Term
| What is a disadvantage to plain films? |
|
Definition
| less detail than other imaging techniques |
|
|
Term
| What are 3 advantages of plain films? |
|
Definition
| Cheaper, portable, and easier for non-radiologist to read |
|
|
Term
| Which way is the x-ray beam passing through the patient in a PA view? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is the advantage to spiral CT vs. classic CT? |
|
Definition
| more rapid and overlap of data |
|
|
Term
|
Definition
1. eliminates problems with delay of transport of films
2. eliminates problems with lost or bad films
3. images that are too dark or light can be manipulated
4. speedy transfer of data
5. requires less storage space |
|
|
Term
| Name 8 things that CT scan is used for. |
|
Definition
1. neuro emergencies - intracerebral hemorrhage
2. visceral neoplasms
3. abdominal trauma
4. pancreatic disease
5. mediastinal studies (extent of tumors)
6. Hodgkin's disease/ lymphoma (staging)
7. Diagnosis of intraabdominal abscess
8. Musculoskeletal - bone and soft tissue disorders |
|
|
Term
|
Definition
| an x-ray of the blood vessels using iodinated contrast agents |
|
|
Term
| Where is contrast introduced in angiography? |
|
Definition
|
|
Term
| What is technically being imaged using MRI? |
|
Definition
| hydrogen atoms in water and fat molecules |
|
|
Term
| What color do bones appear in MRI? why? |
|
Definition
| black - little water or fat, so they emit little to no signal |
|
|
Term
| What do radiodense and radiolucent mean in an MRI? |
|
Definition
| nothing, they don't apply |
|
|
Term
|
Definition
1. Intracranial and intraspinal pathology
2. abnormalities of musculoskeletal system
3. vascular abnormalities
4. abdominal viscera |
|
|
Term
| What are 5 advantages of MRI? |
|
Definition
1. non invasive
2. non ionizing
3. can produce images in virtually any plane
4. greater differentiation of soft tissue structures
5. permits contrast free 3D vascular imaging |
|
|
Term
| Name 4 disadvantages for MRI. |
|
Definition
1. Cannot be used with patients with metallic implants.
2. should not be used in patients with programmable implants
3. takes longer to collect data - 30-40 min
4. claustrophobic patients don't like it |
|
|
Term
|
Definition
| a continuous beam of x-ray is passed through the patient to cast an image on a fluorescing screen - viewed on a high resolution TV; real time |
|
|
Term
| When is fluoroscopy used? |
|
Definition
1. to guide procedures such as arterial and venous catheter placement
2. guide interventional radiological procedures
4. in contrast exams of GI tract |
|
|
Term
| In fluoroscopy, how is the image displayed (colors)? |
|
Definition
| black and white are reversed. Bone is black? |
|
|
Term
|
Definition
| an image produced by direcing a beam of high frequency sound waves into the body and recording the waves reflected back |
|
|
Term
|
Definition
| In chest and MS system due to bony and gas containing structures obscuring tissues lying deeper |
|
|
Term
| What are the advantages of US? |
|
Definition
1. safe - non ionizing energy
2. can be employed in any plane required
3. less expensive
4. portable
5. real time scanning
6. interventional procedures |
|
|
Term
| What are the disadvantages of US? |
|
Definition
| usally takes 20-30 minutes and quality is dependent upon operator. Also, harder to interpret |
|
|
Term
|
Definition
| imaging that uses radio-active isotopes to visualize living organs and tissues (uptake) |
|
|
Term
| Name 5 traits of an ideal isotope for nuclear imaging? |
|
Definition
1. administered in low dose
2. nontoxic
3. short half life
4. readily incorporated into physiological compounds
5. relatively inexpensive |
|
|
Term
| What is nuclear imaging used for? |
|
Definition
| Thyroid, liver, renal, skeletal, lung (perfusion), myocardial blood flow |
|
|
Term
|
Definition
| positron emission tomography (a type of nuclear imaging) |
|
|
Term
| What is a PET scan used for? |
|
Definition
to evaluate physiologic function of organs
earlier detection of some CA
early signs of Coronary artery disease
brain - epilepsy, alzheimer's, other dementias |
|
|
Term
| What does MRI contrast help differentiate? |
|
Definition
neoplasm and chronic cerebral infarct
tumor and perifocal cerebral edema
