Introduction To Medical Imaging
Lecture No.3
Dr. Yousif Mohamed Yousif Abdallah
1. Plain X ray
2. Myelography
3. CT scan
4. MRI scan
5. Ultrasound
6. Isotope Study e.g. Bone scan
7. Angiogram
CT
Ultrasonography
Plain x ray
CT
MRI
Myelography
Ultrasonography
Bone scan
Radiology & Diagnostic Imaging Overview
• X-Rays
– High-energy electromagnetic waves
– Travel in straight lines
– Shorter wave length than visible light
– Able to penetrate solid materials of varying
densities
– Capable of exposing a photographic plate (x-ray
film)
• Much the same way as a camera exposes film
7
Radiology & Diagnostic Imaging Overview
(continued)
• X-Rays (continued)
– Used to visualize internal organs and structures
of body
– Provide valuable means for verifying presence of
illness or disease
• Radiology
– Study of the diagnostic and therapeutic uses of
x-rays
8
Radiology & Diagnostic Imaging Overview
(continued)
• X-Rays (continued)
– Used to visualize internal organs and structures
of body
– Provide valuable means for verifying presence of
illness or disease
• Radiology
– Study of the diagnostic and therapeutic uses of
x-rays
9
PROCEDURES AND TECHNIQUES
RADIOLOGY AND DIAGNOSTIC IMAGING
10
Angiocardiography
(Cardiac Catheterization)
• Pronounced
– (an-jee-oh-kar-dee-OG-rah-fee)
– (CAR-dee-ak kath-eh-ter-ih-ZAY-shun)
• Defined
– A specialized diagnostic procedure in which a
catheter is introduced into a large vein or artery,
usually of an arm or a leg, and is then threaded
through the circulatory system to the heart
11
Angiocardiography
Angiography
• Pronounced
–(an-jee-OG-rah-fee)
• Defined
–A series of x-ray films allowing
visualization of internal structures after the
introduction of a radiopaque substance
13
Coronary angiography
MRI angiography
Cerebral Angiography
• Pronounced
– (seh-REE-bral an-jee-OG-rah-fee)
– (SER-eh-bral an-jee-OG-rah-fee)
• Defined
– Injection of a radiopaque contrast medium into
an arterial blood vessel (carotid, femoral, or
brachial) to make visualization of the cerebral
vascular system via x-ray possible
15
Cerebral Angiography
Renal Angiography
• Pronounced
–(REE-nal an-jee-OG-rah-fee)
• Defined
–X-ray visualization of the internal anatomy
of the renal blood vessels (blood vessels of
the kidney) after injection of a contrast
medium
17
Renal angiography
Arteriography
• Pronounced
– (ar-tee-ree-OG-rah-fee)
• Defined
– X-ray visualization of arteries following the
introduction of a radiopaque contrast medium
into the blood stream through a specific vessel
by way of a catheter
19
Hepatic arteriography
Arthrography
• Pronounced
–(ar-THROG-rah-fee)
• Defined
–The process of taking x-rays of the inside of
a joint, after a contrast medium has been
injected into the joint
• Contrast medium makes the inside of the
joint visible
21
Arthrography
Barium Enema (BE)
• Pronounced
–(BAH-ree-um EN-eh-mah)
• Defined
–Infusion of a radiopaque contrast medium,
barium sulfate, into the rectum
–Contrast medium is retained in lower
intestinal tract while x-ray films are
obtained of the lower GI tract
23
Barium Enema (BE)
Barium Swallow
(Upper GI Series)
• Pronounced
– (BAH-ree-um SWALL-oh)
• Defined
– Oral administration of a radiopaque contrast
medium, barium sulfate, which flows into the
esophagus as the person swallows
• X-rays are taken as barium sulfate flows into
the upper GI tract
25
Bronchography
• Pronounced
–(brong-KOG-rah-fee)
• Defined
–Bronchial examination via x-ray following
the coating of the bronchi with a
radiopaque substance
26
Bronchography
Main air way ronchgraphy
Cholangiography
