2 OMFS (Exam2): Advanced Maxillofacial Imaging

-Facial trauma

-Infection

-Neoplasms

-Surgical Planning

What are some indications for getting a CT for the head and neck:

Muti-detector Computed Tomography

What does MDCT stand for?

axial

A CT produces images of the body that are in _____ cuts

- saggital

- coronal

- axial

Hounsfield values

CT uses ________ to measure attenuation of radiation through tissue, assigns a gray scaled image

- saggital

- coronal

- axial

What are the planes of view available to visualize in a CT?

fan

A CT captures images in a ________ - shaped geometry

coronal

ID the plane of view:

saggital

ID the plane of view:

axial

ID the plane of view:

oblique reformats

ID the plane of view:

iodine

Soft tissue CTs can be enhanced with contrast that is usually ______-based contrast media

intravenously

In OMFS, if you need a tissue contrast, most of the time it is applied:

- intra-arterially

- intrathecally

- intra-abdominally

- intravenously

vessels around infection will engorge/inflame and form a visible rim around the infection = rim enhancement

What is the logic behind using intravenous CT contrast?

-Fast

-Good soft tissue and bone imaging

What are the pros of using a CT:

-High radiation

-Cost

-Requires iodine based contrast for soft tissue (can not be done for iodine allergic or pts with poor kidney function)

What are the cons of using a CT:

- pts allergic to iodine

- pts with poor kidney function

What type of patients should NOT undergo an iodine contrast enhanced CT?

Cone Beam Computed Tomography

What does CBCT stand for?

cone

A CBCT captures images in a ________ - shaped geometry

- Lower radiation compared to standard CTs

- Less artifact scatter

What are the pros of using a CBCT:

-For evaluation of osseous structure and NOT soft tissue structures

-Not covered by medical insurance

What are the cons of using a CBCT:

MRI

This imaging modality applies a magnetic field to tissue, picks up signals produced by magnetized protons, signals are processed using Fourier transform to generate an image:

- Pano

- CT

- CBCT

- MRI

- Technetium 99 bone scans

- PET

magnetic resonance imaging

What does MRI stand for?

MRI

This imaging modality is good for delineating:

- soft tissue pathology (ie parotid gland pathologies)

- Evaluation of suspected osteomyelitis

- Perineural spread of malignancy

- Head and neck infections and neoplasms (requires gadolinium based IV contrast

- TMJ pathology

CBCT

This imaging modality is best for evaluation of osseous structures:

- Pano

- CT

- CBCT

- MRI

- Technetium 99 bone scans

- PET

MRI

This imaging modality is best for evaluation of TMJ pathologies:

- Pano

- CT

- CBCT

- MRI

- Technetium 99 bone scans

- PET

CT

This imaging modality is good for soft tissue and bone imaging:

- Pano

- CT

- CBCT

- MRI

- Technetium 99 bone scans

- PET

MRI

ID the type of Imaging modality:

- Pano

- CT

- CBCT

- MRI

- Technetium 99 bone scans

- PET

CT

ID the type of Imaging modality:

- Pano

- CT

- CBCT

- MRI

- Technetium 99 bone scans

- PET

CBCT

ID the type of Imaging modality:

- Pano

- CT

- CBCT

- MRI

- Technetium 99 bone scans

- PET

Technetium 99 bone scans

ID the type of Imaging modality:

- Pano

- CT

- CBCT

- MRI

- Technetium 99 bone scans

- PET

PET

ID the type of Imaging modality:

- Pano

- CT

- CBCT

- MRI

- Technetium 99 bone scans

- PET

MRI

This imaging modality does NOT use radiation:

-More time consuming

-More expensive

-Less accessible

-Gadolinium may cause nephrogenic systemic fibrosis in patients with renal insufficiency

-Can not obtain MRIs in patients with pacemakers, neurostimulators, any feromagnetic implants/fragments near vital structures

What are the cons of using an MRI:

gadolinium

MRIs can be enhanced with contrast that is ______-based contrast media

MRI

The contrast used in this type of imaging modality may cause nephrogenic systemic fibrosis in patients with renal insufficiency:

- Pano

- CT

- CBCT

- MRI

- Technetium 99 bone scans

- PET

MRI

This imaging modality is contraindicated in patients with pacemakers, neurostimulators, any feromagnetic implants/fragments near vital structures:

- Pano

- CT

- CBCT

- MRI

- Technetium 99 bone scans

- PET

Technetium 99 bone scans

This imaging modality determines bone metabolic activity:

- Pano

- CT

- CBCT

- MRI

- Technetium 99 bone scans

- PET

PET

This imaging modality uses 18-fluorodeoxyglucose (18FDG)

and is used to ID neoplasms ( because they have increased glucose metabolism than normal tissue)

Used for staging and surveillance of head and neck cancers:

- Pano

- CT

- CBCT

- MRI

- Technetium 99 bone scans

- PET

Positron emissions tomography

What does PET stand for?

CT

because PET scans are usually blurry, what other imaging modality is it superimposed with for identification and diagnostic purposes?

- Pano

- CT

- CBCT

- MRI

- Technetium 99 bone scans