DIAGNOSTIC RADIOLOGY

As Clinical Anatomy

Francis Neuffer, M.D. U.S.C. School of Medicine

E-mail: x-ray@med.sc.edu Radiology Website: http://radiology.med.sc.edu Radiology Department: Basement of Library

Penny Al-Emam--216-3701

Speaker note

COURSE GOALS
Understand basics of image

generation.
Relate imaging to gross

anatomy. Appreciate indications and limitations. Develop imaging vocabulary

WHAT IS DIAGNOSTIC RADIOLOGY?

1 year internship
4 year residency

1 year fellowship?

RADIOLOGIST ROLE
Separate: Normal from Abnormal
Characterize / Describe: Abnormality Determine: Suggest:

Extent (stage) of disease Diagnosis / Differential

Recommend: Further exams / follow-up

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X-RAY
Discovered and named by

Dr. W. C. Rentgen at University of Wrzburg, 1895

Awarded first Nobel prize for

physics, 1901
Did not patent invention

PROJECTION -VSTOMOGRAPHIC IMAGE

FOOT AP PROJECTION (ANTERIOR POSTERIOR)

LATERAL FOOT

TOMOGRAPHIC IMAGES ARE IN A SPECIFIC PLANE

AXIAL

CORONAL

SAGITTAL

RT

RT

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CT- HEAD
RT

CT REFERENCE FILM Skull / brain

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RADIOLOGY TOOLS
X- RAY

ULTRASOUND
NUCLEAR MEDICINE

MAGNETIC RESONANCE
COMPUTED TOMOGRAPHY

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HOW IS IMAGING DONE?

IONIZING RADIATION X-ray, CT, Nuclear Medicine

SOUND WAVES

Ultrasound
MAGNETIC FIELDS / RADIO WAVES

Magnetic Resonance

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X-RAY
High Energy Photon --Kilo Electron Volts Ionizing Radiation Exposes Film / Detector

X-ray beam

Projection Data
detector

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X-RAYS
PLAIN FILM RADIOGRAPHY
Chest Mammography Abdomen Spine

Extremities & Joints

Skull
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X - RAY --- FOUR BASIC DENSITIES

Air Soft Tissue Bone Fat

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CONTRAST RADIOGRAPHY
Injection, ingestion, or other

placement of opaque material within the body.

Improves visualization and tissue

separation.
Can demonstrate functional

anatomy and pathology.

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UPPER GI--(GASTRO INTESTINAL)

STOMACH

ORAL BARIUM CONTRAST

WITHOUT CONTRAST-plain or scout film

COLON

BARIUM ENEMA
RECTAL BARIUM CONTRAST
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INTRAVENOUS PYELOGRAM IVP

INTRAVENOUS IODINE CONTRAST

WITHOUT CONTRAST-plain or scout film

ARTERIOGRAM
INTRAARTERIAL IODINE CONTRAST
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COMPUTED TOMOGRAPHY
HIGH ENERGY PHOTON IONIZING RADIATION EXPOSES DETECTOR TOMOGRAPHIC DATA

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CT EXAMPLE

SCAN LEVEL

Air

Fat

Soft tissue

RT

Bone

NUCLEAR MEDICINE

High Energy Photon Ionizing Radiation

--Radiopharmaceutical
Exposes Detector Projection Data Dynamic / Physiologic

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NUCLEAR MEDICINE
EXAMPLES

Bone

PET scan

Liver

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ULTRASOUND

Sound Wave - high

Frequency-megahertz
No Ionizing Radiation
Tomographic Data

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BASIC ULTRASOUND PHYSICS

Ultrasound Production
Piezoelectric Effect
Transducer/Probe

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BASIC ULTRASOUND PHYSICS

Ultrasound Production
Transducer is the speaker &microphone
99% of time is spent listening Only 1% of time is devoted to making ultrasound

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BASIC ULTRASOUND PHYSICS

Acoustic Windows

Dense & elastic structures Liver Spleen Fluid-filled structures Heart Urinary bladder

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B Mode-brightness Most common use Presents real time image

Ultrasound Sector Scanning

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ULTRASOUND
ideal for fluid filled structures

Gallbladder

Kidney

Obstetrics

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MAGNETIC RESONANCE

Hydrogen Protons In a

Magnetic Field
Radio Wave Signal

Transmission
No Ionizing Radiation Tomographic Data

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MAGNETIC RESONANCE
EXAMPLES

RT

Anterior

Brain

Spine
Anterior Posterior

Posterior

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RADIOLOGY EVALUATION

Multiple Choice - Identify

Labeled Images From Digital Film Sets And Lecture Images

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HOSPITAL LINGO
You will hear and see these abbreviations used frequently in the medical community.

X- Ray

Plain Film

Scout Film Cat Scan

Radiograph CT

Computed Tomography Nuclear Medicine Ultrasound Sono

Nuc Med Sonogram MR MRI

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Magnetic Resonance

SUMMARY

TOMOGRAPHY- VS- PROJECTION IMAGES

SECTION PLANES
AXIAL CORONAL SAGITTAL

IMAGE GENERATION OF: Nuclear Medicine

Computed Tomography
Ultrasound X-ray Magnetic Resonance
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OH THE MANY USES OF

NUC MED STUDY OF A HORSES _____! KING TUT

MODERN IMAGING?
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