Basic Principles of Radiology
Basic Principles of Radiology
Basic Principles of Radiology
X-rays
X-Rays
X-Rays
For the majority (if not all) patients entering an
•• X-Rays
X-Rayswere
werediscovered
discoveredby
byProf
Prof
A&E department in a hospital the doctor will Roentgen
Roentgenin
in1895.
1895.
request X-ray. –– (Sometimes
(Sometimescalled
calledRoentenogram!)
Roentenogram!)
•• Called
Calledthem
them“X-Rays”
“X-Rays”short
shortfor
for
“Unknown
“UnknownRay”
Ray” Prof.
Prof.Roentgen
Roentgen
X-rays were discovered over 100 years ago by •• They
Theyare
areaaform
formof
ofradiant
radiantenergy
energywith
with
aashorter
shorterwavelength
wavelengththan
thanvisible
visiblelight.
light.
Prof Roentgen who was experimenting with
Roentgen
Roentgenx-ray
x-ray
machine
machine
gamma irradiation. This is the part of the
electromagnetic spectrum where the
wavelengths are very short. As visible light is
also part of the same spectrum, the technology
behind X-ray machines is very similar to X-Rays
X-Rays
•• Taking
Takingan
anX-Ray
X-Rayisissimilar
similarto
totaking
takingaaphotograph.
photograph.
cameras.
•• The
Theimage
imageisisbased
basedon onthe
thedensity
densityof
ofthe
theobject.
object.
Due to the differences in density, it is possible for the surgeon to identify four basic types of
human tissue in the body – Bone, Organs, Fat and Air.
Air has virtually no density, therefore,
very little gamma irradiation is
absorbed. As a result, the image on an
X-ray corresponding to the presence of
air is black. This means that it is
possible to identify the lungs and
pockets of gas in the patient’s digestive
system.
Finally, if a patient has had previous surgery, then the metal implants, which are even
denser than bone, will appear on X-ray as a white object.
Heart
bones and a metal implant.
Heart
Vertebra Air
Airin
inthe
thelungs
lungs
Vertebra
Gas
Gasininthe
the
Pelvis
Pelvis intestines
intestines
Metal
Metalimplant
implant
on
onthe
thespine
spine
When taking an X-Ray, the radiation AP
AP X-Ray
X-Ray
source is typically in front of the patient and
the photographic plate lies behind the part
of the anatomy that the doctor wants to
examine. This is called an AP (front to
back) X-ray.
Standard
Standard X-ray
X-ray Views
Views Standard
Standard X-Ray
X-Ray Views
Views
AP
AP Lateral
Lateral
•• Provide
Provideaa22dimensional
dimensional
view
viewof ofthe
theanatomy
anatomy
•• Need
Need 22views
views (usually
(usuallyat
at
o
90o))to
90 toevaluate
evaluate
This example of a finger clearly illustrates why the two views might be important. In
one view, the finger looks like the bones are correctly aligned, whereas in the second
view the dislocation of the bones can be seen more clearly.
Fluoroscopy
MRI
Summary
CT and Fluoroscopy are based on X-ray technology. This involves a radiation source
emitting gamma irradiation which is absorbed by the body. As the bone is very
dense, any changes to the bony structure are very clear on the resulting image.
However, the downside is that the patient is exposed to radiation.
MRI is not based on radiation and is very good at identifying changes to the parts of
the body that contain water or fluid. This technology can be very effective at
identifying whether fractures are normal or pathological and whether the body’s
natural response of bleeding is responding to the fracture.