1-Introduction To Radiology
1-Introduction To Radiology
1-Introduction To Radiology
MED437
King Saud University
Color Index:
✓
✓
Important
Notes
Introduction to
Radiology
✓ Extra
Editting File
objectives:
Revised by:
Aseel Badukhon
What is Radiology?
✓ Medical specialty that supervises, perform and interprets
imaging studies.
Diagnostic Modalities :
01 plain X-Ray
Ultrasound (US)
04
05
Nuclear Medicine (NM)
Lowest
Radar
The higher frequency, the higher Air Fat Soft tissue Bone
penetration ability.
Advantages Disadvantages
Technique: Team436
Used In:
1. GIT imaging (e.g. dysphagia, peristalsis).
2. Genitourinary imaging (commonly used for UTIs, Obstructions,
dilatations, collecting system abnormalities).
3. Angiography (vascular system) (assess the blood flow in the
vessels).
4. Intraoperative (during surgery).
5. Foreign body removal.
6. Musculoskeletal.
Advantages Disadvantages
01 02 03 04
Density:
○ Density is measured by Hounsfield Unit (HU). Read more about it here.
○ CT has very small differences in X-Ray absorption values compared with
conventional radiography; the range of densities recorded is increased
approximately 10-fold.
○ So, gradations of density within soft tissues can be recognized, e.g. brain
substance from cerebrospinal fluid, or tumor from surrounding normal
tissues.
Components Densities: image key: shades (densities)
Bone/Ca:
>100->1000
Air: Blood:
-1000 Fat: Soft Tissue: 45-75
-150 20-80
Water:
0
COMPUTED TOMOGRAPHY
lung window Mediastinal window
:)
it has two windows:
1. Wide window: to visualize more structure within a certain organ such as bronchi,
vessels and alveoli in the lung (Lung window). (Bone to visualize cortex, medulla and
trabeculae)
2. Narrow window: to visualize certain structures within certain region such as major
vessels and heart in mediastinum “Vascular structures” (mediastinum window).
Uses of CT:
1. Neuroimaging:
○ Acute head trauma, acute intracranial hemorrhage.
○ We can use CT on patient that presents with headache to diagnose brain tumor.
○ Low sensitivity for:
a. Early ischemic stroke.
b. Intracranial metastatic disease.
c. White matter degenerative disease.
3. Body imaging:
○ Chest, Abdomen, Pelvis (with enteric and IV contrast).
○ Pulmonary nodules, Renal calculi (without contrast).
○ Acute appendicitis (with enteric and IV contrast).
4. Specialized protocols:
Liver masses, pancreatic tissue, renal masses, and adrenal masses.
5. Acute Abdomen:
Decrease rate of false laparotomy (a surgical incision into the abdominal cavity, for
diagnosis or in preparation for surgery).
8. Vascular imaging:
CT angiography I.e. Coronary arteries.
Radiation Risks
There is a major risk behind CT scan:
○ One brain CT scan radiation = 200 X-Ray radiation.
○ One pelvic CT radiation = 400 X-Ray radiation.
So, don’t request a CT scan unless needed, and we can't use it for a pregnant women unless
absolutely necessary.
Advantages Disadvantages
✓ The best soft tissue imaging and × Expensive.
pathology (tumors and infections). × Time consuming. so we can’t use it on
✓ No ionization. emergency patient
✓ Can be done on pregnant women. × May evoke phobias Claustrophobia
✓ Images can be obtained in any plane (phobia of narrow places).
(unlike CT which is taken in axial × No metals allowed.
position). × Motion. (patient movement)
ULTRASOUND
○ Ultrasound is sound waves with frequencies which are higher than those audible
to humans (>20,000 Hz).
○ Ultrasonic images also known as sonograms are made by sending pulses of
ultrasound into tissue using a probe.
○ The sound echoes off the tissue; with different tissues reflecting varying degrees
of sound.
○ The echoes are recorded and displayed as an image to the operator.
○ Needs a well-trained operator.
○ A Doppler ultrasound is a noninvasive test that can be used to estimate the blood
flow through the blood vessels.
EXTRA
Advantages
✓ No radiation.
✓ Can be portable. “easily used in ICU”
✓ Relatively inexpensive.
NUCLEAR MEDICINE
In the nuclear medicine: the source is from
patient while the detector is outside unlike the
others “source were outside”
CT
EXTRA
abdomin
al aorta
EXTRA
EXTRA
PICTURES
MRI
EXTRA
EXTRA
Ultrasound
Nuclear Medicine
EXTRA
SUMMARY
definition pros cons indications
to visualize more structure within certain organ to visualize certain structures within certain
CT scan types such as bronchi, vessels and alveoli in the lung region such as major vessels and heart in
(Lung window).to visualize cortex, medulla and mediastinum (Mediastinal window)
trabeculae (bone)
Fluoros
copy During fluoroscopy, x-ray beams
● Requires
● GIT imaging
are continually emitted and ● Genitourinary imaging
● Functional and ingestion/injection
captured on a screen, producing a ● Angiography
anatomic imaging. of contrast
real-time, dynamic image. This ● Intraoperative Foreign
medium.
physiology/ function
Iodine (e.g. IV
X-ray Opacity vs Lucency Yes - Pregnancy (relative)
pyelogram)
Full bladder
Ultrasound Echogenicity Air (‘microbubbles’) No Body habitus, Operator skill
(gynae scans)
Radioactive labelled
Nuclear Uptake Yes - Pregnancy, Breastfeeding
‘tracer’
Barium/Air/Gastrograf NBM/Bowel
Fluoroscopy Filling defect Yes Poor mobility
in prep
source:
https://www.radiologycafe.com/medical-students/radiology-basics/im
aging-modalities
QUESTIONS
1. Which of the following uses ionizing 6.the window of choice to confirm the
radiation: diagnosis of bronchiolitis ?
a) MRI c) Nuclear medicine a) wide window
2. which of the following is true regarding 7. Which modality is best used to assess for
natural contrast media in the body : motility disorders of the gastrointestinal tract?
a) fluoroscopy c) MRI
a)hair c) blood
b) x-ray d) CT scan
b) fat d) cartilage
3. high atomic number substances will appear 8. the modality of choice to detects differences
...in x-ray? between cancer and normal cells in the
a) light consumption of glucose?
b) dark a) fluoroscopy c) MRI
d 9)
a) US c) x-ray
b 8)
a 7)
b) Nuclear medicine d)MRI
a 6)
d 5)
d 4)
a 3)
b 2)
d 1)
Answers
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