(Intravenous)
• Pronounced
– (koh-lan-jee-OG-rah-fee)
– (in-trah-VEE-nus)
• Defined
– Visualizing and outlining of the major bile ducts
following an intravenous injection of a contrast
medium
28
Cholangiography
Cholangiography
(Percutaneous Transhepatic)
• Pronounced
– (koh-lan-jee-OG-rah-fee)
– (per-kyoo-TAY-nee-us trans-heh-PAT-ik)
• Defined
– Examination of the bile duct structure using a
needle to pass directly into an intrahepatic bile
duct to inject a contrast medium
• Also known as PTC or PTHC
30
Percutaneou cholangiography
Cholangiopancreatography
(Endoscopic Retrograde)
• Pronounced
– (koh-lan-jee-oh-pan-kree-ah-TOG-rah-fee)
– (en-doh-SKOP-ic RET-roh-grayd)
• Defined
– Procedure that examines the size of and the filling of
the pancreatic and biliary ducts through direct
radiographic visualization with a fiberoptic endoscope
32
Endoscopic Retrograde
Cholecystography
(Oral)
• Pronounced
–(koh-lee-sis-TOG-rah-fee)
• Defined
–Visualization of the gallbladder through xray following the oral ingestion of pills
containing a radiopaque iodinated dye
34
Cholecystography
Cineradiography
• (Pronounced)
– (sin-eh-ray-dee-OG-rah-fee)
• Defined
– Diagnostic technique combining the techniques
of
fluoroscopy,
radiography,
and
cinematography by filming the images that
develop on a fluorescent screen with a movie
camera
36
Cineradiography
Computed Axial Tomography (CT, CAT)
• Pronounced
–(kom-PEW-ted AK-see-al toh-MOG-rahfee)
• Defined
–A painless, noninvasive diagnostic x-ray
procedure using ionizing radiation that
produces a cross-sectional image of the
body
38
Computed Axial Tomography (continued)
39
Computed Axial Tomography
Abdominal CT
Voiding Cystourethrography
• Pronounced
– (VOYD-ing sis-toh-yoo-ree-THROG-rah-fee)
• Defined
– X-ray visualization of the bladder and urethra
during the voiding process, after the bladder has
been filled with a contrast material
42
Cystourethrography
Digital Subtraction Angiography (DSA)
• Pronounced
– (DIJ-ih-tal sub-TRAK-shun an-jee-OG-rah-fee)
• Defined
– X-ray images of blood vessels only, appearing
without any background, due to the use of a
computerized digital video subtraction process
44
Angiography
Renal angiogram
Renal CT angiogram
Echocardiography
• Pronounced
– (ek-oh-kar-dee-OG-rah-fee)
• Defined
– Diagnostic procedure for studying the structure
and motion of the heart via ultrasound
• Useful in evaluating structural and functional
changes in a variety of heart disorders
47
Echocardiography
Fluoroscopy
• Pronounced
–(floor-or-OSS-koh-pee)
• Defined
–Radiological technique used to examine
the function of an organ or a body part
using a fluoroscope
49
Fluoroscopy
• Fluoroscopy is a study of moving body structures - similar to
an x-ray "movie." A continuous x-ray beam is passed
through the body part being examined, and is transmitted
to a TV-like monitor so that the body part and its motion
can be seen in detail.
• Fluoroscopy is used in many types of examinations and
procedures, such as barium x-rays, cardiac catheterization,
and placement of intravenous (IV) catheters (hollow tubes
inserted into veins or arteries). In barium x-rays, fluoroscopy
allows the physician to see the movement of the intestines
as the barium moves through them. In cardiac
catheterization, fluoroscopy enables the physician to see the
flow of blood through the coronary arteries in order to
evaluate the presence of arterial blockages. For intravenous
catheter insertion, fluoroscopy assists the physician in
guiding the catheter into a specific location inside the body.
