Advantages of MRI Higher resolution of tissues No ionizing radiation

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Presentation transcript:

Advantages of MRI Higher resolution of tissues No ionizing radiation Multiplanar imaging

Disadvantages of MRI Long imaging time Hazards with ferromagnetic metals (pacemakers, vascular clips, etc) Claustrophobia Higher cost

Relative Brightness of Tissues Fat White Marrow Brain Muscle Gray Body Fluid TMJ Disk Cortical Bone Air Black

Nuclear Medicine

Nuclear Medicine Radioactive compounds Target tissues Radioactive agents pools in the target tissues Detected and imaged by external detectors (gamma camera).

Nuclear Medicine Shows structure and function of the target tissues Static and dynamic conditions Scintigraphy scans or RN (radionuclide) scans Bone scans or salivary gland scans

Technetium 99mTcO4- - thyroid and salivary gland scan 99Tc phosphate - bone scan

Is this an active disease?

Phases of Salivary Gland Scan Flow phase: Five to 10 mCi of 99mTcO4 first 30 to 120 seconds shows flow of blood Concentration phase: next 30 to 45 minutes demonstrate the anatomy and function Washout Phase: administer sialagogue demonstrates secretory capabilities

Cephalometric Radiography Reproducible and standardized views For measurements and assess growth Fixed source to film distance – 60 inches Cephalostats and earplugs help in reproducible positions

Cephalometric Radiography

Contrast Agents

Contrast Agents Radiopaque materials Water soluble Fat soluble 28 – 38% iodine

Phases of Sialography Ductal Acinar Evacuation

Indications of Sialography Acute swelling secondary to ductal obstruction Recurrent Inflammation Palpable salivary gland mass Autoimmune Sialadenitis

Contraindications of Sialography Sensitivity to contrast agents Acute Sialadenitis Limited use in tumor diagnosis

Scintigraphy Sialography Radioactive material Radiopaque material Through blood stream Through duct All glands imaged at the same time One gland at a time Imaged by gamma camera Imaged by fluoroscopy

Contrast Studies: Arthrography

Arthrography Contrast media is introduced in joint spaces Upper vs. lower joint space Viewed by Image Intensifier Fluoroscopy Video recording allows study of joint movement

Contrast Material Injection

Open Position Translation of condyle Reduction of disk