Mid term revision
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Mid Term Revision. Radiological Imaging and Processing 1 Dr Mohamed El Safwany, MD. RADIOLOGIST ROLE. Separate: Normal from Abnormal Characterize / Describe: Abnormality Determine: Extent (stage) of disease Suggest: Diagnosis / Differential

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Mid Term Revision

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Mid term revision

Mid Term Revision

  • Radiological Imaging and Processing 1

    Dr Mohamed El Safwany, MD.


Radiologist role

RADIOLOGIST ROLE

  • Separate: Normal from Abnormal

  • Characterize / Describe: Abnormality

  • Determine: Extent (stage) of disease

  • Suggest: Diagnosis / Differential

  • Recommend: Further exams / follow-up

2


Mid term revision

TOMOGRAPHIC IMAGES ARE

IN A SPECIFIC PLANE

AXIAL

CORONAL

SAGITTAL

RT

RT

3


Radiology tools

RADIOLOGY TOOLS

X- RAY

ULTRASOUND

NUCLEAR MEDICINE

MAGNETIC RESONANCE

COMPUTED TOMOGRAPHY

4


Mid term revision

X - RAY --- FOUR BASIC DENSITIES

  • Air

  • Soft Tissue

  • Fat

  • Bone

5


Automatic processing

AUTOMATIC PROCESSING

TRANSPORTATION SYSTEM

DEVELOPER

FIXER

WASHER

DRYER

REPLENISHMENT SYSTEM


Automatic processor

Automatic Processor


Replenishment system

Replenishment System

Main function: Keep solution tanks full and assure proper solution concentration.

As film is introduced into processor, sensor initiates solution replenishment

Right & wrong way to feed in film

-Feed in along short edge


Digital image printing

Digital Image Printing

Dry processing – no chemistry

No darkroom

Less environmental impact

Reduce costs


I radiographic terminology

I. Radiographic Terminology

General Body Positions

Supine

Prone

Erect (stand or sit)

Recumbent

Lying down in any position

Dorsal (supine)

Ventral (prone)

Lateral


I radiographic terminology1

I. Radiographic Terminology

Specific Body Positions

The body part closest to the IR (oblique and lateral) or by the surface on which the patient is lying

Lateral

Right/Left

Oblique

LPO/RPO

LAO/RAO


I radiographic terminology2

I. Radiographic Terminology

Radiographic Projection

The direction or path of the CR of the x-ray beam

Anteroposterior

Posteroanterior

AP or PA Oblique

Mediolateral or Lateromedial


Ii basic imaging principles

Image Markers and Patient Identification

Patient ID and Date

Anatomic side marker

Additional markers or Identification

II. Basic Imaging Principles


Iii positioning principles

III. Positioning Principles

Positioning Sequences

Traditional Radiography

Step1

Step2

Step3

Step4


Mid term revision

PA Chest (Normal/ ambulance patients) (Basic)

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Mid term revision

Lateral erect chest (Basic)

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Mid term revision

LAO, RAO chest (heart) (special)

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Preliminary bowel preparation

Preliminary bowel preparation

Preliminary bowel preparation in nonacute patients is administered with a combination of laxatives, enemas, and controlled diet. Preparation is important if the patient will be undergoing contrast examination of the gastrointestinal tract or an IVP.

In all other cases, the decision regarding whether or not a patient undergoes preliminary bowel preparation is determined by the requesting physician. Bowel preparation should not be administered to patients suspected of having bowel obstruction, visceral perforations, or abdominal trauma, or to an acutely ill patient


Position of the patient

Position of the patient


Central ray

Central ray

  • For a supine-position radiograph, the central ray (CR) should be perpendicular to the cassette at the level of iliac crests.

  • For an upright-position film, the CR should be horizontal and 2 inches (5 cm) above the level of the iliac crests and should include the diaphragm


Pa skull 0 occipital frontal projection b

PA Skull (0 Occipital-frontal) projection B

22

  • For frontal bone, #s and neoplastic processes of the cranium, Paget’s disease, orbits (obscured by petrous temporals), I.A.M, frontal and ethmoidal sinuses, dorsum sellae.

