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163 Cards in this Set

  • Front
  • Back
what is the unit of absorption/transmission of x-rays in CT? What is this this scale normalized (zeroed) to?
- Hounsfield units
- Normalized to water
what are the five basic densities in CT and generally, how do they relate to each other in degree of attenuation?
air <<< fat < water < soft tissue << bone
(On a conventional image,) compare the terms used in x-ray, CT, ultrasound, and MRI that describe structures that are very white and very black.
WHITE
x-ray: radioopaque
CT: hyperattenuating
ultrasound: hyperechoic
MRI: hyperintense
BLACK
x-ray: radiolucent
CT: hypoattenuating
untrasound: hypoechoic
MRI: hypointense
what is the most common contrast media in CT?
iodine
where is contrast agent injected in a myleogram?
sub-arachnoid space
in CT, what do the terms Window and Level mean?
- window: range of HU to display
- level: center-point of the range of HU to display
in a CT of the lung, what would be a good window and level to view the soft tissues and air of the lung?
- level: -500
- window: 1200

so, the image would be centered at -500 (air) and would range from -1100 (air) to +100 (soft tissue)
in a CT of the lung, what would be a good window and level to view the soft tissues and bones of the nasal cavity?
- level: 300
- window: 2000

so, the image would range from -700 (air) to 1300 (bone)
Compare the advantages and disadvantages of CT to MRI
a fast, low-resolution image used to define the area in which a CT scan will be performed
"scout" or localizer image
how does CT and MRI differ from their ability to construct different views from a scan?
CT can reconstruct different planes and produce 3D images; MRI only shows one plane of section at a time
in radiology, what is a fistulogram?
imaging with contrast agent in a drainage tract
what are the range of MRI magnet intensities commonly used in clinical practice?
0.06 - 4.0 Tesla
what are the two basic units of magnetic field strength used in MRI and what is their conversion
1 Tesla = 10,000 Gauss
describe the three basic spin echo sequences in MRI and what they are measuring? What is the most commonly used technique?
- T1: spin relaxation time (most common)
- T2: loss of spin synchronization (coherence)
- Proton Density: concentration of hydrogen within a tissue
what are four common veterinary applications of MRI?
1. neuroimaging (brain and spine)
2. musculoskeletal
3. cancer imaging
4. vascular imaging (e.g. portosystemic shunts)
in veterinary practice, what are four commonly imaged locations with CT?
1. bone (fractures, luxations, ear disease, spinal disease)
2. nasal cavity (tumors, rhinitis)
3. lungs (tumors, diffuse lung diseases, torsion)
4. abdomen (masses, portosystemic shunts)
a rough image used to determine the planes of imaging in MRI
survey image
what are the three most common imaging planes used in MRI?
- transverse
- dorsal
- sagittal
what is the most commonly used MRI contrast agent? what property does this agent have that makes it hyperintense?
gadolinium: it is paramagnetic so it makes tissues adjacent to the agent relax faster (good for a T1 sequence)
what are four diseases LOCALIZED TO THE BRAIN that are commonly imaged with CT or MRI?
1. masses
2. dilated ventricles
3. multifocal lesions: inflammatory/infection
4. hemorrhage
what are two diseases EXTERNALLY AFFECTING THE BRAIN that are commonly imaged with CT or MRI?
- masses that may be impinging on the brain
- trauma (e.g. fractures of the skull)
what is a common artifact in imaging the brain with CT?
"beam hardening." dense bone stops the x-rays from penetrating underlying tissue and creates areas of hypoattenuation
what are four common abnormalities of the spine that are imaged with CT/MRI?
1. spinal cord compression (disc herniation, masses)
2. inflammation/infection (myelitis, empyema, discospondylitis, spondylitis)
3. spinal cord enlargement (edema, hemorrhage, interparenchymal mass)
4. spinal trauma (fracture, luxation, instability/subluxation)
in fine-tuning a radiographic technique for overexposure or underexposure, what adjustment of kVp would you make? What equivalent adjustment of mAs would produce similar results?
- increase or decrease kVp by 10-15%
- or half/double the mAs
what is the vertebral formula for a cat (cervical - sacral)?
C7 T13 L7 S3
what is the vertebral formula for a dog (cervical - sacral)?
C7 T13 L7 S3
what is the vertebral formula for a horse (cervical - sacral)?
C7 T18 L6 S5
in terms of kVp and mAs, what radiographic technique gives you the best contrast?
low kVp and high mAs
in a spinal radiograph, what is the optimal x-ray beam position?
- centered on the region of interest
- perpendicular to the spinal canal
