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INTRODUCTION to RADIOLOGY
Michael Maristany, M.D.
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MAIN ADVANTAGES OF CT OVER MRI
Rapid scan acquisition Visualization of cortical bone and soft tissue calcifications
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Multi-Detector (Helical) CT multiple planes of detectors in the gantry
Technical innovation allows even faster scanning over a much longer range with even better image quality Radiation exposure greater than single-detector CT “Total body” CT in trauma pts
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16 TB Cavity w FB CT SCAN
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Normal Trachea Aorta Interlobar Rt interlobar artery artery
Confluent shadow of right interlobar artery and superior vein Aorta Interlobar artery Rt interlobar artery Lt interlobar artery Normal Cxr Spine Note: Density is darker inferiorly Rt diaphragm
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Chest Radiology Pneumothorax: “deep sulcus” sign
Pneumonia or Pulmonary Edema Airspace Disease: Silhouette Sign & Spine Sign Pneumoperitoneum: perforated viscus
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Right pneumothorax
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Lingular Pneumonia NL?
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PNEUMO PERITONEUM PLAIN RADIOGRAPH
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Hounsfield Unit Scale (CT Attenuation)
Gas (Air) -1,000 HU Fat HU Water 0 HU Soft tissue to +100 HU Bone +1,000 HU
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Radiographic Densities
Metal Very White Bone White Water Gray Fat Gray-Black Air Black Metal is most Radiodense or Radiopaque. Air is most Radiolucent.
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HOUNSFIELD UNIT SCALE Compares attenuation of each tissue through which the x-ray beam passes with the attenuation of WATER.
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Common Indications for IV Contrast in CT
To visualize blood vessels (Aortic injury, Abdominal Aortic Aneurysm, Pulmonary Embolus) To evaluate for primary or metastatic tumor To evaluate for infection or inflammatory processes To evaluate for traumatic injury
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RLQ pain in a 20 year old male Appendicitis
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