[01.31] General Overview of Radiology V2.2.pdf

Imaging patterns

What is the primary focus for students at "our level" in radiopathologic imaging, according to Dr. Koa-Sales?

Recognize normal radiographic anatomy

What is one key learning objective related to identifying pathologic images?

Enumerate the different imaging modalities

What should one be able to do regarding currently available radiopathologic imaging techniques?

Familiarize with terminologies

What is a key learning objective related to describing radiographic findings?

Radiologic principles, Different imaging techniques, Diagnostic imaging of common diseases, Patterns of radiographic findings

What are the main topics covered in YL6 radiology?

Give an opinion and refer accordingly

What is the ultimate goal of radiology training, rather than clinching a diagnosis?

X-ray

Which imaging modality is considered the "cornerstone" and must be mastered due to its commonality?

Conventional Radiography, Plain Films

What are two other common names for X-Ray?

Ultrasound, Sonography, Sonogram

What are three other common names for Ultrasonography?

Computed Tomography

What is the full name for a CT Scan?

Magnetic Resonance Imaging

What is the full name for an MRI?

Nuclear Imaging

Aside from X-ray, Ultrasound, CT, and MRI, what is another commonly requested imaging modality?

X-ray tube, a medium that transmits the x-ray beam, a method to record the image (recorder), a way to process the recorded image (processor)

What four elements are needed to produce a radiograph?

Film or digital image

What two forms can the recorded image take in X-ray production?

Smaller and provincial clinics

Where are X-ray films still primarily used today?

Dark room, washer, and 3 types of chemicals

What three components are involved in developing X-ray films?

Wet reading

What is the term for interpreting X-ray films while they are still wet?

Preliminary/First read

What is the digital counterpart to "wet reading" for X-ray images?

PACS (Picture Archiving and Communication System)

What system is used to store and make digital X-ray images accessible?

Relatively inexpensive, accessible, and portable

What are three advantages of X-ray imaging?

Php 200-900

What is the approximate cost range for an X-ray in the Philippines, according to the source?

Limited range of densities (2D for film), uses ionizing radiation

What are two disadvantages of X-ray imaging?

Carcinogen

Exposure to ionizing radiation in X-rays is identified as a risk for what?

Analyze risk vs. benefit

What is a doctor's ethical responsibility when prescribing any drug or imaging, especially regarding radiation exposure?

Suspected pleural effusion, chest pain, screening test (e.g., for TB or pneumonia)

What are three possible indications for requesting a Chest (Thoracic/Lung) X-ray?

Posteroanterior (PA) view

Which chest X-ray view is considered better because it shows less magnification of structures?

Gastric or stomach bubble

What common clue is seen in an Abdominal/KUB X-ray?

Diaphragm should not be cut off

What is a key requirement for an Abdominal X-ray, especially to rule out pneumoperitoneum?

Air goes up under the diaphragm

In pneumoperitoneum, where does the air go due to its lighter weight?

Pelvis should not be cut off

What is a key requirement for a KUB (Kidney, Ureter, Bladder) X-ray?

Urolithiasis (stone anywhere along the urinary tract), including kidney stone (nephrolithiasis)

What is a primary indication for a KUB X-ray?

Portable

What advantage of X-ray allows it to be done in an operating room or when a patient cannot move?

Two views

To compensate for X-ray's 2D limitation, how many views are recommended for extremities?

Pre-op (for baseline, patellar dislocation visualization) and Post-op (to check reduction)

What are two indications for a Knee X-ray?

Sunrise view

Which specific Knee X-ray view is best for seeing the patella in relation to the femur?

Attenuation

What is the term for the reduction of the force, effect, or value of something, such as an X-ray beam?

Absorption, scatter, reflection, refraction, and divergence

What five features describe X-ray or sound wave interaction with tissue that contribute to attenuation?

Black (darkest)

How do low-density materials appear on a conventional radiograph?

White (brightest)

How do high-density materials appear on a conventional radiograph?

Air

Which body composition absorbs the least X-ray and appears "blackest"?

Fat

Which body composition appears gray, somewhat darker than soft tissue, on X-ray?

Fluid or soft tissues

Which two body compositions have the same densities and appear gray on conventional radiographs?

Calcium (Bone)

What is the most dense, naturally occurring material that absorbs most X-rays?

Metal

What material usually absorbs all X-rays and appears the "whitest"?

Most attenuating, most dense

What do the "whitest" areas on an X-ray indicate regarding attenuation and density?

Least attenuating, least dense

What do the "blackest" areas on an X-ray indicate regarding attenuation and density?

Suspected lytic lesions, metastatic lesions, suspected fractures

What are three indications for a Skull X-ray?

3 on the right, 2 on the left

How many lobes are typically found in the right and left lungs, respectively?