Fluoroscopy
Hysterosalpingography
• Pronounced
–(his-ter-oh-sal-ping-OG-rah-fee)
• Defined
–X-ray assessment of the uterus and the
fallopian tubes by injecting a contrast
material into these structures
52
Hysterosalpingography
Lymphangiography
• Pronounced
– (lim-fan-jee-OG-rah-fee)
• Defined
– X-ray assessment of the lymphatic system
following injection of a contrast medium into
the lymph vessels in the hand or foot
54
Lymphangiography
Magnetic Resonance Imaging (MRI)
• Pronounced
–(mag-NET-ik REZ-oh-nans IM-ij-ing)
• Defined
–A noninvasive scanning procedure that
provides visualization of fluid, soft tissue,
and bony structures without the use of
radiation
56
Magnetic Resonance Imaging
Mammography
• Pronounced
– (mam-OG-rah-fee)
• Defined
– Process of taking x-rays of the soft tissue of the
breast to detect various benign and/or
malignant growths before they can be felt
58
Mammography
Myelography
• Pronounced
– (my-eh-LOG-rah-fee)
• Defined
– Introduction of contrast medium into the
lumbar subarachnoid space through a lumbar
puncture to visualize the spinal cord and
vertebral canal through x-ray examination
60
Myelography
Positron Emission Tomography Scan
(PET)
• Pronunciation
– (POZ-ih-tron ee-MISH-un toh-MOG-rah-fee)
• Defined
– Computerized radiographic images of various
body structures produced when radioactive
substances are inhaled or injected
62
Positron Emission Tomography Scan
Pyelography
(Intravenous) (IVP)
• Pronounced
– (pye-eh-LOG-rah-fee)
– (in-trah-VEE-nus)
• Defined
– Radiographic
procedure
that
provides
visualization of the entire urinary tract: kidneys,
ureters, bladder, and urethra
• Also known as intravenous pyelogram or
excretory urogram
64
Pyelography
Radiation Therapy
• Pronounced
– (ray-dee-AY-shun THAIR-ah-pee)
• Defined
– The delivery of ionizing radiation to accomplish
one or more of the following:
• Destruction of tumor cells
• Reduction of tumor size
• Decrease in pain
• Relief of obstruction
• To slow or stop the spread of cancer cells
66
Radiation Therapy
Radiation Therapy (continued)
• Radiation Therapy (continued)
– Destroys rapidly multiplying cells regardless if
they are cancerous
– Goal of therapy is to reach maximum tumor
control with no, or minimum, normal tissue
damage
– May be delivered by teletherapy (external)
– May be delivered by brachytherapy (internal)
68
Radioactive Iodine Uptake
• Pronounced
– (ray-dee-oh-AK-tiv EYE-oh-dine UP-tayk)
• Defined
– An examination that determines the position,
size, shape, and physiological function of the
thyroid gland through the use of radionuclear
scanning
• Image of the thyroid is recorded and
visualized after a radioactive substance is
given
69
Radioactive Iodine Uptake
Scanning
• Pronounced
– (SCAN-ing)
• Defined
– Scanning of specific parts of the body with a gamma
camera after an intravenous injection of a radionuclide
material, which is absorbed by the area to be studied
• The image of the area being studied is displayed by
recording the concentration or collection of a
radioactive substance specifically drawn to that area
71
Scanning (continued)
• Bone Scan
–Involves intravenous injection of a
radionuclide material absorbed by bone
tissue
• Used to detect spread of cancer to the
bones,
osteomyelitis,
and
other
destructive changes in the bones
72
Bone Scan
Scanning (continued)
• Brain Scan
– Nuclear scanning of cranial contents 2 hours
after an intravenous injection of radioisotopes
• Useful in diagnosing abnormal findings such
as an acute cerebral infarction, cerebral
neoplasm, cerebral hemorrhage, brain
abscess, aneurysms, cerebral thrombosis,
hematomas,
hydrocephalus,
cancer
metastasis to the brain, and bleeds
74
Brain Scan
Scanning (continued)
• Liver Scan
– Noninvasive scanning technique that enables
the visualization of the shape, size, and
consistency of the liver after the IV injection of a
radioactive compound
