages of X-Rays?

A

Exposure to ionising radiation
Lack of soft tissue detail
Lack of sensitivity in detecting bone density changes

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4
Q

How do MRI’s work?

A

A strong magnetic field that forces protons in the body to align with that field
A radiofrequency current causes the protons to be stimulated, and spin out of equilibrium, straining them against the pull of the magnetic field.
When the radiofrequency field is turned off, the MRIsensorsdetect the energy released as the protons realign with the magnetic field.
Contrast agents (e.g., Gadolinium) may be given to increase the speed at which protons realign with the magnetic field. The faster the protons realign, the brighter the image.

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5
Q

How do MRI works: Radiofrequency (RF) Coils?

A

RF coils are an essential MRI component used for transmission of
The RF field to excite nuclear spins and for reception of the MRI signal.
RF coils play an important role in image quality in terms of:
- signal-to-noise ratio
- signal uniformity
- image resolution
RF coils are associated with potential image artifacts and RF heating that may lead to patient burns.
Proper selection and use of RF coils are therefore essential to:
- achieve optimal image quality
- to maximize diagnostic capability
- prevent image artifacts
- reduce the risk of RF heating and patient burns
Quality control of RF coils is important to ensure proper functioning of the coils to provide consistent image quality and avoid coil problems that may affect image evaluation or interrupt patient imaging.

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6
Q

What is a T1 Weighted MRI?

A

T1-weighted MRI enhances the signal of the fatty tissue and suppresses the signal of the water i.e.
- Fat: Bright
- Fluid: Dark
- Muscle: Grey
- Air: Very dark
- Inflammation: Dark

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7
Q

What is a T2 weighted MRI?

A

T2-weighted MRI enhances the signal of the water i.e.
- Fluid: Bright
- Muscle: Dark grey
- Fat: Light
- Air: Very dark
- Inflammation: Bright

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8
Q

What is a STIR MRI?

A

STIR (Short T1 Inversion-Recovery) sequence Suppresses Fat:
- provides excellent depiction of bone marrow oedema which may be the only indication of an occult fracture

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9
Q

What is a FLAIR MRI?

A

FLAIR (Fluid-attenuation inversion recovery) – Suppresses Fluid
- heavily T2 weighted images with CSF fluid suppression
- highlights hyperintense lesions and improves their detection

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10
Q

What are advantages of MRI?

A

Non-invasive
No ionising Radiation
Good resolution
3D Detailed anatomical images
Provides extremely clear, detailed images of soft-tissue structures
Functional information

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11
Q

What are disadvantages of MRI?

A

Expensive
Noisy
Claustrophobia
First trimester pregnancy
Long scan times
Motion artefacts
Patient may develop an allergic reaction to the contrast agent

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12
Q

What are the absolute contraindications for MRI?

A

Cardiac Pacemaker
Implanted Cardiac Defibrillator
Internal pacing wires
Clips such as cerebral, carotid, or aortic aneurysm
Cochlear implants
Any implant held in by a magnet
Swan - Ganz Catheter
Pregnant/Possibly pregnant

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13
Q

What are the possible contraindications for MRI?

A

Body piercing
Tattooed makeup
Dentures
Hearing aid
Occular implants
artificial limb
joint replacement
metal rods or plates
metal or wire mesh implants
vascular access port of catheter
transdermal delivery system (nitro)
Metal removed from eye
Shunt
Any metal fragments
Heart valve prosthesis
Insulin or other drug infusion pump
Neurostimulator stents, filters, coils
Electrodes
IUD or Diaphragm
Hospitalized
Surgery

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14
Q

How does CT work?

A

A computerized x-ray imaging procedure where a narrow beam ofx-rays is aimed at a patient and rotated around the body, producing signals that are processed by the computer to generate cross-sectional images, or “slices.”
The collected slices are digitally “stacked” together to form a 3D image of the patient, allowing easier identification of basic structures and providing more detailed information about possible tumours or abnormalities.

