Transcript tomographic image

Revision
Dr Mohamed El Safwany, MD.
RADIOLOGIST ROLE

Separate: Normal from Abnormal

Characterize / Describe: Abnormality

Determine:

Suggest:

Recommend: Further exams / follow-up
Extent (stage) of disease
Diagnosis / Differential
2
PROJECTION
-VSTOMOGRAPHIC IMAGE
3
TOMOGRAPHIC IMAGES
ARE
IN A SPECIFIC PLANE
AXIAL
RT
CORONAL
SAGITTAL
RT
4
AUTOMATIC PROCESSING

TRANSPORTATION
SYSTEM
 DEVELOPER
 FIXER
 WASHER
 DRYER
 REPLENISHMENT
SYSTEM
I. Radiographic Terminology
 Body

Surfaces and Parts
For the body
• anterior
• posterior

For the hands and feet
• plantar
• palmar
• dorsum
II. Basic Imaging Principles
 Anode
Heel Effect
Intensity of cathode > anode
 Pronounced



at
Shorter SID
Larger IR
Small focal spot
PA Chest (Normal/ ambulance patients)
(Basic)
8
Lateral erect chest
(Basic)
9
LAO, RAO chest (heart)
(special)
10
Position of the patient

Evaluation criterea for good AP
positioning
The image should include the area from the upper
border of the pubic symphysis to the diaphragm.

Proper alignment -- the vertebral column should
be in the midline position. Ribs, pelvis, and hips
should be equidistant to the edge of the
radiograph.

No rotation -- spinous processes in the center of
the vertebral column and symmetric ilial wings
PA Skull (0 Occipital-frontal) projection
B
For frontal bone #s and neoplastic processes of the cranium, Paget’s disease,
orbits (obscured by petrous temporals), I.A.M, frontal and ethmoidal sinuses,
dorsum sellae.
Patient nose and forehead against the couch center, neck flexed so that OML
is 90 to the couch, MSP 90 to couch center, head not rotated, EAMS
equidistant from the couch top.
Film: HD 24x30 cm
CP: Exits the glabella
CR: 0 (that is 90) to film center
NB/ AP is not recommended as it produces 200 times eyes absorbed dose
produced in the PA position.
14
Lateral Skull (for lateral Sella Turcica)
B
To show evidence of pituitary adenomas.
Same position as for the lateral skull (as in Sim’s position), IOML 90 to
couch top.
Film: HD 18x24 cm
CP: 2 cm anterior and 2 cm superior to EAM.
CR: 90 to film center
15
AP forearm
(Basic)
For #s and dislocations, osteoarthritis (OA), and
osteomyelitis (OM).
Shows the entire radius and ulna, proximal row of the
carpals, and
distal end o the humerus.
Patient sits at end of couch, shoulder at couch level,
forearm/palm supinated, elbow extended, both the elbow
and the wrist joint to be included.
Film: 30x35 cm (35x43 cm for large patients).
CP:
Midshaft (between the wrist and elbow joints).
CR:
90 to film center.
25
16
B Mediolateral Calcaneus
18
Lateral lumbosacral spine (L5 – S1)
B
For lat L5 – S1 joint space, and for spondylolisthesis or other
pathologies of L4 to L5, or L5 to S1
Patient in a lateral recumbent, the knees flexed, support
between knees and the ankles, pad under the waist, rubber
sheet behind the lumbar region.
Film: HD 18x24 cm
CP: 4 cm below iliac crest, 4 cm anterior to the posterior
surface of the body.
CR: 90 V to film center (with sufficient waist support), 8
caudal for waist (with no support).
NB/ Close collimation is necessary because of the high amount of
secondary radiation produced in this view.
Layout and design by A Musa, Department of Radiological Sciences, Faculty of Applied Medical Sciences, King Saud University, Riyadh, Copyright  2003 A Musa
18
 Good
Luck