Skel A- Advanced Imaging For Chiropractor (CT/Bone Scan Flashcards Preview

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Flashcards in Skel A- Advanced Imaging For Chiropractor (CT/Bone Scan Deck (45)
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1

What are the types of advanced imaging for spinal evaluations?

Plain film

CT

CT w/ Myelography

MRI

Radionuclide bone imaging

2

Why do we use advanced imaging?

1. More accurate

2. Detects subtle injuries and pathologies

3. Radiographically in depth analysis needed

4. Failure of response of condition on plain film

3

Nuclear Medicine:

Describe radionuclide bone imaging

Radionuclide bone imaging is a type of nuclear medicine that utilizes radioactive substances, injected intravenously to detect metabolic and physiologically changes in the body that proceed gross structural alterations.

4

Nuclear Medicine:

Radionuclide bone imaging has(Poor sensitive/great specificity or Great sensitivity/poor specificity)

Great sensitivity/ poor specificity

*recall that it will show different disorders similarly but picks up subtle changes *

5

Nuclear medicine:

Radionuclide bone imaging is (non-ionizing/ionizing)

Ionizing

6

Nuclear Medicine:

The most frequently used NM study that analysis bone, joint and soft tissue?

Radionuclide bone scan

7

Nuclear medicine:

A radiopharmacologic agent that distributes into organs and tissues and is carrier of radioactive substances into blood stream

Methyline diphosphate

8

Nuclear medicine:

Radioactive isotope used to emit gamma radiation that is sufficient enough to escape tissue and be detected by a gamma ray detector/camera during bone scans.

Technetium 99

9

Nuclear medicine:

What is the term synonymous for NM scan?

Scintigraphy

10

Nuclear medicine:

In terms of uptake of radioactive isotopes in bone scans, what are hot and cold spots?

Hot spots- areas of increased uptake; increased blood flow in area

Cold spots- areas of decreased uptake; low blood flow in area.

11

Nuclear medicine:

Skeletal scintigraphy was introduced in the early 60’s to capture bone changes plain film couldn’t.

What are the isotopes that were use and why are they not used anymore ?

Flourine-18

Scrontium-85 & 87

They emitted too much radiation or had too short of a half life (time it takes 50% of substance to be deactivated or flushed out of body)

12

Nuclear medicine:

What are the isotopes used today in NM/scintigraphy scans?

(TGI)

Technetium-99 -Methyline diphosphate

Gallium(Ga)-67

Indium(In)-111

13

Nuclear medicine:

Describe the half life of technetium-99- Methyline diphosphate

Tc-99 Methyline diphosphate has a half life of 6 hours. Within 6 hours 50-60% of the isotope is excreted through urination and this continues by 50% each 6hr

14

Nuclear MEdicine:

What are the units to measure NM dose?

Millisieverts

15

Nuclear medicine:

What is the first phase of the bone scan procedure?

Flow phase/ Radionuclide angiogram-rapid imaging every 2-3 seconds for 30 seconds

Vascular

16

Nuclear medicine:

What is the second phase of the bone scan procedure?

Blood pool phase- when tracer is in soft tissue, takes about 5 minutes

17

Nuclear medicine:

What is the third phase of the bone scan procedure?

Delayed of bone phase- Tracer leaves soft tissue and vessels going into bone, takes 2-4 hours (as long as 24hrs)

18

Nuclear medicine:

A positive NM scan is largely based on what?

Blood flow

Rate of bone activity (osteoblastic)

19

Nuclear medicine:

Flow of isotopes in body during bone scan

MDP & Tc-99m, 2-3 sec of imaging for 30 second, Flow phase —> 5 minutes later, isotope in soft tissue, Blood pool phase —> 2-4 hours later, clearance of isotope into bone/skeleton, Delayed/Bone phase —> 24hrs later,in bladder then excreted

20

Nuclear medicine:

Which two organs will show exceptional activity of the isotope radioactive emissions?

Kidney & Bladder

*excretion function*

21

Nuclear medicine

Indications for use of bone scan

BOAB FAMS

(BOAB FAMS)
Bone metastasis

Osteomyelitis

Arthritis

Benign bone lesion

Fractures not readily seen with plain film

Avascular necrosis (Cold Spots)

Myositis Ossificans (Hot Spots)

Spondylodiscitis (Hot Spots)

22

Nuclear medicine:

Contraindications of NM

Pregnancy

23

Nuclear medicine:

NM scans have great (sensitivity/specificity) and poor (sensitivity/Specificity).

Nm is (full body/regional), is (less/more) expensive than MRI, and is (as / less/ more) sensitive as MRI.

Great sensitivity, Poor specificity

Full body

Less expensive

Is as sensitive as MRI (MRI can be more sensitive)

24

Nuclear Medicine:

How does multiple myeloma show on bone scan

Cold spots

25

Computerized tomography:

Describe CT

CT is a further progression from plain film that utilizes a thin slicing mechanism of anatomy through the coordinated motion of the source (tube) and the receptor (cassette) which results in great detail

26

Computerized tomography:

Linear tomography

Tube and cassette move in straight line

27

Computerized tomography:

Plane in which CT image is captured

Axial/transverse plane

28

Computerized tomography:

CT was invented by whom

Godfrey Hounsfield 1970s

Assisted by Allan Cormack

29

Computerized tomography:

The first CT brain scan was done in what year

1972

30

Computerized tomography:

T/F: CT has always been digital

True