recurrent intervertebral disc and surgical scars |
|
|
Term
| What does contrast in US help visualize? |
|
Definition
| blood vessels and vascular organs, stenotic vessels, areas of ischemia, and tumors |
|
|
Term
| What risk is there to using contrast? |
|
Definition
dehydrated patients or cardiac and fluid imbalance patients are at risk
can cause change in viscosity and tonicity of blood, changes in BP, changes in cardiac output, changes in pulse rate |
|
|
Term
| What are some adverse reactions to contrast agents? |
|
Definition
| nausea, vomiting, sneezing, flushes, diaphoresis, feeling of warmth, headache |
|
|
Term
| Name intermediate and severe adverse reactions with contrast agents |
|
Definition
angioneurotic edema, urticaria, wheezing
cardiovascular collapse, laryngeal edema, apnea |
|
|
Term
| Which way do you view CT images? |
|
Definition
| As if you are looking upward from the feet |
|
|
Term
| What structures is the CXR an assessment of? |
|
Definition
| heart, lungs, mediastinum, and chest wall |
|
|
Term
| If the vertebrae are not visible through the cardiac image, is the image over penetrated or under penetrated? |
|
Definition
|
|
Term
| At what level should the right hemidiaphragm be located? |
|
Definition
| below R 10th rib (between 5th and 7th anteriorly) |
|
|
Term
| In the PA view what do the clavicles look like? |
|
Definition
|
|
Term
| What is not good about AP view? |
|
Definition
|
|
Term
| When is the lateral decubitis position helpful? |
|
Definition
| for pleural effusion - it will move with the change in position |
|
|
Term
| When is lordic view used for CXR? |
|
Definition
| assessment of lung apices |
|
|
Term
| What problems does a CXR with poor inspiration have? |
|
Definition
| heart appears larger and poorly defined, pulmonary vessels are more prominent, and there is blunting of the lung bases |
|
|
Term
| Which ribs are more apparent on a frontal view CXR? |
|
Definition
|
|
Term
| Give some reasons for poor inspiration. |
|
Definition
| massive obesity, pain, CHF, or chronic restrictive lung disease |
|
|
Term
| When are expiration films appropriate? |
|
Definition
| to look for suspected foreign bodies, obstructed bronchi and pneumothorax |
|
|
Term
| What pathology shows a white lung field? |
|
Definition
| consolidation (i.e. pneumonia), atelectasis (collapse), pleural fluid accumulation, masses |
|
|
Term
| What pathology shows a black lung field? |
|
Definition
| chronic obsructive pulmonary disease, pneumothorax, pulmonary embolus |
|
|
Term
T/F
Consolidation density is uniform. |
|
Definition
|
|
Term
| What is air in air spaces replaced with in consolidation? |
|
Definition
| exudate, blood, pus, water, tumor cells |
|
|
Term
T/F
The border is not well demarcated in consolidation except where it abuts a pleural surface |
|
Definition
|
|
Term
T/F
In consolidation, the density increases inferiorly. |
|
Definition
|
|
Term
T/F
Air bronchograms may be seen in consolidation. |
|
Definition
|
|
Term
| What is the silhouette sign? |
|
Definition
| When the border of the heart is lost and the whole are seems to be one silhouette. |
|
|
Term
| When is the silhouette sign seen? |
|
Definition
|
|
Term
| When is a bat's wing pattern seen in a CXR? |
|
Definition
| pulmonary edema or hemorrhage |
|
|
Term
|
Definition
| loss of lung volume; collapse |
|
|
Term
| How much of the lung can atelectasis involve? |
|
Definition
| entire lung, entire lobe, segment, or sub-segment |
|
|
Term
| What are the signs of atelectasis? |
|
Definition
increased density of affected lung
shift of mobile structures towards area of atelectasis
hemidiaphragm displaced upward on affected side (R. is normally higher)
overinflation of unaffected lobes
shift of interlobar fissures |
|
|
Term
T/F
Right lung is larger than left. |
|
Definition
|
|
Term
T/F
The left diaphragm should be higher than the right. |
|
Definition
|
|
Term
| How much of the heart should lie to the left of the sternum? |
|
Definition
|
|
Term
| If there is deviation of diaphragm, horizontal fissure, heart, or trachea, what should you suspect? |
|
Definition
|
|
Term
| Where should the horizontal fissure of the right lung lie? |
|
Definition
| center to right hilum to level of 6th rib at axillary line |
