Radiological Examinations

This radiological examination ppt is particularly made for B.Sc OTT Students

1. MEGHANA C DOTT, BOTT, M.Sc Med.Biochemistry RADIOLOGICAL EXAMINATION

2. RADIOLOGICAL EXAMINATIONS TYPES OF RADIOLOGIC EQUIPMENT & ACCESSARIES RADIOLOGIC DIAGNOSTIC PROCEDURES INTERVENTIONAL RADIOLOGY

3. TYPES OF RADIOLOGIC EQUIPMENT & ACCESSARIES Contrast media Radiolucent gasses Radiologic tabel Cassete Fixed x-ray equipment Portable x-ray machine Fluroscope Image intensifier Mobile c-arm image intensifier Computerized digital subtraction processor

4. RADIOLOGIC DIAGNOSTIC PROCEDURE LIST OF RADIOLOGIC DIAGNOSTIC PROCEDURES CARRIED OUT FOR RADIIOLOGIC EXAMINATIONS Chest x-rays Mammography Steriotactic core breast tissue biopsy Computed tomography Ventriculography Arthrography Angiography & arteriography Bronchography Cholangiography Myelography Git x-ray studies Urography Incidental x-ray films

5. CHEST X-RAYS An x-ray study of the chest may be the part of the admission procedure to rule out un suspected pulmonary diseases that would contraindicate the use of inhalational anaesthetic agents

6. MOMMOGRAPHY A technique for projecting an x-ray image of soft tissue of the breast mammography is the most effective screening method for rear diagnosis of small, palpable breast tumours This procedure may be some what painfull for the woman , because compression of breast is need for radioloogic imaging.

7. STERIOTACTIC CORE BREAST TISSUE BIOPSY Imaging equipment is used to steriotactically isolate breast lesions that may not be palpable. Percutanious needle biopsies are performed with the patient under local anaesthesia.

8. VENTRICULOGRAPHY Ventricuclogrphy is the study of the ventricles after injections of a directly into the lateral ventricles of the brain. If intracranial pressure Becomes too great after gas injection, a needle can be inserted to remove the gas It can be used in patients with signs of increased intra cranial presure as a result of Blockade of csf cerebrospinal fluid circulation.

9. COMPUTED TOMOGRAPHY The x-ray beam moves back & forth across the body to project cross-sectional images this technique is refered to as computed tomogaphy (ct), computed axial tomography (cat) or simply scanning. It produces a highly contrasted, detailed study of normal & pathologic anatomy The exact size & location of lesiion in the brain media stainum & abdominal organs are identified Ct scan become an invasive procedure when a radiopaque contrast medium is used to examine the git. Needle aspration can be performed under direct ct visualization Ct exposes the patient to ionizing radiations. Ct exposes the patient to allergic reactions to contrast medium, if used. To ensuure the proper use of this complex equuipment & t protect the patient from unnecessary/excess radiation this procedure is done under the supervision of the quqlified radiologist.

10. ARTHROGRAPHY Arthrogaphy is the study of joint aftr the use of the gas or cntrast medium into it. Through injection of the dye or gas iinjury to cartilage or ligaments can be visualized Arthrography can beusefull in knee arthrogram .

11. ARTHROGRAPHY

12. ANGIOGRAPHY AND ARTERIOGRAPHY Angiography is the study of the circulatory system after injectiion of the radiopaque to permit visualization of the venous blood vessell system. These procedure are usefull in the diffferential diagnosis of arteriovenous malformations, aneurysms,tumours , vascular accidents, or other circulatory abnormalities caused either by traumatic injury or by an acquired structural diseases. Angiography is also used at the time of the surgical procedure to identify the exact location of some types of lesions in the extremities brain, thoracic & abdominal cavity .

13. BRONCHOGRAPHY Study of the tracheobronchial tree. This is donebyinstallation of a contrast medium to aid in the diagnosis of the bronchiectasis , cancer, tuberculosis, and lung abscessor to detect a foreign body The location of a lesion can be determined and the surgical procedure planned accordiinngly .

14. CHOLANGIOGRAPHY Radiography of the biliary ductus after injection or the administration of the contrast medium, orally intravenously or percutaniously . PREOPERATIVE COLANGIOGRAPHY: In addition to pre operative x-ray diagnostic studies some surgeons request request radiologic studies in conjunction with cholecystectomy or cholilithotomy to identify gallstones in the biliary tract. Operative cholangiography Cholangiography performed during a surgical Procedure on the gall bladder. Here surgeons include the cholangiography at the time of surgical procedure in patients in whom they suspect stones might be present in the bile duct. The basic difference between pre operative & intra operative cholangiography is the sit e of administration. For pre operative cholangiography the contrast medium is injected iv through percutaneous veinpuncture . For intra operative cholangiography medium is directaly injection to bile duct.

15. GASTROINTESTINAL X-RAY STUDIES Studies are performed to identify lesions in the mucosa of the GI tract, such as an ulcer, tumour or stricture. Barium sulphate is swallowed by the patients or instilled by enema to be studied.

16. MYELOGRAPHY Lesions in the spinal canal are studied by the myelograph . It helpfull to localize a filling defects, spinalcord tumour.

