Introduction of Veterinary Radiology

Radiology- Branch of medical science that deals with diagnostic and

therapeutic applications of radiant energy.

GENERAL TERMINOLOGY:
❖ Electromagnetic ray: Any ray which travel in electrical field as well as magnetic
field. Eg. X-ray
❖ X-RAYS: X-rays are a form of electromagnetic radiation with high energy, very
short wavelength. no charge or mass and travel at the speed of light through
space as a combination of electric and magnetic fields..
❖ Radiograph (Skiagram, Roentgenogram): It is a composite shadow of structures
and objects in the path of an X-ray beam recorded on the film. Radiography is
the processes involved in getting a radiography whereas the procedure of
looking at a radiograph is called radiology
❖ Radiologist: Any person in medical or veterinary Sciences and Radiological
Physics to use radiant energy in the diagnostic. therapeutic and research fields
of medicine.
❖ Radiographer: A technically trained person who can obtain quality radiographs
for use by a radiologist
❖ Radiant energy: Energy emitted and transferred or propagated through the
matter is called radiant energy or radiation.
❖ Ionization: Any type of energy or matter energy combination capable of
removing one or more orbital electrons from the atom after interaction is
known as ionizing radiation. The process is called ionization.
❖ Kilovolt: The presence due to the forcing electrons along their ions is called
potential difference and is measured in units called Volts. In radiography,
kilovolt is used for the unit. I KV= 1000 Volts
❖ Kv (kilo voltage): The potential difference between cathode and anode.
❖ KVP: Indicates maximum energy available at that kilo voltage setting.
❖ Part Film Distance: It is the distance between the object to be radiographed and
the x-ray film.
Ionising radiation can be classified into two basic types:
I) Particulate or corpuscular radiation: These radiations are composed of
subatomic particles. Of matter and may either be electrically charged or be
neutral. The energy carried by the particles depends on their mass and speed.
Typical particulate radiations are alpha and beta particles , protons, electrons
(cathode rays), neutrons, nuclear fragments etc.
II)Electromagnetic radiation: Production of electromagnetic radiation (EMR) is
another form Of transporting energy through the space. The EMR consists of
both electrical and magnetic fields. Set up by vibrating electrons. The changing
magnetic field is perpendicular to the electrical field. Eg. X-rays and gamma
rays

X- RAY:
➢ X stands for unknown.
➢ X-rays are electromagnetic radiations of high energy and low
wavelength produced by the conversion of kinetic energy of electrons
into electromagnetic radiations. These rays have sufficient energy to
ionise the atom and the ability to penetrate solid matter, animate as
well as inanimate, and so are used to examine the internal structures.
➢ Withelm Conrad Roentgent discovered it unknowingly and named it
x-ray in 1895.
➢ Father of veterinary x-ray: Dr. Richard Eberleen, 1 used in horse
st

PROPERTIES OF X-Ray:
i. X-ray is invisible.
ii. These are electromagnetic radiations and behave as waves.
Their short wavelength ranges from 0.1 to 0.5 A with energy
levels of 25-125 keV.
 iii. X-ray travel in straight line. iv. Speed of x-ray is same as that
speed of light.
v. X-ray have their own frequency and wavelength (high frequency
and low wavelength).
vi. X-ray have effect on somatic cells as they can penetrate inside
cells. vii. X-ray cannot be focused with any lens.
viii. X-ray doesn’t carry any charge, it is inert. ix.
X-ray can produce photographic effect.
x. X-rays produce excitation (process of raising an electron to a
higher energy level) and ionization (process in which an
electron is completely removed from an atom) of the atoms
and molecule of the substances through which they pass.
TYPES OF X-RAY APPARATUS:
1. Portable X-ray machine:
Portable x-ray machines are widely used in veterinary practice. The
advantages are:
• They need little maintenance.
• They can be operated from any 15 A electrical point
• They can be easily transported.
• They are light and easily maneuvered.
The disadvantages is their low milliamperage necessitates longer
exposure time and it predisposes to movement blur. Maximum output
is 70-90 Kv and 15-30 mA.
Uses-Suitable for x-raying of limbs below stifle and elbow of large
animals and abdomen and skeletal system of small animals.
2. Mobile x-ray apparatus:
In machines of this type the transformer are larger to permit higher
output and hence cannot be transported easily. They are mounted on
 wheels, and are cumbersome to use for restive animals. The output
varies from 90-125 Kv and 40-300mA.
Uses-Can be used for large animal for radiographing head, neck, and
limbs and this machine is quite useful for small animal practices

3. Fixed x-ray apparatus:

This machine requires transformer which have to be built in the room
and special electric connection (3 phase). The output ranges from 300-
1000mA and 120-200kv. This type of mahcines are suitable only for
big institutions because of high expenses involved. Suitable for both
large animal and small animal radiography.

PRODUCTION OF X-RAYS:
➢ X rays are produced by energy conversion when a fast moving streams
of electrons is suddenly decelerated in the target anode of the x-ray
tube, or by bombarding a tungsten target with an electron beam it gives
up some of electron of its energy.
➢ Most of the energy (over 99%) will be transformed into heat; the
reminder of the energy will be converted into x-rays. As x-ray beam
passes through the patient differential absorption takes place
depending on the tissue density and shadowgraph is obtained.
PARTS OF X-RAY MACHINE
It consists of four main parts:
• X-ray tube
• Transformers/ Generators
• Tube stand
• Control panel.
The X-Ray tube:
Basic components of an X-ray tube:
1) Air evacuated glass envelope: A vacuum is necessary to prevent
accelerated electrons from colliding with air molecules.
2) Cathode: The cathode is a wire filament (usually tungsten, metallic
point 3400°C) which is the source of the electrons. Electrons are
produced by heating a filament by thermionic emission. The number
of electrons which pass from the cathode to the anode represents the
tube current and is measured in milliamperes (mA)
3) Anode: The anode is a tungsten disc that acts as the target for the
electrons that come from the cathode. X-Rays are produced at the
anode when it is struck by electrons; but only 1% of the incident energy
is converted to X-Rays. The remainder is converted into heat, and
must be dissipated. A fixed anode relies on conduction of the heat
away from the target by mounting it on a copper stem while a rotating
anode allows X-Rays to be produced over a greater area of the target
by rotating it during the exposure.
The Rotating Anode : As the anode spins, the electron beam interacts
with a new part of the anode. Again, a rotating anode spreads the x-ray
formation and heat over a larger area. If it did not spin, the electron
beam would hit the same part of the anode at all times which would
damage the anode. The area where the electron beam hits the anode
is called the focal spot.
4) Others: There are a few other components such as cooling
mechanisms, the window of the tube etc.