|
|
Term
| What are some obstructive causes of atelectasis? |
|
Definition
| neoplasm, foreign body, mucus plug, inflammatory debris |
|
|
Term
| What are some passive causes of atelectasis? (airway remains patent) |
|
Definition
| pleural effusion and pneumothorax |
|
|
Term
| What are some compressive causes of atelectasis? |
|
Definition
| bulla, tumor, pleural effusion, enlarged heart |
|
|
Term
| What does cicatrization mean? |
|
Definition
| produced by organizing scar tissue |
|
|
Term
| What are cicatrization causes of atelectasis? |
|
Definition
| post pirmary TB or granulomatous disease and pulmonary infarct or trauma |
|
|
Term
| What is an adhesive cause of atelectais? |
|
Definition
| respiratory distress syndrome in a new born (inactivation of surfactant) |
|
|
Term
| Name 5 causes of pleural effusion. |
|
Definition
| infection, embolism, neoplasm, CHF, trauma |
|
|
Term
| What position is helpful for seeing pleural effusion? |
|
Definition
| lateral decubitis position because fluid shifts |
|
|
Term
T/F
Pleural effusion blunts the costophrenic angles. |
|
Definition
|
|
Term
| What are 4 possibilities for a solitary pulmonary mass? |
|
Definition
| tumor, abscess/granuloma, consolidation, anatomical abnormality |
|
|
Term
| What is cavitation of a mass? |
|
Definition
| a mass with a center that is less dense (donut) |
|
|
Term
| If air bronchograms are visible in a mass, what is it suggestive of? |
|
Definition
|
|
Term
| When is a CT scan used for masses in the chest? |
|
Definition
| mediastinal invasion, chest wall invasion, peripheral or multiple nodes, calcifcation, differentiation from enlarged pulmonary vessels, best location for biopsy |
|
|
Term
| When is an MRI used to evaluate masses? |
|
Definition
| mediastinal masses - distinguishes vessls from neoplasm |
|
|
Term
| What are the 3 most common lesions of the mediastinum? |
|
Definition
| lymphoma, thymic lesions, and teratomas |
|
|
Term
| When is a PET scan used to evaluate masses? |
|
Definition
| when patient is a poor candidate for biopsy, or in case of whole body scan |
|
|
Term
|
Definition
| hyperinflation of the lungs |
|
|
Term
| What are some signs of COPD in the CXR? |
|
Definition
| increased lung volume (more ribs), flattened or depressed diaphragm, dangling heart, presence of bullae, decreased vascularity |
|
|
Term
|
Definition
| acumulation of air in the pleural cavity |
|
|
Term
| What is a tension pneumothorax? |
|
Definition
emergency!
continue accumulaton of air in the pleural cavity |
|
|
Term
| What is the risk with tension pneumothorax? |
|
Definition
| decreased venous return - hypoxia |
|
|
Term
| What are some causes of pneumothorax? |
|
Definition
spontaneous, trauma, increased intrathoracic pressure,
parenchymal disease - infection, neoplasm, cystic lung disease, COPD |
|
|
Term
| What are some signs of pneumothorax on the CXR? |
|
Definition
| visualization of visceral pleural line, , convex curve of visceral pleural line paralleling contour of chest wall, absence of lung markings distal to th visceral pleural line (most of the time), deep sulcus sign |
|
|
Term
| What is the deep sulcus sign? |
|
Definition
| inferiorly displaced costophrenic angle on supine view - seen in pneumothorax |
|
|
Term
| What type of film is helpful in IDing pneumothorax? |
|
Definition
expiratory film
lateral decubitus if pt cannot stand |
|
|
Term
| What are some signs of tension pneumothorax? |
|
Definition
| shift of mobile structures (away), inversion of the diaphragm, and flatteing of the heart contour on side under tension |
|
|
Term
| What is a pulmonary embolism? |
|
Definition
| obstruction of a pulmonary artery |
|
|
Term
| What is the most common finding with pulmonary embolism? |
|
Definition
| normal CXR that is incompatible with patient's cardiopulmonary distress |
|
|
Term
| What is the most common abnormality found in hosptialized patients who die and are autopsied? |
|
Definition
|
|
Term
| What do you look for with pulmonary embolism? |
|
Definition
| look for increased density or dilation of other arteries and the right ventricle and atrium (compensation) |
|
|
Term
T/F
If you suspect pulmonary embolism from a CXR, you must get other imaging. |
