Diagnostic Imaging for NM Disorders Flashcards

1
Q

What are the routine radiographic projections? What are the special radiographic projections?

A

Routine: AP, PA, lateral, oblique
Special: sunrise, open mouth

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2
Q

The more dense of a tissue, the more OR less x-rays penetrate the tissue to expose the film.

A

Less

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3
Q

The more dense an object, the greater OR lesser absorption of x-rays.

A

Greater

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4
Q

For radiolucent structures, is the density low or high; exposure low or high? Will the structures appear dark or bright?
What would it be for radiopaque structures?

A

Radiolucent: low density and high exposure of film, so they will turn out dark,
Radiopaque: high density and low exposure of film, so they will turn out bright.

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5
Q

What is pneumoencephalography?

A

X-ray imaging following injection of air into subarachnoid space to displace CSF and improve signal contrast; helps to visualize ventricular anomalies.

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6
Q

What is cerebral angiography?

A

X-ray imaging of the blood vessels of the brain following injection of a contrast agent; helps to identify vascular anomalies and occlusions.

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7
Q

What is myelography?

A

X-ray imaging following injection of contrast into CSF to improve contrast/imaging in vertebral column/spinal cord, subarachnoid space, nerve roots.

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8
Q

How do CTs work?

A

It uses x-ray beam and a row of detectors on opposite sides of the head. The detector rotates around the head, and the patient is moved through the scanner, process is repeated. You can either have a single slice or spiral multidetector CT.

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9
Q

What are the three types of density on CT scans? How do they appear?

A

Hyperdense: dense structures (bone, calcifications); white
Hypodense: less dense structures (air); black
Isodense: intermediate density structures (brain tissue); gray

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10
Q

Discuss the density of a fresh hemorrhage, after 1-2 weeks, and after 2-3 weeks, as they appear on a CT.

A

Fresh hemorrhage is white.
1-2 weeks: the clot is broken down and appears isodense with brain tissue.
2-3 weeks: the area of hemorrhage will appear hypodense.

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11
Q

Describe CT with intravenous contrast.

A

Iodine is injected, it is denser than the brain. Areas that have increased vascularity or breakdown of the blood-brain barrier appear hyperdense (white).

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12
Q

Why would you not want to use CT with intravenous contrast if you suspect intracranial hemorrhage?

A

It is harder to distinguish that there is actually a bleed with contrast.

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13
Q

What is the window width? Window level?

A

Window width: range of radiodensities (HU) displayed on an image.
Window level: central density (HU) displayed on an image.

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14
Q

How does an MRI work?

A

Uses magnetic energy and radio-frequency pulses to generate images.

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15
Q

What happens to the protons when the radiofrequency pulse is applied at right angles to magnetization for MRI? What happens when the radiofrequency pulse stops?

A

The protons experience altered alignment, some flip into a higher energy state, when the pulse is applied. The protons realign with magnetic field, energy absorbed while out of alignment is released, when the pulse stops.

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16
Q

What three things determine the intensity of MRI signal?

A
  1. Proton density
  2. T1 (longitudinal) proton relaxation times - net direction of spins
  3. T2 (transverse) proton relaxation times - depends on the net coherence of precessions.
17
Q

Regarding MRIs, what is time to echo? Time to repetition?

A

Time to echo: time at which the signal is captured.
Time to repetition: time at which the radiofrequency pulse is repeated to again displace the protons.

18
Q

What is the difference between a T1 and T2-weight image for MRI?

A

T1-weighted: tissues that rapidly release energy are brighter (fat); tissues slow to release energy are darker (water); assessing the anatomy.
T2-weighted: tissues that rapidly release energy are dark (fat); tissues slow to release energy are brighter (water); assessing abnormal fluid.

19
Q

MRI appearance of chronic ( > 14 days) intracerebral hemorrhage for T1 and T2 weighted images.

A

T1: darker gray outer rim
T2: black outer rim

20
Q

What imaging is considered Neuroangiography?

A

Doppler Ultrasound, CT Angiography. and MRA

21
Q

What is Neuroangiography?

A

Non-invasive procedures to visualize blood vessels.

22
Q

What is the gold standard to visualize blood vessels?

A

Invasive Angiography

23
Q

If you wanted to view arterial stenosis, what type of Neuroangiography would you use?

A

Doppler Ultrasound

24
Q

If you wanted to look at the blood supply to the brain or spinal cord, what type of Neuroangiography would you use?

A

CT Angiography

25
Q

What is an x-ray?

A

X-ray is a plain film or conventional radiograph. Silver atoms are ionized on film.

26
Q

What does an electroencephalography record?

A

Recording of electrical potentials generated in the brain using electrodes on the scalp; it measures brain activiy

27
Q

What does SPECT/PET stand for?

A

Single photon/positron emission computed tomography.

28
Q

What would you use a SPECT/PET scan for?

A

To view the metabolic function of a tissue.

29
Q

What is diagnostic ultrasound?

A

High-frequency sound waves create an image of living tissue.

30
Q

Where are lumbar punctures typically performed? What is the process?

A

Typically between L3-L4, the reason for completing a lumbar puncture is to collect CSF. The needle must penetrate supraspinous, interspinous, and ligamentum flavum to get the fluid out. You must pierce the dura and arachnoid mater as well.