1. Angiographic facilities Tortorici Chapter 11

2. Designed around exam table 500 sq feet min. (25 x 20) 60 sq feet in control room Wide doors, (multiple) Ample cabinets/counters Fluorescent & incandecent lights on dimmer O2 Suction Crash Cart Sinks Phones Surgical Lamp Apron storage Angio Suite Control room

3. Bi-plane C-arms

5. Control room Cath Lab Cath Lab Peripheral Lab Sterile set-up Dirty Utility Elevators Film Files Medical Director Specials lab Supervisor Reading Room Private Consult Employee Lounge Recovery Out patient reception Out patient waiting Darkroom Restrooms Changing rooms Storage Multi- Format Cameras Nurses’ Office Cath lab Supervisor Waiting/Recovery rooms Offices Storage/Utility Near Surgery

13. Generators and Tubes Generators (Film or digital) 1000 mA 3 phase or high frequency (constant potential) Tubes High heat capacity (6/sec. for 5 s., or, for cine up to 60 a second).3 and 1 mm focus (fractional focus) Smaller anode angle (7-10 o instead of 17-20 o ) Faster rotors (10,000+ instead of 5,000) Anode heat Formula kVp x mAs x generator factor (times number of exposures)

14. Generators and Tubes Magnification radiography How is it done? What happens to detail? How is detail improved? Magnification formula SOD SID OID Object size Mag factor % magnification SID = Image Width SOD = Object Width 40” = 5” 20” = X Object size = Mag factor = % magnification = 2.5” 2X 100%

15. How a Fluoroscopic Image Gets Intensified and Digitized 1. X-rays pass through the body or are attenuated, thus capturing a pattern of the parts they pass through. From the X-ray tube 2. X-rays excite atoms of fluorescent screen, light is given off. This is fluoroscopy in its simplest form but the image is very dim. 3. Light stimulates a photoemissive material to liberate electrons. Image pattern is maintained 4. Electrons are accelerated toward a tiny fluorescent screen at other end of image intensifier. Concentration of electrons and added kinetic energy make image tens of thousands of times brighter. 5. Optical lens focuses light 6. Video camera (old) or CCD microchip, like in home camcorders) translates image into electrical (video) signal 7. Computer assigns pulses from video signal values in binary code (0s and 1s) and stores them as image data Video signal 8. Displayed on monitor Video signal Image Intensifier

16. Cine film. For heart studies, 35mm filming of multiple projections of the coronary arteries and left ventricle. Most institutions have gone digital, but many will still have cans of film and a cine projector stashed in an archive. A C-arm fluoroscope Image intensifier X-ray tube Cine camera Patient table Video camera

17. A C-arm fluoroscope Image intensifier X-ray tube Cine camera Patient table Video camera Cameras or “Pickup Tubes” * Vidicon (standard fluoro) * Plumbicon (better contrast, less lag, but more mottle)

18. CCD Image Intensifiers Lightweight Fast movements Photoelectric detectors embedded in layers of silicon Each pixel is 6 to 25 microns in size, and can store 10,000 to 50,000 electrons.

19. 1. If an object is radiographed at 40” SID and an OID of 12”, what is the magnification factor? 2. A 3400 RPM rotating anode is employed to maximize heat dissipation in an angio x-ray tube. 3. If the linear magnification is 1.6, what is the area magnification? 4. The anode of a typical angiographic x-ray tube should have an angle no larger than: 5. The most efficient x-ray generator, and the one best suited to the demands of arteriography is: 6. The recommended focal spot size for performing magnification arteriography is: 7. If 12 exposures are made at 75 kVp, 500 mA, 100 ms on a 3 phase, 12 pulse unit, how many heat units are produced? 8. Which of the video pick-up devices has the least amount of lag time?