  • Patient nose and forehead against the couch center, neck flexed so that OML is 90 to the couch, MSP 90 to couch center, head not rotated, EAMS equidistant from the couch top.

  • Film: HD 24x30 cm

  • CP: Exits the glabella

  • CR: 0 (that is 90) to film center

  • NB/ AP is not recommended as it produces 200 times eyes absorbed dose

    produced in the PA position.


Pa axial skull 15 caldwell pro jection for facial bones b

PA Axial Skull (15 Caldwell) projection for facial bones B

23

  • For #s, neoplastic processes of frontal, parietal and facial bones, and for cranium and an unobstructed view of the orbits, I.A.M, frontal and ethmoidal sinuses, clinoids, dorsum sellae, zygomatic bones.

  • Same position as for PA

  • Film: HD 24x30 cm

  • CP: Exits the naison.

  • CR: 15 caudal (for showing the petrous ridges). 25 - 30 gives better view of

    orbital rim and floors and superior orbital fissure.


Ap axial towne s projection for mandible b

AP Axial (Towne’s projection – for mandible)B

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  • For #s, neoplastic or inflammatory processes of the condyloid processes of the mandible.

  • Same position as for Towne AP (OML 90 to couch top.

  • Film: HD 18x24 cm

  • CP: Glabella (midway between EAMs and angles of the mandible). A CP at one inch anterior to level of TMJs will show TMJs.

  • CR: 35- 40 caudal to RBL .


Lateral skull general b

Lateral Skull (general)B

25

  • Same indication as for PA (0). A horizontal beam is used for trauma cases to show air-fluid levels in the sphenoid sinus (a sign of # in the base of skull with internal bleeding) with CR 25-30 caudad – Clark!

  • Patient in a semiprone (Sim’s position), recumbent or erect sitting, head in a true lateral (required side close to the film), MSP parallel to couch, IPL 90 to couch top.

  • Film: HD 18x24 cm

  • CP: 5 cm superior to EAM .

  • CR: 90 to film center .


Lateral skull for nasal bones b

Lateral Skull (for nasal bones)B

For nasal bone fractures.

Head in true lateral (same position as for lateral skull as in Sim’s position) or erect, chin adjusted so that both IPL and IOML are 90 to couch top.

Film: HD 18x24 cm

CP: 1.25 cm inferior to naison

CR: 90 to film center

NB/ A long narrow cone should be used.

26


Submentovertex smv s

Submentovertex (SMV)S

27

  • For base of the skull (Basilar view), occipital bone, mandible, foramen ovale and foramen magnum, TMJs, orbits, zygomatic arches, sphenoidal, maxillary sinuses and mastoid processes.

  • Patient supine or erect sitting, chin raised, neck hyperextended till IOML is parallel to film, MSP 90 to couch top. A pillow under patient’s back allows for sufficient extension.

  • Film: HD 24x30 cm.

  • CP: Midway between angles of mandible (2 cm anterior to level of

    EAMs).

  • CR: 90 to IOML.


Parietoacanthial om waters view for sinuses b

Parietoacanthial (OM) (Waters View for sinuses )B

28

  • Best for maxillary and frontal sinuses and nasal fossae. Also shows other inflammatory conditions (secondary ostemyelitis, and sinus polyps).

  • Patient erect, neck extended, chin and nose against couch, head adjusted till MML is 90 to the film, OML makes 37 with film. AML makes 90 to the film, a long narrow cone should be used.

  • Film: HD 18x24 cm

  • CP: At level of lower border of the orbits to exit at the acanthion.

  • CR: 90 horizontal to film center


Parietoacanthial om open mouth waters for sinuses s

Parietoacanthial (OM) (Open-Mouth Waters for sinuses )S

29

  • Same as for Waters..

  • Same position as for Waters view, but with open mouth (patient drops his jaw without moving the head).

  • Film: HD 18x24 cm.

  • CP: At level of lower border of the orbits to exit at the acanthion.

  • CR: 90 horizontal to film center


Thank you

Thank You


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