Other parts of an X-Ray machine

• The filament circuit to beat the filament,
• The high voltage circuit to provide the high potential difference
across the tube.
• A timer to control the duration of the exposure.
How x-rays are produced or what goes on in the tube?
Step 1: The cathode filament is heated thus electrons to be emitted
form the filament and form a cloud around the filament. A focusing
cup keeps the electrons in a tight cloud.
Step 2: At this point, voltage is applied to the tube, which causes the
electrons that are waiting in the cloud on the filament to accelerate
toward the anode.
Step 3: Electrons collide with the anode and two things happen: 99%
of the energy is released as heat and 1% energy converse to X-ray.

➢ X rays are generated by two different processes when high speed

electrons lose energy in the target of the x ray tube due to radiative
interaction:
1) Characteristic radiation or Line radiation-
When the projectile electron interacts with the electron in the K
shell of the traget atom rather than the electron in the outer shell
it results in the ejection of electron in the K shell if the energy of
the projectile electron exceeds the binding energy of the ejected
electron. This results in transient electron vacancy in the K shell
into which an electron from the outer shell or from another atom
falls and this process continues till the atom becomes stable. This
shifting of electrons results in emission of X-ray photon which
possoses an energy equal to the difference between the binding
energies of the electrons involved. Hence the X-ray photon
energy is characterisitic of the shells involved in an element and
so called as characteristic radiation.
2) Bremstrahlung radiation or Breaking radiation-
When the projectile electron approaches the nucleus of the atom
avoiding the orbital electrons, it slows down, due to the opposite
charges, and gets difflected from its original course. During this
 the incident electron loses its kinetic energy, due to its slow down,
and this loss of kinetic energy is emitted as X-ray photon.
The X-ray produced by this type is called bremstrahlung or
breaking radiation. The incident electron may also collide with
the nucleus at times, converting all its kinetic energy to a single X-
ray photon.

X-ray generators:
➢ An X-ray generator is the device that supplies electric power to the X-
ray tube. An X-ray generator begins with a source of electrical energy.
An X-ray tube cannot use simple alternating current. If an alternating
current is applied to an X-ray tube electrons would first go toward the
anode. then they would reverse and go toward the cathode. This would
only happen one time because the cathode would be destroyed. To
keep electrons going in one direction. the generator must first convert
the alternating current into direct current. A rectifier performs this
function.
➢ A rectifier is a device that allows current to flow in only one direction.
There are two ways to rectify alternating current and make it flow in
only one direction:
Half-wave rectification: In this type of rectification, the tube emits X- ray
only half of the time. The inverse voltage of AC is removed from the
supply to the tube by rectification. In this form of rectification the negative
part of the sine wave is simply chopped off. Used normally in dental X-
ray only.
Full-wave rectification: In this form of rectification, the negative part of
the sine wave is inverted. This allows X-rays to be formed during the
whole cycle of current.
Basic atomic physics to understand basic interaction of X-ray with matter:
All elements have atoms. Each atom has a central nucleus, and electrons at
the periphery arranged in shells . The nearest shell to the nucleus is
designated as K shell and consecutive shells as L, M and so on. When an
incident beam of X-ray strikes matter, there is interaction with the target
atom, a single or all electrons may be involved. This interaction produces
certain effects which are mostly related to the intensity of incident photons
required to initiate an interaction and the extent of energy transfer that
occurs in the process. The electrons present in each shell are specific in
number, e.g. inner most K shell contains two electrons, if more electrons
are present they must move to L shell which can contain eight electrons.
Since nucleus is positively charged and electrons are negatively charged,
there is a force of attraction called binding energy. The binding energy of
K shell, i.e. nearest to the nucleus, is maximum. This binding energy
decreases towards the periphery and the electrons of the outermost shell
are loosely bound or almost free. To dislodge an electron from its orbit, an
energy greater than its binding energy is required.
BASIC INTERACTION OF X-RAY WITH MATTER:
For an X-ray examination, the part to be examined is kept between the
X-ray source and an X ray film. Thus the X-ray beam emitted by the
machine traverses through the part to be examined to reach the film,
carrying useful information which is recorded as an image on the film.
While passing through the patient:
• Some X-rays are differentially transmitted through the patient
carrying useful information.
• Some photons are absorbed and cease to exist.
• Some are deflected from their course as scatter radiation which
carries no useful information and rather decreases the quality of a
radiograph by causing fog on the film.
X ray photon can interact with matter in five ways of which the
Photoelectric effect and Compton effect are important in diagnostic
radiology.
1. Coherent scattering
2. Photoelectric effect
3. Compton effect
4. Pair production
5. Photo disfiguration
Coherent scattering-
In scattering, interaction causes only a change in the direction of
photon without transfer of energy and thus no ionisation. In this
effect, either a single or all electrons do vibrate to produce radiation
to cause some fog on the film, but percentage of scatter radiation is
so low (5%) that it is also not of much interest in diagnostic radiology.
Therefore, only photoelectric and compton effects, of much
importance in diagnostic radiology.
Photoelectric effect-
The effect is mostly produced when x-ray photons interact with inner
shell electrons of a atom (KLM). It occurs more with low energy
incident photons and high atomic numbers element, provided that
the photons have sufficient energy to over come electron building
energy with atom.
Compton effect-

• As an incident photon encountered a free electron of the outer shall

of the atom, the photon travel in a new direction as scatter radiation.
Compton effect produce almost all the surface radiation
encountered is diagnostic radiology. It is the major radiation hazzard
y fluorspar examinations.
 • Photon defected at a narrow angle is electron to reach the film being
exposed to cause fog. When an incident photon with energy slightly
greater than the binding energy of a k shell electron encounter the
scatter, the k shell electron is affected from its shell. The photon
disappears as most of its energy is utilized to over come the binding
energy of k shell electron.
• The free electron flies off as photoelectron. Another electron from
an adjacent or outer shell of another atom immediately fills in to the
void created by an ejected electron. As this electron drops in to the
created void, it gives off energy is the form of characteristic radiation.

FACTORS AFFECTING RADIOGRAPHIC QUALITY

An good diagnostic radiograph is one is which there excellent details,
correct density and the proper scale of contrast. The proper use of
various radiographic exposure factors KVP, mA Time and FFD are
employed.
QUALITY OF RADIOGRAPH:
➢ Quality of radiograph is directly influenced by the quality of the
beam. As the proportion of high-energy photons increases, quality
is also improved. Intensity is a measure of the amount of radiation
produced.
➢ Various factors affect the quality and intensity of the beam. These
include:
1) Radiographic Factors
2) Geometric Factors
3) Photographic Factors
Radiographic Factors:
1) Exposure factors:
• kV: the greater the potential difference across the tube, the faster
the electrons move and the higher the energy of the X-ray
photons. Thus the quality and intensity are increased.
• mA: the higher the tube current, the greater the intensities of all
the photon energies and the intensity of the beam is increased.
• Time: the longer the exposure, the greater the time during which
X-rays are produced. And the greater the beam intensity. The
time (seconds) and mA are generally considered together as the
composite factor mAs.

2) Focal film Distance (FFD):

Increasing distance from the source of radiation results in a decrease
in the intensity of the beam, according to the inverse square law,
Hence, doubling the distance from the tube head will result in a
beam of one quarter its original intensity.