• Useful in detecting cysts, abscesses, tumors,
granulomas, or diffuse infiltrative processes
affecting the liver
76
Liver metastasis CT scan
Liver enlargement
Scanning (continued)
• Lung Scan
– Visual imaging of the distribution of ventilation
or blood flow in the lungs by scanning the lungs
after the patient has been injected with or
inhaled radioactive material
78
CT lung scan
Scanning (continued)
• Spleen Scan
– Noninvasive scanning technique that enables
the visualization of the shape, size, and
consistency of the spleen after injection of
radioactive red blood cells
• Useful in detecting damage, tumors, and other
problems
80
Liver spleen scan
Small Bowel
Follow-through
• Pronounced
– (Small Bowel Follow-Through)
• Defined
– Oral administration of a radiopaque contrast
medium, barium sulfate, which flows through
the GI system
• X-ray films are obtained at timed intervals to
observe the progression of the barium
through the small intestines
82
Tomography
• Pronounced
– (toh-MOG-rah-fee)
• Defined
– X-ray technique used to construct a detailed
cross-section, at a predetermined depth, of a
tissue structure
• Useful in identifying space-occupying lesions
in the liver, brain, pancreas, and gallbladder
83
Tomography (liver tumour)
Ultrasonography
(Ultrasound)
• Pronounced
– (ull-trah-son-OG-rah-fee)
• Defined
– Procedure in which sound waves are transmitted
into the body structures as a small transducer is
passed over the patient’s skin
• Sound waves are reflected back into the
transducer and are interpreted by a computer
that converts waves to a composite picture
form
85
Ultrasonography (continued)
• Abdominal Ultrasound
– Use of reflected sound waves to provide reliable
visualization of the liver, gallbladder, bile ducts,
pancreas, kidneys, bladder, and ureters
86
Ultrasonography
Ultrasonography (continued)
• Pelvic Ultrasound
– Noninvasive procedure that uses high-frequency
sound waves to examine the abdomen and
pelvis
– Can be used to locate a pelvic mass, an ectopic
pregnancy, or an intrauterine device, and to
inspect and assess the uterus, ovaries, and
fallopian tubes
88
Pelvic Ultrasound
Ultrasonography (continued)
• Renal Ultrasound
– Noninvasive ultrasound of the kidneys that is
useful in distinguishing between fluid-filled cysts
and solid masses,
detecting renal calculi,
identifying obstructions, and evaluating
transplanted kidneys
• Thyroid Echogram (Ultrasound)
– Ultrasound
examination
important
in
distinguishing solid thyroid nodules from cystic
nodules
90
Venography
• Pronounced
– (vee-NOG-rah-fee)
• Defined
– Technique used to prepare an x-ray image of
veins, which have been injected with a contrast
medium that is radiopaque
– Also called phlebography
91
Venography
Xeroradiography
• Pronounced
– (zee-roh-ray-dee-OG-rah-fee)
• Defined
– A diagnostic x-ray technique used to produce an
electrical image rather than a chemical image
• Uses less radiation and exposure time than
ordinary x-rays
93
Xeroradiography
X-Rays
• Pronounced
– (ECKS-rays)
• Defined
– The use of high-energy electromagnetic waves,
passing through the body onto a photographic
film, to produce a picture of the internal
structures of the body for diagnosis and therapy
95
X-Rays (continued)
• Chest X-Ray
– Visualization of the interior of the chest
– Provides diagnostic information about the
following:
• Tumors, inflammation, accumulation of fluid,
accumulation of air, bone fractures, diaphragmatic
hernia, size of heart, calcification, placement of
centrally located intravenous access devices
96
X-Rays (continued)
• Chest X-Ray Views
– Posteroanterior (PA)
• X-rays pass through the posterior (back) to the anterior
(front)
– Lateral
• X-rays pass through the person’s side
– Oblique
• X-rays are taken from different angles
– Decubitus
• X-rays are taken with person in recumbent lateral position –
aids in localizing fluid
97
Chest X-Ray
Questions
Thank you