|
Definition
|
|
Term
| What imaging do you use to look for PE? |
|
Definition
|
|
Term
| What are some indications for CT scan? |
|
Definition
clarification of abnormal findings on CXR
staging of lung and esophageal cancer
detecting of metastatic disease
evaluation of solitary nodule
suspected mediastinal or hilar mass
suspected pleural tumor
suspected pulmonary embolism
detecting source of hemoptysis
CT guided needle aspiration and/or drainage |
|
|
Term
| How many times the CXR radiation does chest CT expose a patient to? |
|
Definition
|
|
Term
| What are the indications for MRI? |
|
Definition
| evaluation of mediastinal or hilar tumors, staging of lung cancer when CT indicates invasion of chest structures, suspected aortic disection, evaluation of mediastinum and hilum in patients allergic to contrast, congentital and acquired heart disease |
|
|
Term
| What are the indications for Ultrasound? |
|
Definition
| evaluation of fluid collection in pleural space, US guided thoracentesis |
|
|
Term
T/F
US is useful for evaluation of lesions. |
|
Definition
| False, it cannot cross air-tissue borders |
|
|
Term
| What are the indications for nuclear medicine studies? |
|
Definition
| suspected pulmonary embolus (V/Q), differentiation of benign and malignant pulmonary nodules (PET), dection of recurring or metastatic tumors (PET), detection of recurrence of lymphoma (gallium), staging of inflammatory disease (gallium), detection of infection |
|
|
Term
| What is the principle diagnostic tool for cardiac imaging? |
|
Definition
|
|
Term
| How is CXR used in evaluation of the heart? |
|
Definition
|
|
Term
| What has largely replaced cardiac fluoroscopy? |
|
Definition
|
|
Term
| What are radioisotope studies used to evaluate in cardiac imaging? |
|
Definition
|
|
Term
| Which imaging study distinguishes flowing blood from structures? |
|
Definition
|
|
Term
| What basic things can you learn about the heart from the CXR? |
|
Definition
| size, shape, pulmonary vascular abnormalities, and cardiac calcifications |
|
|
Term
| What 4 CXR views are done in a cardiac series? |
|
Definition
| PA, left lateral, r. anterior oblique and l. anterior oblique |
|
|
Term
| What should be the max diameter of the heart? |
|
Definition
| < 1/2 the greatest internal diameter of thoracic cage (applies only to PA view |
|
|
Term
| When might the heart appear falsely enlarged? |
|
Definition
| AP view, with high diaphragm - less than full inspiration, supine position, with abdominal distention, or with abnormalities of the chest cage, rotaion, density that obscures heart border, mediastinal shift |
|
|
Term
| When might heart appear smaller? |
|
Definition
| COPD - over distention of lungs |
|
|
Term
T/F
The left atrium is not seen under normal circumstances. |
|
Definition
|
|
Term
| What does left atrial enlargement do to the shape of the heart? |
|
Definition
| loss of concavity on left side |
|
|
Term
| Give 2 causes of left ventricular enlargement. |
|
Definition
| hypertension, aortic valve disease |
|
|
Term
| What are 3 causes of r. ventricular enlargement? |
|
Definition
| pulmonary disease, pulmonary artery hypertension, tricuspid valve disease |
|
|
Term
T/F
The size of the pulmonary vessels is greater at the base of the lungs than at the apex. |
|
Definition
|
|
Term
| When are Kerley B lines seen on CXR? |
|
Definition
| interstitial pulmonary edema - due toCHF |
|
|
Term
| When is peribronchial cuffing seen? |
|
Definition
|
|
Term
| When is a bat-wing configuration seen? |
|
Definition
|
|
Term
T/F
Kerley B lines are seen in pulmonary edema. |
|
Definition
|
|
Term
| What is pericardial effusion? |
|
Definition
| heart is enlarged due to fluid in the pericardial sac |
|
|
Term
| What is the most useful imaging for evaluation of pericardial effusion? |
|
Definition
|
|
Term
| What are some causes of widened mediastinum? |
|
Definition
| aortic aneurysm, thyroid enlargement, mediastinal lymph node enlargement, aortic dilation, esophageal dilation, thymic tumors, trauma |
|
|
Term
| What do you do if you suspect aortic aneurysm? |
|
Definition
| get CT, echo, or MRI immediately |
|
|
Term
| What imaging is used routinely on pts with suspected traumatic injury to heart and/or great vessels? |