3) Movement of the patients or Motion unsharpness:

Motion unsharpness is the loss of Radiographic quality due to the
movement of either the patient or the X-ray tube or the film during
X-ray exposure. In veterinary radiology, movement of the patient is
the problem. Shortest possible exposure time and appropriate
reasoning measures can reduce this problem.
4) Beam restricting devices:
Small fields of exposure may result in less scatter. Less scatter means
a better image. Common devices used to accomplish this task of
decreasing the size of the X-ray field are cones, cylinders, and
aperture diaphragms. Currently, the standard technology Is the
collimator.
Geometric Factors:
1) Image magnification:
➢ Shorter the distance between light source and object greater the
magnification.
➢ Magnification = Focal Distance(FFD)/Part Film Distance(PFD)
➢ Short FFD increases the magnification and longer FFD decreases
the magnification.
➢ Short PFD results less magnification and distortion and increased
PFD cause more Magnification.

2) Image Distortion:
Shape and size of the object being examined when altered on
radiograph due to unequal magnification of different portions
distortion of the image is evidenced.

3) Image unsharpness (Penumbra)

It refers to the region of partial illumination that surrounds the
complete umbra (true shadow) causing undesirable blurred region
on the radiograph.
Objective qualities of a good radiograph:
Three main visible requirements of a good radiograph are
• Excellent detail
• Correct density
• Proper scale of contrast.
Detail:
Detail is the degree of definitions of an object on a radiograph. Good
detail is the true reproductions of an object. The factors affecting the
detail are:

• Shorter Focal Spot film distance. (FFD)

 • Closeness of the object to the film. Use of intensifying screen.
• Movement of either the patient, cassette on movement of the
machine.,
• Screens, film contrast.
• Over exposure or under exposure.
• Focal spot size.
• Any condition fogging the film will bring out loss of detail.
Density:
➢ Radiographic density is determined by the amount of light absorbed
by an exposed x-ray film and is a measure of the degree of blackness
of the film.
➢ Radiographic density is affected by te subject density which the
weight per unit volume of different body constituents. The density
of the radiograph varies directly with milliamperage, provided all
other factors remains constant.
➢ Higher milliamperage produces more x-rays and thus more density
and lower milliamperage results is less density. Radiographic density
varies directly with exposure time. Radiographic contrast is the
difference in density between the image of parts or structures on the
radiograph.
Contrast:
➢ Contrast is the difference between blacks, grays and whites. There
can be long scale contrast and short scale contrast. Radiographic
contrast varies inversely with the kilovoltage. The lower the kv
produces a radiograph with a "short scale of contrast". Secondary
radiation and scattered radiations causes lack of contrast. Improper
development of film and use of warm developer cause lack of
contrast. To get good radiograph in veterinary patients the following
technique should be followed :
 • Fastest exposure time possible (To prevent movement blur)
• Higher kvp.
• Constant distance
• Constant milliamperage

Contrast radiography:
A contrast medium is a either highly radiolucent or highly radiopaque
substance, which is administered to a patient to increase radiographic
contrast within an organ or system. Contrast radiography is a special
radiographic procedure using contrast media.

CLASSIFICATION:
There are two categories of contrast media:
i) Positive contrast media
ii) Negative contrast media

Positive contrast media:

➢ They absorb more X-rays than do soft Tissues or bones. E.g. barium
(atomic no. 56) or iodine compounds (atomic no.53). These are
radiopaque and appear white on radiographs.
➢ Positive contrast media is used to fill or outline a hollow organ (e.g. G.I.
tract, urinary bladder), or can be administered intravenously for
immediate visualization of the vascular supply or for subsequent
excretion evaluation.
➢ Ideal characteristics of ideal positive contrast media:
• Should be of high atomic number (preferably more than 50).
• Should be either inert or its metabolic byproducts should not be
toxic.
 • Should retain in the organ to be radiographed only for a desirable
period.
• Contrast agents used for excretory organs must specifically be
excreted through that in sufficient concentration for diagnostic
quality of radiograph.

➢ Adverse reactions: Adverse reactions after injection of positive contrast

agents can be described under two categories:
1) Chemotoxic or local reactions: These reactions include all types
of allergic responses, Urticaria, head jerks, muscle fasciculation
etc.
2) Systemic or hypersensitive reactions: These reactions may occur
even with a small dose of the contrast agent but increasing the
dose increases the incidence. Reaction may occur due to a
mediator release (histamine), antigen-antibody reaction

➢ Broad classification of positive contrast media:

1) Barium sulphate preparations: Barium sulphate is exclusively used
for outlining alimentary tract. It is insoluble and is not absorbed in
the body. Therefore, its use should be avoided if perforations are
suspected. If it enters peritoneal or pleural cavity, it remains
permanently in situ and may provoke granulomatous reaction. It is
available as powder, suspension or paste.

2) Soluble iodine preparations: These form the largest single group of

contrast media. All conventional and low osmolarity contrast media
fall in this category. Their adverse reactions, ideal properties and
information about low osmolarity agents has already been briefed in
this section. Commonest conventional agents are the sodium and
 megluimine salts of iothalamic, diatrizoic Or metrizoic acids. Since
these are ionic, they dissociate in solution.

3) Cholycystapaques: These are water soluble organic iodine

preparations but exclusively Excreted through the biliary system.
These agents are thus exclusively used for outlining biliary System
and gall bladder. Intravenous preparations (Meglumine iodoxamate,
ioglycamate or iotroxate) Are better than oral preparations (Sodium
iopodate, Topanoic acid) as absorption through oral route is variable.

4) Viscous and oily preparations: Since water soluble contrast media are
quickly eliminated, viscous and oily preparations are indicated when
this is not a desirable feature. These agents are less irritant. Because
of their immiscibility with water, these preparations are not suitable
for intravascular use. Their use in veterinary practice is limited to
lymphangiography, dacrocystorhinography and hysterosalpingo-
graphy. These can be used for myelography if non-ionic agents are
not available. Propyliodone is a viscous agent while iodised oil and
iophendylate are oily agents.
Negative contrast media:
➢ Agents with low specific gravity, They are gases like air, oxygen and
carbon dioxide appear black on a radiograph.
➢ An ideal negative contrast media should be
• Inert.
• Low specific gravity
• Quickly dissolved in the body fluids.
• Quickly eliminated from the body.
➢ Negative contrast media is used to fill or outline a hollow organ like
urinary bladder, which is appeared black on a radiograph.
➢ Eg. CO2, O2, N2O
CONTRAST TECHNIQUES:
DACROCYSTORCHIOMOGRAPHY
➢ Contrast Radiographic study of the nasolacrimal duct, Contrast agents
are administered via very small Catheter into the superior puncta.
➢ Water soluble contrast agent are used and hence quick Radiographic
exposure to required because of their rapid is drainage
➢ If not available Rose Bengal microbiology agent can be used.