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15
Q

How does CT work - Windowing?

A

CT Windowing (AKA grey-level mapping) - an image processing task that helps highlight the key anatomy so that the images can be analysed easily.
The most common window settings include:
Bone window - For viewing the bones
Soft tissue window – to evaluate soft tissues e.g., solid organs and vasculature
Lung window - for evaluating the lungs
Abdomen window - to evaluate the abdominal cavity and its contents
Brain window - to evaluate the brain parenchyma (typically on a non-contrast scan)
- sensitive at picking up intracranial haemorrhage with a narrow window

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16
Q

What are advantages of CT?

A

Non-invasive
Quick and painless
Relatively cheaper than MRI
Better availability compared to MRI
Good visualisation of bony structures and calcified lesions
Ability to detect or exclude the presence of more serious problems

17
Q

What are disadvantages of CT?

A

Exposure to ionising radiation
Pregnancy
Patient may develop an allergic reaction to the contrast agent

18
Q

How does Ultrasound work?

A

Ultrasound probes (AKA transducers) use ceramic crystal materials (piezoelectric) to produce sound waves above the threshold frequencies of human hearing (above 20KHz)
Piezoelectrics create sound waves when an electric field is applied and vice versa. This allows the transducer to detect waves that bounce off boundaries between different structures (e.g., between tissue and bone).
The speed and timing of each reflected sound wave is measured to determine the distance between the transducer and the boundary which generates images.
During an ultrasound exam, gel is applied to the skin to prevent air pockets from forming between the transducer and the skin, blocking ultrasound waves from passing into the body.

19
Q

What are advantages of Ultrasound scans?

A

No ionising radiation
Non-invasive
Quick and painless
Relatively cheaper than MRI
Better availability compared to MRI
Portable
Real-time visualisation of structures

20
Q

What are disadvantages of Ultrasound scans?

A

Anisotropy – where a structure is highly reflective to US
Bone blocks US waves
Artefacts are common
Operator dependant

21
Q

What are clinical indication for plain radiography/x-ray?

A

The most accepted indications include:
- Exclusion of fractures e.g.
- recent significant trauma - previous injuries
- Assessment of joint or spinal disease e.g.
- Pain
- Infection
- Arthropathy
- Degenerative disease
- Limited mobility
- Osteoporosis - Scoliosis - Spondylolisthesis - Assessment of cardiopulmonary disease
- Pre-surgical assessment
- History of Cancer

22
Q

What are clinical indications for CT - Brain?

A
  • tumours
  • traumatic or spontaneous hematomas
  • stroke or oedema
  • skull fracture or hydrocephalus
  • calcifications or arteriovenous malformations
  • hydrocephalus
  • sinusitis
  • empyema
23
Q

What are clinical indications for CT - Neck?

A

Tumours or benign masses
- thyroid nodules
- lymphadenopathy

24
Q

What are clinical indications for CT - Spine?

A

fractures
- degenerative changes, stability or disc pathology
- osteomyelitis

25
Q

What are clinical indications for CT - Bone?

A

complex bone fractures
- eroded joints
- tumours
- osteomyelitis

26
Q

What are clinical indications for CT - Gynaecology?

A

cyst
- fibromas
- tumours

27
Q

What are clinical indications for CT - Chest?

A

tumour
- pneumonia
- metastasis
- benign masses
- pulmonary & pleural oedema
- tuberculosis
- pulmonary embolism
- traumatic injury to the lungs
- oesophageal rupture
- ingested foreign body
- fibrosis

28
Q

What are clinical indications for CT - Abdomen?

A

primary tumours
- metastases
- abscess
- ascites
- cholecystitis
- appendicitis
- renal calculi
- pancreatitis
- obstruction
- lymphadenopathy
- foreign body

29
Q

What are clinical indications for CT - Screening?

A
  • colon and lung cancer
30
Q

What are clinical indications for CT - Biopsy?

A
  • CT guided to different organs for adequate tissue extraction