|
Definition
|
|
Term
|
Definition
| ultrasound examination of the heart and great vessels |
|
|
Term
| What is the principle diagnostic tool for cardiac abnormalities? |
|
Definition
|
|
Term
| When is coronary arteriography used? |
|
Definition
| ischemic heart disease, asymptomatic pats with abnormal exercise tolerane tests, pts prior to cardiac surgery, pts after CABG, and patient with MI for interventional therapy |
|
|
Term
T/F
Radioisotope studies allow for the early detection of ischemic heart disease without the risks of catheterization. |
|
Definition
|
|
Term
| What is highly sensitive and specific for detection of coronary artery disease? |
|
Definition
|
|
Term
| What type of imaging can detect soft plaque not seen in catheterization studies? |
|
Definition
|
|
Term
| What are the advantages of CT scan? |
|
Definition
non invasice
scan entire heart in less than 15 sec
no hospital stay
cost effective
better depiction of abnormalities
provides clear demo of calcium deposits and plaque
delineates stenosis of coronary arteries
analyze coronary arteries, heart valves, heart muscle, ventricles, plaque and lung parenchyma all at once |
|
|
Term
| What imaging studies are used to evaluate the abdomen? |
|
Definition
|
|
Term
| What things are plain films useful for in the eval of GI? |
|
Definition
| calcifications, intestinal perforations, obstructions |
|
|
Term
T/F
If bowel perforation is suspected, use a barium enema. |
|
Definition
|
|
Term
T/F
CT is the modality of choice for MOST abdominal abnormalities including trauma. |
|
Definition
| True - liver, biliary tree, vessels and lobes of liver, gallbladder, spleen, kidneys, adrenals, pancreas, aorta, inferior vena cava, psoas muscle, bladder, bowel, bones, anterior abdominal muscles |
|
|
Term
T/F
You cannot use IV contrast in renal patients. |
|
Definition
|
|
Term
| What is US used to evaluate? |
|
Definition
| Liver (ascites), pancreas, gallbladder, reproductive organs, kidneys, aortic aneurysm |
|
|
Term
T/F
MRI is often used for problem solving a difficult diagnosis. |
|
Definition
| True - finding extension of known disease, etc. |
|
|
Term
| What % of gallstones are radiopaque? |
|
Definition
|
|
Term
|
Definition
| small, rounded calcifications that represent calcified venous thrombi, usually found in pelvic veins of women and are not pathological |
|
|
Term
T/F
There is almost always air in the rectum and sigmoid colon. |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| air in the biliary system |
|
|
Term
T/F
CT is recommended for ulcers. |
|
Definition
|
|
Term
T/F
Biopsy is necessary for accurate diagnosis of gastric carcinoma. |
|
Definition
|
|
Term
| What is the most common mass lesion of the small bowel? |
|
Definition
|
|
Term
|
Definition
| absence or sig decrease of peristalsis |
|
|
Term
T/F
80% of bowel obstructions are in small bowel. |
|
Definition
|
|
Term
| What is a functional ileus? |
|
Definition
| when 1 or more loops of bowel lose their ability to propagate peristaltic waves |
|
|
Term
| What is the most common GI malignancy? |
|
Definition
| colorectal cancer - most originate in sigmoid area |
|
|
Term
| What is the preferred exam for colorectal cancer? |
|
Definition
| CT - but endoscopy is gold standard |
|
|
Term
| What is the imaging of choice for appendicitis? |
|
Definition
|
|
Term
| What is the preferred imaging for liver, biliary tree, and gallbladder? |
|
Definition
US or CT
US is less useful for distinguishing benign v. malignant cancer |
|
|
Term
| What is the preferred imaging for blunt trauma to liver, biliary tree, and gallbladder? |
|
Definition
|
|
Term
| What is used to evaluate gallbladder disease? |
|
Definition
|
|
Term
| What is the 2nd most common cancer of GI tract? |
|
Definition
|
|
Term
| What is the most common neoplasm of spleen? |
|
Definition
|
|
Term
| What is the most common malignancy of the spleen? |
|
Definition
|
|
Term
| What is the most commonly injured intra-abdominal organ? |
|
Definition
|
|
Term
| What is the best imaging to eval trauma to spleen? |
|
Definition
|
|
Term
|
Definition
Finding the inverse probability
he probability that the pt has a disease after a test result is proportional to the pretest disease probablity |
|
|