Dark or black

How does air in the lungs appear on a chest X-ray?

Bright

How does the heart appear on a chest X-ray?

Dark

How does the trachea appear on a chest X-ray?

The right diaphragm is naturally higher than the left

What is a normal finding regarding the position of the diaphragms on a chest X-ray?

Liver

What organ typically pushes the right diaphragm upward?

Brightness on the radiologic right (supposed to be dark), indicating possible cancer, solid mass, or liquid

What is an indication of abnormality in a chest X-ray, as shown in the comparison image?

Correlate salient features from history-taking and physical examination

Since one image can represent many diseases, what must be done with imaging findings to make a good diagnosis?

Trachea deviates to the contralateral mediastinal side, heart deviates to the right

In the presence of pleural effusion, how do the trachea and heart deviate from their normal positions?

Stomach bubble

What specific structure, representing air in the stomach, is seen under the left hemidiaphragm in a normal abdominal X-ray?

Dark or black

How does air in the large intestines appear on a normal abdominal X-ray?

Abnormal

Is it normal to see air in the small intestines on an abdominal X-ray?

Air in the small intestines, caused by gut obstruction

What is an indication of abnormality in the abdominal X-ray sample image for gut obstruction?

Kidney, Ureter, and Bladder

What organs does KUB stand for in a KUB X-ray?

Not necessarily included

Is the diaphragm necessarily included in a KUB X-ray?

Staghorn calculi

What specific type of calcifications that conform to the calyces of the kidney were observed in the abnormal KUB X-ray?

Bright

How do staghorn calculi appear on an X-ray?

Lucent abnormality, lytic lesion, less dense than surrounding bone

What describes the appearance of a mass/tumor in the frontal area of an abnormal skull X-ray?

Foreign body

What was found in the pelvis of the male patient in the sample pelvic X-ray?

Visible penis, narrow subpubic angle, android shape pelvis

What are three pelvic X-ray findings typical in male patients?

High-frequency sound waves

What type of waves does ultrasound use to produce images?

Reflecting and absorbing properties of tissue

What determines the image created in an ultrasound?

Fluid and soft tissues

Through what mediums do sound waves propagate well in ultrasonography?

Air and calcium

What two substances block or scatter sound transmission in ultrasound?

Full bladder

Why is ultrasound done on a full bladder when viewing surrounding reproductive organs?

Attenuation

What is the term for the reduction of sound waves in ultrasound, similar to X-rays?

Varying shades of gray

How are tissues displayed on ultrasound images?

Smooth and bright

How does skin appear on ultrasound?

Bright or dark

How can fat appear on ultrasound, for example, in the breast where it's usually darker?

Dark

How does muscle appear on ultrasound?

Black

How does fluid generally appear on ultrasound?

Bright

How do tendons typically appear on ultrasound?

As a bright line

How does bone appear on ultrasound?

White (omentum)

How does fat typically appear in a scrotal ultrasound?

Dark (hydrocoele)

How does fluid appear in a scrotal ultrasound?

Speckled pattern of tissue texture with blood vessels (testes)

How do solid tissues, such as testes, appear in a scrotal ultrasound?

Displacement of vessels, mass effect, change in color

What three indicators suggest lesions like a hernia in a scrotal ultrasound?

Posterior sonic shadowing

What specific ultrasound finding can indicate a calcium-containing structure like a gallstone?

Highly reflective

What characteristic makes an object appear "bright" in ultrasound, such as gallstones?

Sound passes through freely

What characteristic makes fluids like bile appear "dark" in ultrasound?

Bright echoes (essential echo complex)

What are the bright echoes seen in a kidney ultrasound, representing the collecting structures?

Calyces filled with calcium

What causes the bright echoes and posterior shadowing in kidney ultrasound?

Intussusception

What is the condition where a segment of the bowel goes into an adjacent segment?

Obstruction

What complication can intussusception cause?

Necrotic bowel that needs to be resected

What severe outcome can occur if intussusception is left unattended?

Estimates velocity of moving objects in the body, such as blood

What is the primary function of Doppler ultrasound?

Vascular application

What is the main diagnostic area where Doppler ultrasound is useful?

To check for blocks in the brain

What is a specific clinical application of Doppler ultrasound related to carotid arteries?

No ionizing radiation, portable, can image in real time, useful in obstetrics/children/vascular evaluation

What are four advantages of ultrasound imaging?

Operator-dependent, cannot image air-containing structures, cannot penetrate through bone, limited by body habitus (poor visualization in obese individuals)

What are four disadvantages of ultrasound imaging?

Computerized Axial Tomography (CAT)

What is the full alternative name for CT?

X-rays

What type of technology does a CT scan use, similar to conventional radiography?

More radiation

Do patients receive more or less radiation exposure from a CT scan compared to an X-ray?