SIOLOGRAPHY
➢ Contrast radiographic study of Salivary gland.
➢ Indications:
• Hernia in the salivary gland – Their will be always Saliva in mouth,
leads to erosion of buccal mucosa And promote microbial growth..
• Obstruction in Stenson and Parotid duct.
➢ Water Soluble contrast agent (Iohexane) is used.

BRONCHOGRAPHY
➢ Contrast radiographic study of outlining of alveoli and complete
bronchial tree. The contrast material is then administered by means
of a catheter through the endotracheal tube.
➢ Oil based Contrast agent are used as they are less irritant and also
water based contrast agent causes aspiration pneumonia.
➢ Left lung study → patient has to lie down left side.
➢ Right ling study→ Patient has to lie down right side.
➢ Animal should be fast for 24-36 hours.
OESOPHAGOGRAPHY(BARIUM SWALLOW)
➢ Contrast radiographic study of oesophagus. This technique is used to
evaluate both structural and functional status of the oesophagus after
introduction of a positive contrast agent.
➢ Oesophagraphy is indicated to diagnose cases of oesophageal
obstruction, stenosis, diverticulum, perforations and mucosal
diseases.
➢ It should not be used if rupture of the thoracic part of the oesophagus
is suspected.
➢ Barium sulphate suspension in water. With its viscosity similar to that
of light cream, is usually used as a contrast agent. Water soluble iodine
based agents are recommended if cervical oesophageal rupture is
suspected.
➢ Dose- 1-2 ml/kg

RETICULOGRAPHY
➢ Contrast radiographic study designated to diagnose cases of reticular
hernia in cattle and buffaloes by feeding barium sulphate suspension.
➢ Any obstruction, growth, foreign body in reticulum can be diagnosed.

BARIUM SERIES
➢ The technique is used to examine radiographically the gastrointestinal
tract. It is routinely used in small animals but is of limited value in
ruminants. However, it can be used in sheep, goats and calves to
visualise major part of the tract.
➢ The procedure is indicated to evaluate structural and functional status
of the gastrointestinal tract. Since barium is reported to cause
granuloma formation in the peritoneal cavity, the technique should
be avoided if rupture of the stomach or intestines is suspected.
➢ Contrast agent- Barium sulphate
 ➢ Animal should be feed off for about 36 hours and water off for 12
hours before study, and magnesium sulfate should be given orally 12
hours before study.
Dog- @5-10 ml/kg for 24 hours
Cattle- @2ml/kg for 36 hours

BARIUM ENEMA
➢ It is used to outline the colon and rectum in suspected cases of intra-
luminal or extra-luminal obstructions. This technique is not indicated
if perforation is suspected.
➢ Contrast agent- Barium sulphate. Infused via catheter to fill the colon.
➢ Animal should be feed off for about 36 hours and water off for 12
hours before study, and magnesium sulfate should be given orally 12
hours before study.
➢ Warm soap water enema is indicated about 2 hours before the study.

PERITONEOGRAPHY
➢ It is the contrast radiographic study of the peritoneal cavity and its
contents by injecting negative contrast agent like air (pneumoperito-
neography) or a mixture of a negative and a positive contrast agent
(double contrast peritoneography).
➢ The technique is indicated to determine the locations of various
abdominal organs and suspected abdominal mass if any but should
not be used in suspected diaphragmatic hernia because of danger of
pneumothorax.
➢ Contrast agent(air or CO2) is infused via catheter into the peritoneal
cavity through left paralumbar fossa in case of pneumoperito-
neography.
UROGRAPHY/INTRAVENOUS PYELOGRAPHY (IVP)
➢ It is the contrast radiographic study of the kidneys, bladder and
ureters by injecting positive contrast medium to diagnose
abnormalities of urinary tract.
➢ Water soluble contrast agents are mainly used for proper elimination.
Eg. Sodium iothalamine, Iohexane
➢ This technique is unsuitable in severely dehydrated patients because
of risk of Fatal anuria.

CYSTOGRAPHY
➢ It is a radiographic study performed to help in evaluation of the urinary
bladder for extramural, mural, or intraluminal lesions. Cystography is
easy to perform with relatively few complications. Different types of
cystography (positive versus negative contrast) may be used.
➢ Negative contrast cystography (Pneumocystography): Simply catheterize
the bladder (using sterile technique) → drain all the urine from the
bladder through a three way stop cock, instill air or gas into the bladder
until it becomes slightly turgid take lateral and ventrodorsal radiographs.
➢ Positive contrast cystography: Drain the air out of the bladder in
pneumocystography and replace it with approximately 50 mL of positive
contrast medium turgid take lateral and ventrodorsal radiographs. The
positive contrast media can be diluted with 50% with sterile water as
large volumes are excessively opaque and expensive. This positive
contrast cystogram will provide more acute detail of the mucosa and the
bladder wall as compared to negative contrast study.
➢ Double contrast or double contrast alongwith pneumoperitoneum
provides better result.
INTRAOSSEOUS PHLEBOGRAPHY/OSTEOMEDULLOGRAPHY
➢ The technique is used to visualise intraosseous and extraosseous
venous channels of a long Bone.
 ➢ It can be used to aid diagnosis of delayed and non-union of a fracture,
degenerative arthritis And bone neoplasms. It has also been used to
diagnose avascular necrosis.

MYELOGRAPHY
➢ The technique refers to the contrast radiographic examination of the
spinal cord and emerging spinal roots after injecting the contrast
material into the subarchnoid space.
➢ It is indicated to diagnose intervertebral disc protrusion, intraspinal
lesions, vertebral canal haemorrhage and spinal cord oedema.
➢ It should not be used in cases of meningitis, myelitis, myelomalacia
and when myelography has been done in the recent past.
➢ Technique:
Any contrast material used for myelography should be non-irritating.
Air can be used but does not provide adequate contrast. Metrizamide is
an agent of choice being non-ionic, non-irritating, Water soluble agent.
The contrast column is also visualised for a longer time.
➢ Site of injection- Forman Magnum and Lumbo-Sacral joint.
➢ Its dose is:
Dogs- 0.2 to 0.4 ml/kg
Neonatal calves- 0.3 to 0.4 ml/kg.
➢ For myelography, the animal should be anaesthetized and all aseptic
precautions should be taken to inject the contrast medium.

ARTERIOGRAPHY
➢ It refers to the contrast radiographic examination of the arterial
system of an area.
➢ It is indicated to study the arterial pattern in normal subjects from
anatomy point of view and to study variations in patterns due to a
pathological process. It is also indicated to diagnose arterial
occlusion.
 ➢ Water soluble contrast agents are used. Since these agents are
irritating, the procedure should be used after anaesthetising the
animal.

ARTHROGRAPHY
➢ The technique is used to visualise structures of a diarthrodial joint
after injection of a positive or negative contrast medium or a
combination of both. The technique aids in diagnosis of various joint
abnormalities or diseases.
➢ Technique
Double contrast study provides better results and is being discussed
here. In such a study, positive contrast coats the joint margins while
negative contrast demonstrates the whole joint. When used alone,
positive contrast is rapidly resorbed and also has a tendency to mask
intra articular lesions. The negative contrast does not provide
sufficient details.
➢ Among contrast agents, meglumine and sodium diatrizoate, diluted
as a 20 to 40% solution with saline or distilled water, provide better
results which are injected in the joint.