17. UROGRAPHY Urography is the radiologic study of the urinary tract. Urographic studies are described as follows. 1.cystography 2.Cystourethrography 3.Intravenous pyelography (IVP):study of the structure of the urinary tract and kidney functions. 4.Retrogradepyelography: the study of the shape and position of the kidney & ureter . Retrograde pyelography is used to visualize the renal pelves . Voiding cystourethrography:the study of contour & patiency of the urethra.

18. INCIDENTAL X-RAY FILMS An unanticipated need for an x-ray films occurs when a sponge, needle, or instrument is taken during wound closure. A x ray film will confirm wether the items is still in the patient.

19. INTERVENTIONAL RADIOLOGY Invasive procedures performed under radiological control. Examples: balloon angioplasty Coronary angioplasty stent placement Inferior vena cava fitter placement. Cardiac catheterization, angioplasty & stent placement are Performed in a interventional radiology department.

20. FOLLOWING ARE SOME OF THE INTERVENTIONAL RADIOLOGY TECHNIQUES Magnetic Resonance Imaging (MRI) Ultrasonography Plethysmography Endoscopy Nuclear medicine studies Radionuclide Total body scanning PET Scan Scintigraphy Lymphoscintigraphy (lymph node mapping)

21. MRI is based on the magnetic properties of the hydrogen in the body Unlike CT Scan MRI does not use radiations The patients lies flat inside a large electromagnet MRI looks at both the body’s structure & functions. It distinguishes between fat, muscles, compact bone & bonemarrow , brain & spinal cord, fluid filled cavities, ligaments & tendons and blood vessels. MAGNETIC RESONANCE IMAGING (MRI)

22. THE MAJOR APPLICATIONS OF MRI ARE AS FOLLOWS Detection of tumours Inflammatory diseases Infections Abscesses Used in the evaluation of the function of central nervous system, cardiovascular system, & other organs.

23. MRI paramagnetic IV Contrast media, such as like gadopentetate,are sometimes used to localize tumours in the central nervous system. MRI paramagnetic IV contrast media (GADOPENTETATE) do not contain iodine, and allergic reactions are rare. The magnetic field can cause ferromagnetic components of implants, such as pacemakers & cochlear implants, to malfunctions.

24. The magnetic field will also disable metallic device in the area, such as cardiac monitors, infusions pumps & wristwatches. Some patients feel a sense of claustrophobia in a conventional MRI Machine. MRI is used during selected neurosurgical procedures. Dedicated MRI Interventional rooms permit the use of MRI during the actual surgical procedures.

25. ULTRASONOGRAPHY Ultrasonography is a technique uses ehoes of the ultrasound pulses to delineate objects or areas of different density in the body. Ultrasonography uses sound waves to produce images on a screen, which allows medical providers to view internal structures of the body. The basic component of any diagnostic ultrasound system is its specialized transducer.

26. The transducer converts electrical impulses to ultrasonic waves at afrequency greater than 1 million cycles per second. These ultrasonic frequencies are transmitted into tissues through a transducer placed on skin. Water soluble gel is placed to the skin to maintain air tight contact between the skin and the transducer, because ltrasonic waves does not travel well through air.

27. Ultrasound is not effective in the presence of bone or gas in the gastrointestinal tract. The image can be recorded on video tapes or printed to provide a permanent record known as echogram or sonogram. Ultrasonogrphy does not expose the patient to radiation & contrast medium.

28. ADVANTAGES OF ULTRASONOGRAPHY Whether used as a preoperative or intra-operative diagnostic technique ultrasonography is ; Ultrasonography is rapid, painless, non invasive procedure. Ultrasonography distinguishes between fluid-filled & solid masses. Ultrasonography is less time consuming procedure. Ultrasonography requires less tissue manipulation than do other intraoperative diagnostic procedure. Ultrasonography does not exposes the patient to radiation & contrast media.

29. USES OF ULTRASONNOGRAPHY Ultrasonography is a useful adjunct in the diagnosis of the followings; Space occupying lesions in the neonatal brain:- the ECHOENCEPHALOGRAM will show a shift of the brain caused by tumour Ultrasound can distinguish between a cystic & a solid tumour mass in the kidney, pancrea liver ovaries & testies . Ultrasonography is the best imaging technique in the patients gallbladder diseases.

30. Emboli (air, blood, fat) Ultrasonography is particularly useful in the early diagnosis of pulmonary embolism. Ultrasonography is useful to determine the need for a caesarean section (c-section) if the head is too large for vaginal delivery. Ultrasonography is also used to determine the position of the fetes & placenta.

31. Ultrasonography is used to identify the gender and to detect foetal abnormalities. ECHOCARDIOGRAPHY : (ultrasonic cardiography). Cardiac defects like structural defect, insufficient valvular movement, and blood flow volumes within the heart chambers & myocardium can be detected by this diagnostic technique known as ECHOCARDIOGRAPHY.

32. DOPPLER STUDIES The Doppler ultrasonic velocitydetector emits a beam of 5-10 megahertz (mh2) the is directed through the skin into the blood stream. Doppler originally