1 As Clinical Anatomy RADIOLOGY Speaker note Dr Mohamed El Safwany, MD.

Intended learning outcome  The student should learn at the end of this lecture Clinical Radiological Anatomy.

Intended Learning Outcomes  Understand basics of image generation.  Relate imaging to gross anatomy.  See clinical relationship to basic science.  Appreciate constraints and limitations.  Develop imaging vocabulary.

WHAT IS RADIOLOGY?  Medical specialty that supervises and interprets imaging studies.  Reports findings to referring physicians. 4

RADIOLOGIST ROLE  Separate: Normal from Abnormal  Characterize / Describe: Abnormality  Determine: Extent (stage) of disease  Suggest: Diagnosis / Differential  Recommend: Further exams / follow-up 5

X-RAY  Discovered and named by Dr. W. C. Röentgen at University of Würzburg, 1895  Awarded first Nobel prize for physics,

PROJECTION -VS- TOMOGRAPHIC IMAGE 7

8 FOOT AP PROJECTION (ANTERIOR - POSTERIOR) RT

9 LATERAL FOOT

10 TOMOGRAPHIC IMAGES ARE IN A SPECIFIC PLANE SAGITTALAXIALCORONAL RT

11 CT- HEAD CT REFERENCE FILM Skull / brain RT

RADIOLOGY TOOLS 12 X- RAY ULTRASOUND NUCLEAR MEDICINE MAGNETIC RESONANCE COMPUTED TOMOGRAPHY

HOW IS IMAGING DONE?  IONIZING RADIATION X-ray, CT, Nuclear Medicine  SOUND WAVES Ultrasound  MAGNETIC FIELDS / RADIO WAVES Magnetic Resonance 13

X- RAY  High Energy Photon --Kilo Electron Volts  Ionizing Radiation  Exposes Film / Detector  Projection Data 14

X-RAYS PLAIN FILM RADIOGRAPHY  Chest  Mammography  Abdomen  Spine  Extremities & Joints  Skull 15

16  Air  Soft Tissue  Fat  Bone X - RAY --- FOUR BASIC DENSITIES

CONTRAST RADIOGRAPHY  Injection, ingestion, or other placement of opaque material within the body.  Improves visualization and tissue separation.  Can demonstrate functional anatomy and pathology. 17

18 UPPER GI --(GASTRO INTESTINAL ) BARIUM ENEMA RECTAL BARIUM CONTRAST WITHOUT CONTRAST-plain or scout film STOMACH COLON ORAL BARIUM CONTRAST

19 INTRAVENOUS PYELOGRAM – IVP INTRAVENOUS IODINE CONTRAST ARTERIOGRAM INTRAARTERIAL IODINE CONTRAST WITHOUT CONTRAST-plain or scout film

COMPUTED TOMOGRAPHY  HIGH ENERGY PHOTON  IONIZING RADIATION  EXPOSES DETECTOR  TOMOGRAPHIC DATA 20

SCAN LEVEL CT EXAMPLE RT

NUCLEAR MEDICINE  High Energy Photon  Ionizing Radiation --Radiopharmaceutical  Exposes Detector  Projection Data  Dynamic / Physiologic 22

NUCLEAR MEDICINE EXAMPLES  Hepatobiliary 23  Renal  Bone

ULTRASOUND  Sound Wave - high Frequency  No Ionizing Radiation  Transmitter / Receiver  Tomographic Data 24

ULTRASOUND EXAMPLES Gallbladder Kidney Obstetrics 25

 Hydrogen Protons In a Magnetic Field  Radio Wave Signal Transmission  No Ionizing Radiation  Tomographic Data 26 MAGNETIC RESONANCE

MAGNETIC RESONANCE EXAMPLES  Brain 27  Spine  Knee RT

 Multiple Choice - Identify  Labeled Images From Digital Film Sets And Lecture Images 28 RADIOLOGY EVALUATION

29 HOSPITAL LINGO X- Ray Plain Film Scout Film Radiograph Computed Tomography Cat Scan CT Nuclear Medicine Nuc Med Ultrasound Sono Sonogram Magnetic Resonance MR MRI You will hear and see these abbreviations used frequently in the medical community.

SUMMARY  TOMOGRAPHY- VS- PROJECTION IMAGES  SECTION PLANES AXIAL CORONAL SAGITTAL  IMAGE GENERATION OF: Nuclear Medicine Computed Tomography Ultrasound X-ray Magnetic Resonance 30

Text Book  David Sutton’s Radiology  Clark’s Radiographic positioning and techniques

Assignment  Two students will be selected for assignment.

Question  Define tomographic planes?

Thank You 34