FASCIAGRAPHY
➢ It is a contrast radiographic study of tendons and associated
structures. The technique can be used to diagnose adhesions,
calcification and rupture of tendon and muscles.
➢ Technique
• Apply a tourniquet each proximal and distal to the site. Introduce
a 16-18 G needle, using aseptic technique, between the muscle and
tendon.
• Inject room air till area between the two tourniquets is moderately
distended.
SCATTER RADIATION AND IT’S CONTROL:
➢ Scatter radiation refers to radiation which deviates from the primary
beam both in direction and wavelength after interacting with a
medium or a patient being exposed to X-rays.
➢ Scatter radiation may follow different directions, if angle of scattering
from the primary beam is less than 90°, it is forward scatter and if
angle of deflection is more than 90°, it is called back scatter.
➢ At low kVp most scatter is backwards while at high kVp most is
forward.
➢ If no device is used to check this scatter radiation, 50% blackening
of a processed film may be entirely due to scatter radiation. Apart
from affecting the quality of a radiograph, scatter radiation is also
hazardous to personnel working in radiology section.
Factors affecting scatter radiation:
➢ The relative intensity of scatter radiation is directly proportional
to the following factors: i) Kilovoltage ii) Body part thickness iii)
Field size.
➢ Kilovoltage:
As the kVp increases, scatter radiation due to compton effect,
and per cent transmission of X-rays through the patient
increases but patient dose due to photoelectric effect decreases

➢ Body part thickness:

The quantity of scatter radiation increases with increased body
part thickness

➢ Field size:
Larger the field size, more is the scatter radiation reaching the
film. Radiographic Quality can be increased by using a small
field size as scatter radiation gets a large angle to Escape away
from the film.
Scatter radiation control devices:
➢ Main scatter radiation control devices are beam collimators and
grid.
➢ Use of filters also reduces scatter radiation but primary objective
is to remove low energy photons from the primary beam so as
to reduce patient dose.
1) Beam collimator
➢ Collimation refers to the regulation of X-ray beam by beam
restricting devices to restrict it to the site of the part of the patient
under examination.
➢ Collimation offers following advantages:
Reduction in scatter radiation and thus improvement in
radiographic quality.
Decrease in patient dose by reducing the area being exposed
➢ Several types of collimators are available which are placed in the
path of X-ray beam as close to the tube. Following types of
collimators are most commonly used:
i. Aperture diaphragm
ii. Cones and cylinders
iii. Variable aperture collimator
➢ Aperture diaphragm:
• It is simplest of the collimators and is made of a sheet of lead
with a circular, square or rectangular hole in the centre that
permits X-ray beam to pass through.
• Disadvantage
i. large penumbra formation at the periphery.
ii. Inconvenience experienced while frequently changing the
diaphragm as a separate size of diaphragm is required for
each size of the film.
➢ Cones and cylinders
• These are conical or cylindrical metal tubes that channel an X-
ray beam to the required field size. the base of a cone or cylinder
is made-up of lead to absorb x-ray. Both of these devices are
ineffective in removing penumbra.
• A cylinder produces comparatively less penumbra. Since size of
cones and cylinders are fixed, these are appropriate only for
specific radiographic examination.
 ➢ Variable aperture collimator
• This beam restricting device
with adjustable lead shutter is
the best and most commonly
used in diagnostic radiology.
• There are two sets of
adjustable diaphragms placed
one above the other to work
in pair. This allows
rectangular or square fields of
exposure of varying
dimensions.
• Variable aperture collimator offers following advantages over
other beam restricting devices:
➢ X-ray beam can be adjusted to a variety of rectangular shapes
and sizes.
➢ Exposure field can be illuminated to permit its visualisation.
➢ Penumbra is greately reduced.
➢ Rectangular beam obtained with adjustable lead shutter
exposes only the area of interest thus reducing the patient
dose.

2) Grid
➢ Grid is a flat plate containing series of alternating strips of
radiodense (lead) and radiolucent (interspacer) material encased in
a protective covering of thin aluminium. The interspace material is
made of plastic or aluminium and has the main function of
supporting lead strips at required angle and position. Aluminium is
generally preferred.
➢ Grid is placed between the part to be examined and cassette so as
to absorb scatter radiation falling on the film.
➢ Use of grid, however, results in removal of large quantity of X-rays
required to produce desired radiographic density and thus
exposure factors have to be increased to compensate for the loss.
➢ A grid should be used when the body part to be radiographed is
thicker than 10 cm.
➢ Types of Grid:
i. Parallel grids (linear grid):
Grids are composed of parallel lines of lead strips. Paralle!
Strips absorb oblique scatter radiation while interspaces allow
X-rays, perpendicular to the surface of the grid to pass through
to expose the film.
ii. Focused grid:
Here, lead strips, may be paralleled or crossed, but are angled
in alignment with the primary X-ray beam.
iii. Cross-hatched grids:
Here, grids are composed of parallel lines of lead strips and
have Two sets of grid lines running perpendicular to each
other.
iv. Potter-Bucky diaphragm (Bucky diaphragm/Bucky grid):
Grid is moved back and forth during the radiographic
exposure. By moving the grid back and forth, the grid lines are
blurred Over the resulting radiograph and can not be seen.
This type of system is also called a moving Grid system.
➢ Grid Ratio:
• The grid ratio is the height of the lead strips divides by the
distance between The strips. The higher the ratio, the more
efficient a grid is. In general grid ratio ranges from 4:1 to 16 :1.
• High ratio grids absorb more scatter radiation than low ratio grids.
 • If exposures are to be made under 90 kVp, usually 8:1 or 10:1
grids are recommended. Higher ratio grids are recommended for
higher kVp ranges.
• Use of 16:1 grid increases the patient dose significantly and so are
rarely used.
• A 5:1 grid absorbs about 85% of scatter radiation while 16:1 grid
can absorb 97% of it.

➢ Grid frequency:
• It is the number of lead strips per inch in a grid. Most grids have
frequencies in the range of 60-110 lines per inch.
• Grids with higher frequencies (more lines per inch) show less
distinct grid lines on a radiograph as lead strips are much thinner.
• Such grids, however, require higher exposure and are less
effective in absorbing high energy scatter radiation. Therefore, as
the grid frequency increases, grid ratio has to be increased to
maintain same efficiency.

