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Radiology
Diagnostic Imaging Methods
Built from Fundamentals of Diagnostic Radiology
What’s inside
9 sections · 176 slides
Overview
- Imaging methods keep evolving
- Diagnostic imaging methods at a glance
Conventional Radiography
X-ray generation, detectors, views, and the five densities
- What x-rays are
- X-ray film cassette
- Film radiography
- Conventional radiography
- Computed radiography (CR)
- Digital radiography (DR)
- Fluoroscopy
- Conventional angiography
- Naming views by beam direction
- Naming views by patient position
- Five basic radiographic densities
- The five densities in order
- How anatomy becomes visible
- Erect PA chest radiograph
- Silhouetting hides structures
- Right middle lobe pneumonia
Cross-Sectional Imaging
Pixels, voxels, windows, and the PACS workstation
- Pixels and voxels
- Image matrix and pixels
- Window width and window level
- Gray scale and window settings
- PACS image manipulation
Computed Tomography
Hounsfield units, scanner types, contrast, artifacts, and windows
- How CT reconstructs an image
- How CT reconstructs an image
- Computed tomography scanner
- The Hounsfield scale
- Typical CT numbers
- Voxel size and slice thickness
- Conventional (single-slice) CT
- Helical (spiral) CT
- Multidetector CT (MDCT)
- CT angiogram of the aorta
- CT fluoroscopy
- Dual-energy CT
- Why CT uses intravenous contrast
- Timing contrast for the liver
- Liver blood supply
- CT artifacts
- Volume averaging
- Beam hardening artifact
- Beam hardening artifact
- Motion artifact on CT
- Motion artifact on CT
- Streak and ring artifacts
- Streak artifact from metal
- Quantum mottle
- Principles of CT interpretation
- Standard CT window settings
- CT windows for soft tissue and bone
Magnetic Resonance Imaging
T1 and T2, pulse sequences, fat suppression, safety, and artifacts
- What MR measures
- T1 and T2 relaxation
- How MR makes an image
- Field strength and imaging time
- Spin-echo sequences
- TR and TE settings
- Fast spin-echo sequences
- Inversion recovery and STIR
- Gradient recalled echo (GRE)
- Echo-planar imaging
- Diffusion-weighted and tensor imaging
- MR spectroscopy
- Why suppress fat
- Fat saturation
- STIR for fat suppression
- Chemical shift (opposed phase) imaging
- Opposed-phase fat suppression
- Advantages and limits of MR
- Gadolinium contrast in MR
- Contrast enhancement in MR
- MR safety: activated implants
- MR safety: metal objects
- MR safety: what is allowed
- MR artifacts
- Magnetic susceptibility artifact
- Magnetic susceptibility artifact
- Motion artifact on MR
- Motion artifact on MR
- Chemical shift misregistration
- Chemical shift artifact
- Truncation error
- Aliasing (wraparound)
- Reading MR tissue signal
- Free water signal
- Proteinaceous fluid
- Soft tissue and fat signal
- Flowing blood signal
- MR of hemorrhage over time
- Early hemorrhage
- Subacute hemorrhage
- Chronic hemorrhage and hemosiderin
- Rules of MR soft tissue contrast
- MR signal strength of tissues and fluids
- MR appearance of hemorrhage
- MR sequences (T1 and T2 weighting)
Ultrasonography
Pulse-echo imaging, Doppler, harmonics, elastography, and artifacts
- How ultrasound works
- Transducers and frequency
- Sector versus linear array transducers
- Acoustic windows
- The Doppler effect
- Doppler modes
- Color and spectral Doppler
- Tissue harmonic imaging
- Elastography
- Two kinds of elastography
- US artifacts
- Acoustic shadowing
- Acoustic shadowing
- Acoustic enhancement
- Acoustic enhancement
- Reverberation artifact
- Mirror image artifact
- Mirror-image artifact
- Ring down (comet tail) artifact
- Twinkle artifact
- Twinkle artifact
- Principles of US interpretation
- Fluid versus solid on US
- Ultrasound biosafety
Radiographic Contrast Agents
Iodinated, gadolinium, gastrointestinal, and ultrasound agents
- Iodinated contrast overview
- Ionic versus nonionic agents
- Iodinated contrast pharmacology
- Adverse reaction rates
- Mild and moderate reactions
- Severe reactions
- Local effects and extravasation
- Postcontrast acute kidney injury
- AKI diagnostic criteria
- PC-AKI risk factors
- eGFR and kidney disease staging
- Stages of chronic kidney disease
- Who needs renal screening
- Hydration and dialysis
- Metformin
- Safe use of iodinated contrast
- Special patient groups
- Iodinated contrast agents
- Gadolinium contrast overview
- Gadolinium adverse reactions
- Gadolinium risk factors
- Nephrogenic systemic fibrosis (NSF)
- NSF clinical features
- NSF risk and mechanism
- Gadolinium tissue retention
- Avoiding NSF
- Gadolinium-based contrast agents
- Barium sulfate
- Gas agents
- Water-soluble iodinated GI agents
- Ultrasound contrast (microbubbles)
Radiation Risk and Patient Safety
Dose, pregnancy, children, skin effects, and ALARA
- 72M
- Risks of ionizing radiation
- Low-dose risk evidence
- Putting CT risk in perspective
- Radiation dose comparisons
- Radiation dose to the patient (1 of 2)
- Radiation dose to the patient (2 of 2)
- Pregnancy radiation risks
- Fetal dose and thresholds
- Radiation dose to the fetus (1 of 2)
- Radiation dose to the fetus (2 of 2)
- Children and radiation
- Skin reactions
- ALARA and protection actions
- Protection in pregnancy
Radiology Reporting
What a report must contain and how findings are communicated
- The radiology report
- Report components: demographics and clinical information
- Report components: findings and limitations
- Report components: impression
- Communicating critical findings
- Key takeaways
- References
- References (continued)
- References (continued)
- References (continued)
- Brant and Helms' Fundamentals of Diagnostic Radiology