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16 Cards in this Set
- Front
- Back
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Role of RNI for bone pathology
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- What is RNI used for - shows function rather than anatomy (poor spatial resolution, low tissue contrast, low SNR, low photons detected) (malfunction of organs and sensitive to pathology just not which type).Often used in conjunction with other modalities (requires correlation) - Involves IV injection of radiopharmaceutical which selectively concentrates in specific areas, particularly where high blood supply/more turn over (e.g. #, tumour, infection, mets). Incorporates radioactive isotope, which emits low energy gamma). E.g. technetium 99m (labelled phosphate complexes), short half life 6hrs, decays quickly so can reduce rad dose and side effects - e.g. Bone scintigraphy - images metabolism, highly selective - Adv: Min invasive - low morbidity and reactions, radiop readily available - Earlier than plain film as increased uptake often precedes plain film changes, must be made in context with clinical indications |
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Role of CT in lung pathology
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- through use of HRCT - What is it? - uses narrow beam collimation to take thin slices of lung parenchyma (1mm thick), doesn't scan whole lungs, 1cm intervals - Used in conjunction with cxr - Adv - don't need contrast as lungs already have high contrast (less reactions), quick, readily available, characterise lesions, identify small nodules not seen on ct, high spatial freq, - Dis - cant be used for lung cancer, £, lots of noise due to thin slices - Highly sensitive - e.g. interstitial lung disease |
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ROLE OF RADIOGRAPHER 3PT AND OBJECTIVES |
- Physical support -Psychological - Teamwork - Prep - usual q, check prep, smoking/med/diab, explain - D&R - gown - IC - sp - H&S - crash -RP - record dose and drugs, aprons |
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Usual aftercare
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-Changed -Results -transport -Drug side effects -Cup of tea -Rehydration - less barium impaction -Lax - constipation |
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Barium swallow
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I: Dysphagia, reflux Nill by mouth See oesophageal mucosa and cardio-oesopheal junction |
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PERFOR OR FISTULA OR ANASTAMOSIS- NEED WATER SOL
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NO PREP
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Barium meal
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I: Indigestion, weight loss Prep: Nill by mouth, buscopan (IV 20mg) Double contrast used - barium sulphate, carbex granules and citric acid Can see gastric mucosa and duodenum |
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Barium meal and follow through (transit study, series of plain films watching passage to ileocecal valve)
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I: Partial obstruction, IBD C: Complete obstruction, ?perf P: Nill by mouth, bowel prep and metoclopramide (Antinausea and speeds up transit) See stomach mucosa and JID |
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Small bowel enema
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Same as above P: Nill by mouth ,bowel prep, + anaesthetic spray and gel (NG tube) Contrast is reduced density 75mls/min - Double contrast - barium and methyl cellulose |
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Comparison of small bowel enema and small bowel follow through (Adv/ds of enema) DR DQ NERDI |
Advantages - Rapid infusion of barium sulphate at controlled rate (full amount reaches, not absorbed) - Quicker procedure - no serial images - Double contrast - better distension of small bowel, better diagnosis of dilatation - Double contrast - better visualisation of small bowel Dis - NG Unpleasant - Effects of methylcellulose and anaesthetic gel - Radiologist - time consuming, most FT by radiographer - Dose - screening for insertion and procedure - Invasive - risk of infection |
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Alternative modalities for GIT
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- NM bowel transit study (IBD) - pet/ct - met spread - MRI - small bowel imaging, rectal ca spread - CT-staging, ct colonography - US intusscusception Plain - abdomen erect and chest |
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Double contrast barium enema (lower GIT)
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I: Change in bowel habit, obstruction C: Toxic megacolon, incomplete bowel prep P: Laxitives, low residue fat free diet day before - Uses double contrast, barium sulphate and air - rectal catheter. Buscopan/pepperimint oil (20mg IV) A: resume normal diet, mild lax?, fluid to avoid impaction, inform of side effects Adv - social interaction, less reactions, avoids colonoscopy D - movement, holding in, people in room, radiation dose, risks of barium impaction, vaginal intubation, buscopan/driving |
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Importance of bowel prep? |
-Fleet, citramag, picolax, kleen prep - Optimal images Presence of faeces can mimic or hide pathology |
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CTC - provides 2d/3d images (lower GIT)
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I: Same as before - change in bowel habit, obstruction C: Incomplete prep, recent ab/pelvic surgery *Common are crohns/IBD *Looks for filling defects and at mucosal lining Prep: Laxitives, clear liquid diet 24 hours, alternative oral contrast allows faecal tagging (stools same att as mucosa, oral BaS 48hrs prior software can remove) - Use bowel distension through air (rectal catheter) or CO2 automated insufflation -IV buscopan 20mg (reduce pain of inflation, reduce peristalsis) Technique -Scout view - check bowel distension - Supine and prone - see colonic segments better and to allow even distribution of gas |
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Comparing CTC and DCBE (3QQ my cousin bret is cool), eds
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Adv: - 3d and 2d images - Quicker 10-15mins - Quicker recovery - Movement - less (better for less mobile) - CAD (more sensitive to ca and polyps) - Blinds - Readily available - Extra-colonic structures viewed - Tolerance increased - Invasive - minimal (less side effects of barium) - Colonoscopy - have CTC same day (cant have - Ba after risk perf) Dis Expensive Dose Social interaction reduced |
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