3) Filters
➢ Primary purpose of placing a filter between the patient and X-ray
tube is to remove less energetic (soft) X-rays from the primary beam
which have no chance to reach the film. The filtered X-ray beam
decreases the exposure dose of the patient and scatter radiation.
These factors intum increase the radiographic detail.
Recording of image:
X-ray Film:
X-ray film composition
➢ The composition of X-ray film is similar to that of a photographic
film. Photographically active or radiation sensitive emulsion is
coated on both sides of a transparent base (double emulsion film).
➢ A thin layer of adhesive is used to achieve firm attachment between
the emulsion and base. The
emulsion is protected from
scratches, pressure or
contamination during use
by a thin layer of gelatin
called supercoating.
Thickness of a radiographic
film is about 0.25 mm.
Film base
• Firm film base provides support to fragile photographic emulsion.
• An ideal film base should have following characteristics:
a) It should be flexible, inert, light in weight and easy to handle.
b) It should be relatively transparent.
c) Undesirable visible patterns should not be produced on it.
d) It should not absorb too much light when radiograph is being
viewed.
e) The shape and size of the base must not change during
developing process or during storage life.
➢ The present day X-ray films have either polyester or cellulose
triacetate base.
 Film emulsion
➢ Emulsion is composed of a homogenous mixture of gelatin and
silver halide crystals. The gelatin is made from bone and offers
following advantages:
1) It keeps silver halide crystals well dispersed and prevent
their clumping.
2) Processing solutions can penetrate gelatin without affecting
its strength or performance.
TYPES OF X-RAY FILMS
Two types of X-ray films are used in diagnostic radiology, screen and
non-screen types.
Screen films
These types of films are primarily more sensitive to ultraviolet and blue
light range which originates from calcium tungstate crystals of the
intensifying screens. A screen film requires less exposure to produce an
image as compared to non-screen film because of intensification factor of
intensifying screens.
Non-screen films
These films are used for direct X-ray exposures i.e. without use of
intensifying screens. Emulsion’s thickness of non-screen films is more
than that of screen films in order to absorb as much X-rays as possible
and thus a prolonged processing time is required. Most non-screen films
are more sensitive to direct ionising radiation and considerably less
sensitive to blue light in comparison to screen films. These films require
higher exposure because of absence of intensifying screens and more
thickness of film emulsion. Such films are useful in radiographic
examination of extremities to detect hair line fractures or slightly bony
changes and in dental radiography to obtain better detail.
Intensifying screens
➢ Intensifying screens interact with X-ray beam that has penetrated the
patient and reached to the cassette. Screens convert most of the
radiant energy (95%) into visible light that has almost same
information as the original X-ray beam. The visible light thus
produced and remaining X rays (5%) interact with the film.
➢ The use of screens intensifies the effect of X-ray beam on the film
as it is far more sensitive to visible light than to X-rays. The screens
thus allow reduction in the exposure factors required to obtain a
diagnostic radiograph.
➢ Construction of screens:
• An intensifying screen consists of four distinct layer with a total thickness
of about 0.4 mm. These layers are: i) base, ii) reflecting layer, iii)
phosphor layer in a binder and iv) protective layer.
• Base: Base provides mechanical support to active phosphor layer and is
made of either high grade card board or polyester. Base should be
chemically inert and moisture resistant. It should not suffer damage due
to radiation and should not discolour with age.
• Reflecting layer: Thin reflecting (layer is spread between the base and
phosphor layer. It is made of shiny white substance such as titanium
dioxide or magnesium oxide. The reflecting layer reflects back the light
directed towards the base to the film.
• Phosphor layer: It is the active layer of the intensifying screen and its main
function is to convert X-ray energy into visible light. The materials mostly
used as phosphor are calcium tungstate, barium lead sulphate and zinc-
cadmium sulphide.
• Protective layer: It is a transparent layer placed close to the film. It consists
of a cellulose Compound and serves following purposes:
➢ Physical protection to the phosphor layer.
➢ Prevents static electricity
➢ Provides a surface that can be cleaned without affecting the phosphor
layer.
Film processing:
Four tanks are required for manual film processing namely, developer
tank, Rinser tank, Fixer tank and Washing tank. These vertical tanks are
available in 9, 13, 22 liters capacity.
Processing is composed of four separate steps:
1) Development:
➢ The first step is placing the film in developing solution. Developer
consists of reducing agents that convert silver halide crystal into
metallic silver to convert latent image to visible image.
➢ Developing time usually is 4-5 minutes at 20°C temperature of
developing solution. However, higher temperature requires less
developing time. Films with density are then rinsed and placed in
the fixer tank in order to retrieve some information from the film.
Composition of developing solutions:
1. Reducing Hydroquinone • Convert exposed silver halide
agent crystals to metallic silver.
• Provides contrast in image
2. Activator Sodium • Soften and swell film emulsion so
carbonate reducing agent can act on the film.
• Provides alkaline medium for
reducing agent.
3. Restrainer Potassium • Controls the activities of the
bromide reducing agent so that fogging of
the film does not occur
4. Preservative sodium • Controls rapid oxidation of
sulphide developing agents
5. Solvent Water • Used as solvent for this chemicals.
2) Rinsing:
➢ To prevent mixing of developing solution with fixing solution, the developed
exposed film is rinsed in a running water tank by agitating the film for 10-30
seconds. Water need to drip down the film before being transferred to fixer.,
If running water is not available, use 128 ml glacial acetic acid in one liter
water (stop bath) for the same purpose.
3) Fixer:
➢ The next step is the placing the film in a fixer solution to remove the
unexposed silver crystals, to stop development of the film by neutralization
of developing agents and hardening of film emulsion. Fixing time is usually
double the period of development. However, films need to keep for another
10 minutes in the fixing solution for hardening of the emulsion. As silver gets
dissolved in fixer, strength of the fixing solution reduces.
Composition of fixing solutions
1) Fixing agent Sodium thiosulphate or • Acts to remove unexposed
Ammonium thiosulphate silver crystals
2) Acidifier Acetic acid or sulphuric • To neutralize developing
acid solution
3) Hardner Ammonium chloride or • Shrinks and hardens film
ammonium sulphide emulsion
4) Preservative Sodium sulphide • Maintain chemical balance of
the fixing solution
5) Solvent Water • Used as solvent for this
chemicals.

4) Wash: The final step is the washing of the film to remove excess fixing agents
and Residual silver. Washing is carried out in a larger tank with running water.
If fixer is left on the Film. It will turn brown and hazy.

