7. what is an x-ray image Flashcards

1
Q

LOs

A
  • Describe the shadows that make up a conventional x-ray image
  • Explain the various factors that can affect a conventional x-ray image
  • Describe the different types of x-ray images that are available including film-captured images, tomographs and digital images
  • Explain the limitations of these various different x-ray images
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2
Q

how is a radiographic image produced

A
  • by x-rays passing through an object and interacting with the silver halide emulsion on the film or with a digital image receptor
  • interaction results in blackening of image once processed
  • final image = 2-D, superimposed
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3
Q

what determines the exten if blackening in the images

A
  • n.o x-rays reaching the image receptor (this depends on density of object)
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4
Q

radiodensity of shadows/ colours in radiograph?

why this colour?

A

Black = radiolucent – no absorption

White = radiopaque – total absorption

Grey = mixed – varying absorption

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5
Q

what to consider when understanding radiographs?

A

Understanding factors affecting the shadows/ colours in the radiograph
* Object Material
* Object thickness/density
* Object Shape
* X-ray beam intensity (exposure factors)
* Position of object, image receptor and X-ray beam

  • knowledge of anatomy hard tissues
  • Appreciation of limitations of a 2D picture effect of superimposition
  • knowledge of diff types if images and their limitations
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6
Q

what is burnout?

why may it occur?

clinical impact?

A
  • as exposure increases, there is increased blackening (this is known as burnout in which small, fine structures of patient does not create a
    radiographic shower)
  • using an intensity too high
  • may prevent from seeing fine small structures
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7
Q

clinically why does bone produce a varied appearance radiographically?

A
  • varies in thickness + density
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8
Q

EGs (AZ NOTES) (DON’T NEED TO LEARN, JUST UNDERSTAND)

A

Various factors affect these shadows:
* Object Material
- metal objects will appear completely white

  • Object thickness/density
  • larger thicker cylinders absorb more x-ray photons and appear white
  • Object Shape
  • the 2D image doesn’t always represent the full picture as there is the 3 rd dimension to consider
  • X-ray beam intensity (exposure factors) - VARIES
  • Position of object, image receptor and X-ray beam
  • distortion of image may occur if positioning wrong
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9
Q

Ideal position of object, image receptor and X-ray beam for imaging?

A
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10
Q

effect of changing position of object, image receptor and X-ray beam?

A
  • image foreshortened
  • image elongated
  • image distorted
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11
Q

Surface knowledge of anatomy for X-rays

A

Mandible/maxilla

Hard tissue of tooth structure

How roots are positioned

Anatomical cavities in jaws
- e.g maxillary air sinus

Internal anatomy of maxilla/mandible
- trabecular pattern of mandible
- cortical desne bone forms lower border of mandible

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12
Q
  1. limitations imposed by 2-D images?
  2. how these may be overcome?
A

1.
X-rays are a single 2d view

Can’t accurately tell what the 3D structure would look like

2.
Maybe take multiple radiographs with 2 views

E.g parallel + perpendicular

  • maybe not reliable due to superimposition of overlying structures
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13
Q

3 main types of images

A

Conventional film captured images

Tomographs (sectional radiographs)

Digital images

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14
Q

What are the limitations of film captured images ?

A

= standard X-rays used in most clinics

2D representation of 3D objects

Affected by changing exposure factors
- kV, mA and time

Affected by geometrical distortion

Affected by chemical processing faults

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15
Q

Effects of exposure factors on film captured images

A

KV
- determines energy of photons/ quality of beam
- determines penetrating power of photons
- affects film contrast
- kilovoltage increased, image = greyer with many more shades of grey;
- KV decreased, image = black and white with fewer shades of grey

mA and TIME (secs)
- determine quantity of x-ray photos
- affect degree of blackening of film
- overexposed = too black
- underexposed = too pale

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16
Q
  1. effects of processing faults on film captured images?
  2. clinical impact?
A

1.
Over developed = too black

Under developed = too pale

Under fixed = brown

Solutions too hot

2.
chemical processing errors limit clinical usefulness of conventional film captured images

17
Q

1.
What are tomographs ?

2.
benefits?

