3B2010 Subject: Radiology Topic: Introduction to Radiology

Date: June 13, 2008 Lecturer: Dra. Irene Bandong Trans Group: Riz, Alphe, AM

Introduction to Radiology -based on the same principles involved in the

I. DIANOSTIC X-RAY sonar used
X-rays are useful: -painless
-In diagnosis of disease involving ones,
lungs, gut kidneys & gall bladder
-In CT-scan, Mammography
-In detecting congenital, inflammatory, Advantages
traumatic, degenerative & neoplastic  No radiation risk
disease  Non-invasive
 Inexpensive
PLAIN STUDY:  Painless
-Certain diseases need only plain X-rays for
 Don’t require contrast material
diagnosis e.g. in bone, lungs, intestines,
 Sedation is not required
kidneys & gall bladder stones
 Anechoic
 RADIO-OPAQUE/ DENSE (white) - No sound through transmission
Differential Diagnosis:
 Isoechoic
Infiltrate/ inflammatory process
- With margin
Mass/tumor
- Sagittal and transverse evaluation
Fluid
Lithiasis  Echogenic/ Hyperechoic
Foreign ody e.g. coin - Solid: white
- Mass: black
 RADIOLUCENT- black; air
Pneumoperitoneum SOLID NODULE VS. CYST
Pneumothorax
Pneumomediastinum  SOLID NODULE
Pneumopericardium -Well defined
Tumor -Ovoid shape
-With uniform internal echoes
FLUOROSCOPY CONTRAST EXAMINATION
 Contrast (barium/iodine)  CYST
-is given orally/IV/ other routes depending -Well defined
upon region (part) under investigation -Round or oval shape
-Anechoic
 Upper gastrointestinal series (UGIS)
-Enhance through transmission
-To evaluate the esophagus, stomach,
duodenal bulb and the prox small bowel
Limitations of the UTZ
segments
-Large body habitus, obese patients limit
 Smal intestinal Series (SIS) image quality as the overlying adipose tissue
-To evaluate the small bowel segments -Have trouble penetrating bone
 Barium Enema (BE) -Performs very poorly when there is gas
-To evaluate the colonic segments -It is operator-dependent
 IVP -There is no scout image as there is with CT
-Intravenous contrast for functional & scan and MRI.
structural assessment of kidneys -Once an image is acquired there is no exact
 Hysterosalpingogram studies way to tell which part of the body was imaged
-To evaluate uterus & tubes of infertile women
 Angiogram study III. MAMMOGRAPHY
-To evaluate the lumen of blood vessels -special type of imaging
-Plays a central role in early detection of
II. ULTRASOUND breast cancer because it can show cancer
signs in te breast even years before a patient
or physician would be able to feel a breast Attenuation Value
cancer lump  Hyperdense (white)
-Screening mammography can assist in the +1000 calcium
detection of disease even if a woman has no >250 compact bone
complaints of symptoms 30-230 spongy bone
70-90 coagulated blood
BENEFITS 50-60 whole blood
-Use for early detection of breast cancers
-Ability to detect small tumors/ non palpable  Iso dense
nodules and microcalcifications, first 20.70 soft tissue
indication of breast cancer > 18 exudate
<18 transudate
LIMITATIONS
-The appearance of an image may be  Hypo Dense
compromised if there is powder on the breasts 0 water
or undergone breast surgery -50 to -75 fat
-Need to compare the image to views from -1000 Air
previous examinations
-Declines significantly with increasing breast V. MRI
density with dense breasts -Technique that uses a magnetic field and
-Breast implants can also impede accurate radio waves to take multiple cross-section
mammogram readings images of the body, which are then assembled
into a three- dimensional image by a
IV. CT SCAN computer
-Technique that uses X-rays to take many -Uses radio frequency waves
multiple “cross-section” images of the body, -No ionization radiation is used
which are then assembled into a three- -Gives multiplanar display (axial, coronal,
dimensional image by a computer. It is sagittal and transverse)
painless non-invasive radiological
investigation What are the advantages of MRI over CT
Scan?
Uses of CT Scan
 No radiation
-Detection, measurement, localization, extent
 NO bony or air artifac
of lesions and its relationship to other organs
-Characterization of borders, composition and  Multi-section imaging
content  High intrinsic contrast
-Used for staging tumor  Specificity & extension of disease is
-Locating internal bleeding and organ damage more accurate
in trauma patients  Few diseases can be diagnosed early
-Detecting and staging tumors of various body  MRI can distinguish between
parts proteinaceous or H2O containing mass
-Detecting sources of infection and deep  In breast MRI, it can detect ruptured
abscess implant
-Detecting urinary stone disease without x-ray
dye Limitations:
-Performing non-invasive blood vessel imaging -Can not be used by people with pacemakers
(CT angiography) or other metallic implants
-More expensive than the price for CT
DISADVANTAGES -Not very useful for bones
-Requires placement of an intravenous line for -Even very slight movement of the part being
IV contrast scanned can cause very distorted images that
-Exposes patient to radiation will have to be repeated
-Contrast toxicity or allergy
-Most young children require sedation to
undergo CAT scan