5) Drying: After washing, water is allowed to drain and film is either air or machine
dried. Film should not come in contact with each other. Dust free room with
proper air circulation is preferable for air-drying. Drying cabinet with electric
heater quicken the drying process.
Processing steps:
1) Check the level of processing solutions.
2) Stir the solutions.
3) Check temperature of solutions.
4) Select correct size film hanger.
5) Switch on safe light, switch off white light.
6) Open cassette on dry bench and take out the film by grasping a corner
with thumb and finger
7) Fix film in hanger.
8) Close cassette.
9) Place film in developer. Set the timer for required developing time.
Agitate film for few seconds to remove air bubbles. Check that films
do not touch each other or sides of the tank.
10) Clean hands, reload cassette with a fresh film.
11) At the end of developing time, lift the film out and allow developer
to drain.
12) Rinse film (10-20 seconds).
13) Transfer film to fixer, agitate it for a few seconds, Replace
developing tank lid.
14) Once film has been cleared (about 2-3 minutes in fresh fixer
solution), white light can be switched on. Film can be viewed in an
emergency case for provisional diagnosis. Replace film in fixer and
replace fixer tank lid. Keep the film in fixer for 10-20 minutes.
15) Wash film in running water for about 20 minutes.
16) After washing, allow the film to dry.
Radiation hazards and safety:
Biological effects of radiation
➢ The X-ray beam while traversing the tissue. X-ray photon forces the
electrons to be ejected from the atomic lattice. Thus, the atom left with
surplus positive electrical charge. Hence, the cells with in the tissue
come to a state of high chemical reactivity and initiate biological effects.
This results in cellular damage which leads to pathological and
physiological changes leading to “radiation sickness”
➢ Radiation insult may be somatic (harmful to person in his lifetime)
and/or genetic effects (affect several generations). Leukemia (blood
cancer) and malignant tumors are common sematic effect while atomic
explosion are examples for genetic effects.
➢ After the transfer of radiant energy to the atoms and molecules of the
living tissue of the body in the form of excitation and ionization, direct
and indirect effects of radiation can produce the resultant chemical
changes in the molecules.
➢ Direct effects appear due to absorption of energy by the molecules.
➢ Indirect effects are caused by the products of radiation decomposition
(radiolysis) of water and other solutes of the body.
➢ Mechanism of action:
Radiolysis stimulates formation of free radicals with unpaired
electrons. These free radicals and H₂O₂ formed by them are highly
reactive and mutagenic. These free radicals with high energy readily
break chemical bonds in vitally important macro molecules of the
body such as proteins, nuclide acids and lipids.
Radiation sensitivity of different body cells
➢ Radiation affects the reproductive ability of proliferating cells by
damaging the mitotic linked. Thus, regularly proliferating cells seen to
 be most radiosensitive. Cells, which do not proliferate (nerves and
muscles), are generally radio-resistant.
➢ The degree of injury to different tissues by whole body radiation can
be described as under:
1) Lymphoid tissues: The lymphocytes of lymph nodes, thymus and
spleen are highly radiosensitive. Within 15 minutes after a moderate
dose of total body irradiation, there is marked reduction in cell
division.
2) Bone marrow: The precursors of red blood cells, granulocytes and
platelets are radiosensitive, Erythroblasts are most sensitive while
myelocytes are somewhat less sensitive.
3) Cardiovascular system: The heart, and large arteries and veins are
radioresistant. The endothelium of the capillaries, however, is
radiosensitive.
4) Digestive system: Most of the clinical symptoms arise as a result of
changes in the digestive system. Ulcers and erosions in the buccal
cavity result from large doses. The pharynx and oesophagus are
somewhat radioresistant.
The stomach is quite radiosensitive and degenerative changes
are apparent within 30 minutes. Pepsinogen secreting cells are
adversely affected. Parietal cells are functionally disturbed resulting
in decreased hydrochloric acid production. The net effect is gastric
ulcers and haemorrhages.
The duodenum is the most sensitive part of the small
intestine. The large intestines are, however, less sensitive but are
prone to ulceration. The net effect of small and large intestine
injuries is loss of Quids and their decreased absorption.
5) Skin: Germinal layer of the epidermis is adversely affected. Higher
doses of radiation cause cell death and increased cellular
differentiation at the expense of cell division. Radiation erythema is
a most prominent sign in individuals with light colour skin.
 6) Urinary system: Parenchymal cells of the kidneys are radio resistant.
The damage to the kidneys occurs due to injury to the blood vessels.
The resultant ischaemia produces hypertension.
7) Male reproductive organs: The male accessory organs, epididymis
and vas deferens are radioresistant. In testes, leydig cells, sertoli cells
and interstitial tissues are radioresistant. Spermatogonia are highly
sensitive while mature sperms are morphologically resistant but at
higher doses may not be able to fertilise ova. If fertilisation occurs,
the implantation fails.
8) Female reproductive organs: Ova and the granulosa cells are highly
radiosensitive.

General Principles Of Radiation Safety:

➢ Increasing the distance between the radiation source and
personnel.(Doubling the distance from the source will reduce the
radiation exposure by a factor of four)
➢ Use of protective barriers- Lead Aprons, Lead gloves, Lead Googles,
x-ray room and equipment.
➢ Reduction of exposure factors and unnecessary radiography.
➢ Use of radiation monitoring devices.
➢ The X-ray beam filtration , collmation and proper shielding of the tube
head.
➢ Person under 18 years of age should not be involved in radio graphic
exposures because of the sensitivity of the growing tissues.
➢ Because of the extreme sensitivity of human embryos at certain stages
of development pregnant women should also not be involved
Radiation measurements:
➢ Roentgen(R): It is the unit for exposure to X-rays or gamma rays i.e., it measures
the quantity of ionisation. It is defined as a unit of radiation exposure that will
liberate a charge of 2.38 x 10 coulombs per kilogram of air. R is that quantity
of X-rays or gamma radiation which produces one electrostatic unit (2.08 x 10’
ion pairs/cm³) in 1 cc of dry air after its ionisation at 0°C and 760 mm.
➢ Rad (radiation absorbed dose) is used as the unit of absorbed dose following
exposure to any type of ionising radiation. One rad is equal to the radiation
necessary to deposit energy of 100 ergs in 1 g of irradiated material (100 ergs/g).
When soft tissues are exposed to X-rays or gamma rays, rad and R are nearly
equivalent.
➢ Rem(roentgen equivalent man):The biological effects of various types of
radiations differ a lot. In order to equate all types of radiation in terms of
biological effects, the unit Rem (roentgen equivalent man) was evolved.
One rem = rad × quality factor. Quality factor relates to the biological
effectiveness of the given radiation. The quality factor for X-rays and gamma
rays is one and for alpha particles 20.
Diagnostic ultrasonography:
Ultrasound is defined as high frequency sound wave greater than audible
sounds (more than 20.000 Hz). For diagnostic applications, frequencies of
1-10 MHz are used. Pulse-echo principle is followed in ultrasound imaging
i.e. when a sound wave travels in a pulse and is reflected back it becomes
an echo.
Properties of ultrasound:
➢ Ultrasound cannot propagate through vacuumed area and transmission
through gas is poor.
➢ A higher frequency penetrates less far but provides better resolution.
➢ The axial resolution of the ultrasound system is limited by the pulse
length and so to get high resolution, short pulse is to be generated.
Transducer:
➢ Transducer is composed of one or more piezoelectric crystals. Upon
stimulation of these crystals electrically, shape is changed and sound
waves of a particular frequency is generated. The frequency of a
transducer is calculated by the times the crystal expands and contracts
per second.
➢ It is expected that a transducer emits a single frequency sound wave, but
in reality, it emits ultrasound waves of many frequencies on either side
of main frequency (bandwidth of transducer). Narrowest bandwidth is
always desirable.
➢ The distance between the transducer (which emits and receives
ultrasound signals) and the patient must be bridged by a suitably coupling
agent.
➢ Coupling agents: It is required to bridge the gap between the transducer
face and the patient because ultrasound travels poorly through air.
Mineral oils, liquid paraffin, aqueous ultrasonic gel (mostly used) can be
used as coupling agents.
➢ Three main types of transducers available are:
1) Linear array:
Linear array transducers are composed of thin rectangular clips lined
up side by side, each of it produce sound waves. Thus, the produced
beam is rectangular and permits a good visualization of superficial
structures with an easy analysis of the Anatomical relationship.
2) Convex/Curved array:
Here, crystals are placed in curvilinear fashion. Hence, imaging of a
greater area is achieved with the same contact area.
3) Sector/ Phased array
This is most modern transducer that contains a single crystal, which
oscillates or rotates to produce a fan shaped beam. This small size
transducer is better in terms of maneuverability and access to thoracic
and abdominal organs through a small contact area. This type of
transducer more readily visualizes deeper structures whereas
superficial structures are not well visualized.
➢ As the transducer is placed in close contact with the body surface through
a coupling medium. It undergoes continuous modification which occurs
through three processes viz. absorption, reflection and scattering
➢ Absorption:
It occurs when the energy in the sound beam is absorbed by the
tissues thereby converting it into heat. Absorption process forms the
basis of therapeutic ultrasound.
➢ Scattering:
It occurs when the beam encounters an interface that is irregular and
smaller than the sound beam. The portion of the beam that interacts
with this interface is scattered in all directions. Since the scattering
interfaces are small, only a small portion of the beam is involved. There
are two other closely related phenomena, refraction and diffraction of
which refraction is a common cause of artifacts.

