conventional and advanced imaging techniques

____= use of ____ (xrays) to produce high resolution images

• image produced is called a _____

conventional radiograph, ionizing radiation, radiograph

conventional radiography requires 3 things

xray beam source, patient, xray image receptor

____: loss of ____/____as pass through a medium

• each tissue type ___ varying amounts of radiation

attenuation, intensity, amplitude, absorbs

radio____ objects = ____ penetrated by x rays

• has such great ___ that is ___ almost all xrays from beam

• ex: ____

• ___xrays reach image receptor = object is ____

opaque, not easily, radiodensity, attenuates, metal implant, no, white

radio___ objects = ____ penetrated by x rays

• ___xrays reach image receptor = object is ____

lucent, easily, most, dark

most attenuation to least attenuation

metal, bone, water, fat, air

radiographs are diagnostically inadequate for imaging ___, ___, ____ because the structures are too ___

muscle, tendon, ligaments, radiolucent

radiographs are ___ dimensional

• need ___ images from different angle for accurate imaging

  • provide info about ___ of the imaged structures

  • locate ___/___ bodies

    • determines alignment of ___/___/___

2, 2, dimensions, lesions, foregin, bones, joints, fractures

angle a radiograph image is taken from = _____

• 3 angles =

projections, anteroposterior/posteroanterior, lateral, oblique

reported finding from radiograph can be

• ____ for suspected clinical diagnosis

• ____ for suspected clinical diagnosis

• ____, may require additional imaging to confirm or rule our

positive, negative, inconclusive

advantages of radiography

-____

-____

-identifies many ____

-facilitates patient ____

convenient, inexpensive, pathologies, decisions

disadvantages of radiography

-limited use for ____

-___ dimensional - superimposition of bones

-____ exposure

soft tissue, 2, ionizing radiation

contrast enhanced radiographs

• contrast medium is injected ___ imaging

• radio____ = ___ contrast (look ___)

• radio____ = ___ contrast (look ___)

• combination = ____ contrast

before, lucent, negative, black, opaque, positive, white, dual

____= real time ____

• exposure to continuous ___

• ____image on screen

• can be used to ___ or ___

  • barium swallow/angiography = ____

  • stent placement, epidural injection = ___

    • often requires ____

fluoroscopy, radiograph, xray beam, moving, diagnose, guide interventions, diagnostic, interventional, contrast medium

DEXA = ______

• used to measure ____

  • low dose ______

• typically used for ____ and ___

dual-energy x-ray absorptiometry, bone mineral density, ionizing radiation, thoracolumbar spine, hip

dexa recommended for women age ____ and up and men age ____ and up and other individuals at risk for developing ____

65, 70, early osteoporosis

___-score compares patient results to the average peak bone mineral density of a ____

T, healthy young adult

___-score compares patient results to the average ____

Z, age and gender matched bone mineral density

t score values

normal =

osteopenia =

osteoporosis =

-1 or higher, -1 to -2.5, -2.5 or higher

___score is usually higher than ___score

Z, T

CT stands for `

computed tomography

computed tomography - xray beam _____

• produces a series of thin ____ images

• high dose of ____

• slices are stacked to create a ___ image

rotated around patient, cross-sectional, ionizing radiation, 3D

Computed Tomography (CT)

more ___ than traditional radiographs

• good definition of ___

• difficult to differentiate between ___ ( ___ vs ___ )

detail, bone, soft tissue, tendons, ligaments

CT scans are valuable for evaluation of

• ___conditions

• ___(clot and tumors)

• ___and ___ tissue tumors

• ____ abnormalities

• small ___ fragments

brain, lungs, bone, soft, intra-articular, bone

CT scans disadvantages

• average volume effect = computer assigned ____ may display the same shade of gray for more than 1 ____

• ____ dose of ionizing radiation

• ____

density, tissue type, high, expensive

nuclear imaging

____ are ingested or injected

• 2 parts

  • pharmaceutical targets for ___ by specific ___

  • radionuclide that releases ___ as it breaks down

• imaging captures ___ of ___ after it has been taken up by metabolically active ____

radiopharmaceuticals, uptake, organ, radiation, decay, radionuclide, tissues

nuclear imaging

• ____ rays

  • single plane imaging = ____

  • 3-dimensional = ____

• ____- 3 dimensional

gamma, scintigraphy, SPECT, positrons

nuclear imaging - bone scintigraphy

• aka ____

• indications: subtle ___, primary and metastatic ____, infections, avascular ___, metabolic ____ disease, unexplained ____

• positive findings = ____ (“hot spot”)

• limitation = lack of ____

bone scan, fractures, bone tumors, necrosis, bone, bone pain, increased uptake, specificity

magnetic resonance imaging

-___ ionizing radiation

-the interaction of a strong ____ and ____ waves conducted through tissue

-collects multiple ____ to produce a ____ image

-high-quality images

• ____ is clearer with MRI than with CT

no, magnetic field, radiofrequency, slices, 3D, soft tissue

primary use of MRI

evaluation of ____ trauma, internal ___ pathologies, and ___

soft tissue, joint, tumors

two types of MRI images

T-1 weighted and T-2 weighted

T-1 weighted MRI images

• ____ appears bright/white

• ____ appear dark

• show normal ____, ____ and ____ containing masses

fat, fluids, soft-tissue, fat, fat

T-2 weighted images

• ____ appear bright/white

• show ____ and ___ (inflammation, trauma, tumors)

water and fluids, fluid, abnormalities

MRI contraindications - ____

MRI precautions - ____ and ____

metal implants, claustrophobia, pregnancy

most clinically useful modality for PT

ultrasonography

ultrasonography

• generation of images using ____

  • difference in wave ___ and ___ of various ____

• used for: identification of ____, soft tissue ___, lesions in ___/___/___ and ____ flow

• real-time allows for ___ imaging

• no ___

reflected sound wave, absorption, reflection, tissues, cysts, tumors, muscle, tendons, ligaments, blood, dynamic, ionizing radiation

produces a picture of a joint

arthrography

arthrography

-contrast material is injected into ____

-effectively identify abnormalities of the ___, synovium,, ____ and/or articular cartilage

limitation: not ___ and vary in ___

however, can be used in conjunction with other ____ like ___ and ____ to improve image quality

joint space, capsule, ligaments, multiplanar, detail clarity, CT arthrography, MRA

used for imaging of spinal cord with contrast

myelography

myelography

___, ___ or ____ imaging of spinal canal and contents with ___

identifies = ruptured ___, spinal ___, ___ and spinal cord ____

CT, MRI, radiograph, contrast, discs, stenosis, tumor, compression

procedurs under the guidence of imaging

• ____ procedures

• ____ steroid injections

• spinal ____ blocks

• needle ___

• ____ aspiration

vascular, epidural, nerve, biopsy, joint

most important for PTs to

• recognize ___ for diagnostic imaging

• recommend ____ imaging

• accurately ___ the appropriate area

• correlate ___ with patients ____

indications, most appropriate, identify, radiologic findings, clinical presentation