A

1.
Sectional radiographs

2.
‘Slice of an object’

Object is split in multiple sections (eg like loaf of bread analogy)

Avoids problems caused by superimposition

18
Q

Different types of tomographic images of the maxillofacial skeleton

A

Simple linear tomographs

Complex multidirectional tomographs

Computed tomographs = CT scans

Cone-beam computed tomographs

Dental panoramic tomographs

19
Q

What are simple linear tomographs ?

A

Produced by moving the film + X-ray tube head during exposure

Centre section of patient = linear focal plane
- only this section of patient is imaged
- other structures in front + behind on centre section are blurred out due to movement
- thickness of centre section determined by movement taken place
- large movement produces a thin slice
- small movement produces a thick slice
- Blurring is common due the movement of equipment

20
Q

How can blurring from simple linear tomographs be improved

A
  • Reduced and resolution improved via use of complex multidirectional tomography
  • Performed by scanora unit
21
Q

What are complex multidirectional tomographs?

A

Uses complex spiral motion between X-ray tube head and film (instead of linear)

Still has a centre of rotation - corresponds to slice that will be I’m focus

Designed for use in maxillofacial region
- cross-sectional slices of jaws

22
Q

What are computed tomographs / CT scan ?

A

Used in medical imaging

Complex equipment

Patient lies down and moved into central hole of CT unit

Ring of image receptors and X-ray unit spirals around patient

Designed to create axial tomographic slices

Can be placed together for a 3d image

23
Q

What are cone beamed radiographs?
name if unit?
what it produces?

A

CT scan designed for dental use

Sirona-Galileous unit
- only images maxillofacial skeleton + part of cranial base

Produces cross sectional tomographic images of jaws in any plane

3d construction possible using software

24
Q

why do you need to understand about tomographs?

25
How do panoramic machines work ?
X-ray tube head and film move around patients head Tube head starts on RHS of patient Tomographic layer starts on LHS - curved section - corresponds to shape of dental arch - so teeth and supporting structures will be depicted in focus on final image X-ray beam has to pass through structures on left and right before hitting film - RHS structures (don't want to see) can cause a shadow on LHS structures (want to see)
26
Limitations of panoramic radiography
Malpositioning of teeth can cause them to be blurred + out of focus - wont fall inside width of sliced section Operator can affect panoramic image by mispositioning the patient X-ray beam has to pass through both sides of jaws - creates ghost shadows - appears at a slightly higher level than real shadow as X-ray beam angled upwards at 8 degrees
27
What are the real hard tissue shadows?
Nasal septum Hard palate Zygomaticus / cheekbone Maxilla Mandible Hyoid bone
28
What are the real soft tissue shadows ?
Soft palate Ear lobe Dorsum of tongue Nasal labial fold
29
What are the equipment shadows ?
Bite peg Plastic head support
30
What are the ghost shadows?
L shaped mandible Cervical spine Airspace between tongue and hard palate
31
Limitations of panoramic tomographic images ?
Only represents a sliced section of patient - lacks an overview Blurred - movement of tube head + image receptor Affected by patient shape + positioning of teeth Complex - overlayed by soft tissue shadows, equipment shadows, ghost shadows , air shadows Affected by processing faults Affected by exposure factors Resolution relatively poor - indirect action film screen combo
32
Digital images limitation of digital images (module 5 recap)
Digital Images: - Made up of pixels - 256 shades of grey - Each pixel assigned shade of grey depending upon amount of radiation that reaches sensor Limitations of Digital Images: - 2D representations of 3D objects - Affected by geometrical distortion - Affected by software image processing
33
CONCLUSION
- x-ray images = complicated pictures - not all x-ray images are the same