➢ Reflection:
It is the redirection of a portion of the ultrasound beam back towards
the source. The reflection gives rise to echo and forms the basis of
ultrasound scanning. Interfaces between tissues of different accoustic
impedence give rise to different echoes. These echoes are converted by
piezoelectric effect into electrical signals and displayed onto an
oscilloscope screen.
➢ Once the echoes are converted into electrical signals, these are processed
and transformed into a visual display of the measure of the amplitude of
the echo. This is known as echo quantification. For displaying this echo
amplitude information, different modes are used. There are three
modes of display in diagnostic ultrasound: A, B and M.
➢ Amplitude (A) Mode-
This is the simplest form of display. It displays two parameters of
the echoes in the form of spikes i.e. distance from the transducer and
 the amplitude. The horizontal line shows the distance and the amplitude
is depicted on the vertical line. It is rarely Used these days.
➢ Brightness (B) Mode-
In this mode. The image represents a slice through which
ultrasound Beam is passed and brightness of the dots of the screen is
made proportional to the amplitude of the echoes.
In real time B-mode scanner, sound beam automatically and rapidly
moves in the scan plane and image is continuously updated to allow
movement to be seen. This is very Popular mode in use in veterinary
practice.
➢ Motion (M) Mode-
It is a revision of real time scanning and records position and motion
of the echo and resembles A-mode except that A-mode also records the
amplitude in addition to the position. Each spike is replaced with dot on
the display. Images are moved along a horizontal axis.

SCANNING PROCEDURE
1) Preparation of patient:
Patient should be prepared by clipping, shaving and cleaning the hair
and skin. Coupling agents are placed in the area of interest liberally to
keep good contact of the transducer and skin without the presence of air.
Air blocks the ultrasound completely. Close contact requires having
minimum attenuation of the sound beam. Ultrasound scanning warrants
considerable co-operation from the patient. In highly temperamental
animals, tranquillizer/sedative may be advocated before examination.
Overnight fasting of the animal is advised. Laxative may be given on the
previous day to clear bowel of faeces and gas.
2) Patient positioning:
It is important to position the animal to get acoustic window for proper
image. Scanning may be performed by placing the animal on dorsal,
 right/lateral recumbency or in standing position depending upon the
organ to be scanned and availability of good acoustic window. Acoustic
window is an area may be natural or artificial through which ultrasound
beam can pass avoiding gas and bone. Full urinary bladder acts as good
acoustic window for scanning of pelvic organs, like wise through spleen
left kidney can be examined better. The organs of tissues are need to be
examined in orthogonal view (at least in two planes) one in transverse
and other one in longitudinal/sagittal. Oblique views are also advised in
few occasions.
3) Image interpretation:
Images are usually displayed as white against a black background.
Various terms used to describe the image are as follows:
• Hyperechoic or echogenic: These present the bright echoes which
appear as white on conventional scans. Such images are given by
highly reflective interfaces such as bone and air.
• Hypoechoic: These appear as grey images or dark screens and are
given by interfaces of moderate reflection such as soft tissues.
• Anechoic or echolucent: In the absence of any echo, the image is seen
as black. It is represented by complete transmission of sound such as
through fluids. The image formed on the scan screen is actually a
mixture of the images of different echoes depending on the area
scanned. Fluids will give an anechoic image as the sound beam passes
uninterrupted. There is often a normal bright area immediately deep
to fluid and this phenomenon is called acoustic enhancement.
Artifacts of ultrasonography:
A sonologist should be aware of the common artifacts to avoid errors in
image interpretation. These artifacts are:
➢ Acoustic shadows: These are caused by attenuation or reflection of the
sound beam at an acoustic interface.
When this happens, the pulse is
unable to reach the deepe interfaces
to produce any echoe. In order to
cast a shadow, the interface must
reflect a large percentage of the
sound beam. The most common
acoustic shadows of clinical
significance are those caused by
cystic, renal and biliary calculi. Gas
causes near total reflection of the beam.
➢ Reverberation: Reverberations are the largest source of positive artifact
echoes that are not real. When sound beam arrives Back at the
transducer, a portion of the sound beam is absorbed by the transducer
crystal to produce a small electrical pulse that records the echo. The
remainder, however, is reflected back into the patient. So the echo
bounces back to the transducer and is again reflected trough the patient
and back to the transducer. This process of echo bouncing back and
Forth between the two interfaces is known as reverberation.
➢ Mirror images: This effect occurs at
highly reflected interfaces. Returning
echoes reach the transducer under a
time delay and are registered on the
image as being a highly echogenic
interface that is in the path of the beam.
➢ Comet-tail: This is caused by a highly reflective interface most commonly
the air fluid interface. Comet-tail occurs most commonly in partially
consolidated lung at the interface between the diaphragm and lung, and
at the interface between the bowel wall and bowel gas.
Applications of ultrasound in ruminants have not been fully exploited, but
for pregnancy diagnosis. There could be numerous organs which can be
scanned using an ultrasound scanner. The organs which are usefully
scanned are the liver, kidney, urinary bladder, spleen, uterus, ovaries, seat
and udder. In ruminants, the use of a rectal linear scan head could be quite
versatile for the diagnosis of ovarian and uterine disorders. In small animal
and equine practice, ultrasound is now routinely used as a diagnostic aid.