Specialty Imaging PPT Flashcards

(51 cards)

1
Q

What is the name of the procedure that examines the CNS structures situated within the vertebral canal?

A

Myelogram

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2
Q

Spinal cord and its _______ structures with the

use of contrast

A

Nerve

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3
Q

Spinal Cord Review

A

Slender, elongated structure

Adult – 18” to 20” long

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4
Q

***Spinal Cord Extends from

A

brain (connects to medullaoblongata @ level of

foramen magnum) to space between _1st & 2nd_vertebra

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5
Q

Spinal Cord ends @

A

L1-L2

Cornus Medullaris

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6
Q

Spinal Cord connects to

A

31 pairs of spinal nerves

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7
Q

***Spinal Cord Most pathology and trauma occur in the

A

Cervical & lumbar areas of the spine

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8
Q

Myelograms are used to identify

A

– Extent
– Size
– Level of pathological process

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9
Q

***Pia mater

A

Inner sheath; adhere closely to spinal cord

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10
Q

***Subarachnoid space

A

Wide space separating arachnoid from pia mater
– Continuous with ventricular system of brain
– Ventricles & subarachnoid space contains cerebrospinal fluid
» CSF produced in ventricles

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11
Q

***Arachnoid

A

Delicate, central sheath

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12
Q

***Dura mater

A

Outermost sheath

– Strong fibrous covering of brain and spinal cord

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13
Q

***Subdural space

A

Separates dura from arachnoid space

– Does not communicate with ventricular system

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14
Q

***What are some of the indications for a myelogram?

A
  • Extrinsic spinal cord compression caused by a herniated disk, bone fragment, cyst or tumor (Most common-HNP)
  • Spinal cord swelling resulting from traumatic injury
  • Identifies narrowing of subarachnoid space
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15
Q

***What are some of the contraindications for a myelogram?

A
  • Blood within CSF
  • Arachnoiditis (inflammation)
  • Increased intracranial pressure
  • Recent lumbar puncture (w/t 2 weeks)
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16
Q

***What contrast agent introduced in late 1970s for myelogram?

A

Water‐soluble

Nonionic Iodinated

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17
Q

***Nonionic & water‐soluble contrast

A

– Provide visualization of nerve roots
– Readily absorbed by body
• _4-5_hours hazy effect; undetectable after 24 hours

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18
Q

Nonionic & water‐soluble contrast good enhancement for

A

CT of spine (follow‐up)

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19
Q

***What type of injection is used for a myelogram?

A

Intrathecal injection

Store intrathecal injection separate from other contrast

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20
Q

***Where is the contrast for a myelogram commonly injected?

A

L2-L3 or L3-L4 interspace

Also @ cisterna magna between C1 & occipital bone

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21
Q

Most commonly used contrast agents for myelogram are

A

– Isovue

– Omnipaque

22
Q

Using ionic contrast may

cause

A

Severe & fatal neurotoxic reactions

23
Q

***Lumbar Myelogram Procedure

A
Contrast (_9-12 mL) slowly injected
• Angulation of table for distributing contrast
– Erect to Trendelenburg
– Head fully extended
-Patient is monitored for 4 to 6 hours
• Patient’s head and shoulders elevated 30 to 45 degrees
• Bed rest for several hours
– Avoid strenuous activity for 72 hours
24
Q

What are some common complications of a myelogram?

A
Headache
Nausea/vomiting
Seizure
Allergic reaction
Bleeding
Infection
25
Myelogram Demonstrates
– Deformity in subarchnoid space | • Obstruction of passage of contrast within space
26
Myelogram Conus projection
– Demonstrates conus medullaris | – AP position with CR @ T12‐L1
27
***What is the name of the procedure for radiography of a joint or joints?
Arthrogram
28
Radiologic examination of soft tissue structures of joints after injection of 1 or 2 contrast agents into capsular space
– Pneumoarthrography (gaseous) – Opaque arthrography (water‐soluble iodinated) – Double‐contrast arthrography (combination)
29
***MRI
has reduced number of arthrograms
30
***What are the most frequent sites for an arthrogram to be performed?
Knee & shoulder Hip, wrist & TMJ
31
***Images are taken for arthrogram
Fluoroscopy and conventional images
32
What are some common indications for a knee arthrogram?
* Tears of the joint capsule, menisci or ligatments (trauma) | * Baker’s cyst (nontrauma)
33
Purpose of knee arthrogram
Demonstrate and assess knee joint & | associated soft tissue
34
***What are indications for a shoulder arthrogram?
* Evaluation of partial or complete tear in rotator cuff or glenoidal labrum * Persistent pain or weakness * Frozen shoulder
35
***Where is the injection site for a shoulder arthrogram?
* ½ inch inferior and lateral to the coracoid process | * Spinal needle is used due to deep location of capsule
36
Shoulder Arthrogram Procedure
* Single contrast: 10 to 12 mL of contrast | * Double contrast: 3 to 4 mL of contrast along with 10 to 12 mL of air
37
Shoulder Arthrogram Projections
– AP (internal/external) – 30‐degree AP oblique – Axillary – Tangenital
38
Shoulder Arthrogram Increasingly performed with
MRI | – Injection of gadolinium contrast into joint capsule
39
CT follows double contrast arthrogram
Images obtained @ 5‐mm intervals
40
Wrist Arthrogram Indications
•– Trauma – Persistent pain – Limitation of motion
41
Wrist Arthrogram Contrast is injected
– Dorsal wrist @ articulation of radius, scaphoid & lunate – 1.5 to 4 mL
42
***Hip Arthrogram
Performed most often on children – Evaluate congenital hip dislocation before & after treatment
43
***If performed on adults – Detect loose hip prosthesis – Confirm presence of infection
Cement used to fasten hip prosthesis components – Barium sulfate added to cement (radiographically visible) ***Use SUBTRACTION technique
44
Injection site of Hip Arthrogram
¾” distal to inguinal crease & ¾” lateral to palpated femoral pulse • Spinal needle
45
***What is the name of the radiologic procedure that examines the nonpregnant uterus, accessory organs and vagina?
HSG
46
***What are some indications for an HSG?
* Assessment of female infertility * Size, shape and position of uterus & uterine tubes * Delinate lesions (polyps, tumor masses or fistulous tracts) * Patency of uterine tubes
47
***What are some contraindications for an HSG?
- Pregnancy - Acute pelvic inflammatory disease - Active uterine bleeding
48
***The HSG examination should be scheduled approximately
7 to 10 days after the onset of menstruation.
49
***What position will be the patient be placed in to facilitate the flow of contrast during an HSG?
Trendenlenburg | LITHOTOMY position
50
Where should the contrast spill out into when performing an HSG?
Peritoneal cavity
51
How much contrast is used to fill the uterine cavity and how much is needed to fill the uterine tubes?
4 to 5 ml | Additional 4 to 5 ml for uterine tube patency