1. ORL Radiology BANDAR AL-QAHTANI, MD KSMC

2. Roles we should know Don't read X-ray without clinical information Always keep in closed contact with the radiologist Remember that radiology is an objective examination Always correlate radiology films with clinical information Start systemic :patients name,sex,age,date of examination,axial vs coronal vs sagital, T1 vs T2,+/- contrast In medico legal problem –should be ordered

3. Simple X-ray. CT scan. MRI scan

4. X-ray Less radiation of CT scan. Quick Usefull in trauma and ??FB Less accurate than the other modality Good in sinus diseases /trauma (air vs bone ) To assess nasal # and possible opaque FB In chest and vertebral spines Risky in pregnancy-especially 1 st trimaster

5. Lateral x-ray nose

6. Waters view of sinus

7. CT scan -more radiation than simple X-ray -excellent visualization of the bones and (for certain extent) the soft tissues like sinus and middle ear diseases. -very informative in neck problems -with iIVcontrast- -in issues of medico legal judgement -replaced by MRI scan in soft tissues -brain,orbit -faster than MRI -risky in pregnancy -especially the 1 st trimaster

8. -terminology -axial vs coronal vs sagital -related to a solid bony landmark –hard palat -sagital parallel to sagital sinus in the brain -radio opaque contrast

10. Sagital view

11. Coronal view -best for sinus diseases/trauma

12. Axial view of the sinus

13. Axial temporal bone scan

14. Axial temporal bone

15. Axial neck CT scan with contrast

16. Coronal vs sagital CT scan neck

17. MRI scan -no radiation -magnetic field applied for the tissues then measure the holding capacity of the tissues to that field – tissues are resonating -longer examination time than CT scan- anxiety/phobia -relatively safer than CT scan in pregnancy -T1 vs T2 (early scan vs late ) -needs experienced radiologist to read the films

18. MRI cont” -air appear black -vascular structures -black -bones appear – black -excellent soft tissues visualization (brain,orbit,muscle..etc -fat is variable in TI and T2 mostly hyper intense in T1 and hypo intense in T2 -fluid is hypo intense in T1 and hyper intense In T2 (CSF..etc ) and variable in case of thick protein content

19. MRI scan

20. QUIZ

21. ANY QUESTIONS