in an x-ray, what phenomenon causes intervertebral disc spaces on the edges of the film appear to be narrow compared to those in the center?
beam divergence
what two basic radiographic views are used for spinal x-ray?
lateral and VD
if an animal is a suspected trauma/fracture/luxation to the spine, how can the animal be safely positioned for a VD view?
lateral recumbency with the screen held vertical and against the dorsum. The x-ray beam penetrates from ventral to dorsal, perpendicular to the screen
in a proper x-ray of the cervical spine, what should be included in the cranial and caudal extremities of the image
caudal skull to T1
which intervertrbral disc spaces of the cervical spine are usually more narrow than the rest?
C2-3
comment on the appearance and unique features of C3-C7 on a spinal x-ray.
- C3-C5 look the same
- C6 has large ventral laminae of the transverse processes
- C7 has a tall spinous process
what special views are used in addition to the VD and lateral views of the cervical spine?
1. oblique lateral
2. flexed lateral
why should a flexed lateral view of the cervical spine be performed with extreme care
because if there is joint instability, the dens could compress the spinal cord
what views are used to image the equine cervical spine
standing lateral views
what is the normal appearance of C1-2 and C6 in a standing lateral view of the equine cervical spine?
C1-2 do not overlap
C6 has a short body and a large transverse process
what is the equine cervical sagittal ratio? what is normal?
of the cervical vertebrae:
- minimal sagittal diameter / height of vertebral body
- Should be >/= 48
what are the the cranial and caudal extremities of a proper thoracic spinal radiograph?
C7 to L1
what is the proper animal positioning and beam location of a thoracic spinal radiograph of a small/medium size dog or a cat?
- pull forelimbs cranially
- center at T6/T7
- include C7 - T1
how do you align the spine for a proper thoracic spinal radiograph of a deep-chested dog?
put a wedge under the sternum
where does a rib articulate with its corresponding vertebral body?
at the cranial aspect
what is the most common anticlinal vertebra in the dog/cat?
T11
what are the the cranial and caudal extremities of a proper lumbar spinal radiograph in the dog/cat? where is the beam centered?
- T13 to sacrum
- beam centered at the midpoint of the last rib and the coxofemoral joint
what is the reason for regions of increased radioopacity in the ventral aspects of the intervertebral disc spaces of a normal lumbar spinal radiograph
transverse processes (note they are largest in the lumbar region)
what is the reason for regions of increased radioopacity within the vertebral canal of a normal lumbar spinal radiograph
accessory processes overlay the intervertebral foramina
where does the diaphragm attach to the spine in the dog/cat?
L3 and L4
in the cat and dog, why do L3 and L4 show poor margination on their ventral aspects?
because the diaphragm attaches there
how do the lumbar vertebrae of dogs appear different than cats
dogs: shorter and "stocky"
cats: they are longer than their diameter
what is a transitional vertebra
For example, T13 in some dogs/cats, where the vertebra has characterisits of both a thoracic and a lumbar vertebra. This is normal. Can also happen with L7 and sacrum/ilium
what are some potential adverse affects of using contrast agent in a myleogram
- can worsen neurologic signs
- seizures
- bradycardia
- apnea
- vomiting
- death
what are five indications for myleography?
1. confirm site of spinal cord injury as identified or suspected on normal radiograph
2. multiple abnormalities identified on survey radiographs
3. survey radiograph not consistent with neurological examination
4. define the extent of a lesion
5. help determine if surgical intervention is indicated
what are two common contraindications for myleography?
1. infection
2. elevated intracranial pressure
what are the two sites of injection of x-ray contrast agent in a myleogram?
1. cerebellomedullary cistern (AO junction)
2. L5-6
what are the four most common positioning techniques for a myleogram?
1. neutral
2. flexed
3. extended
4. traction
what does leakage of contrast agent typically look like in a myleogram?
inconsistent margins due to accumulation of contrast agent in the IV foramina and nerve roots
what is the purpose of taking orthogonal radiographs?
triangulation
what effect is caused by two structures of the same opacity that do not touch
summation
what effect is caused by two structures of the same opacity that DO touch
silhouette
what are three basic abnormalities of soft tissue size in the musculoskeletal radiograph?
1. atrophy
2. focal increase
3. diffuse increase
what are two basic causes of soft tissue atrophy in the musculoskeletal radiograph?
1. disuse
2. neurogenic
what are the two types of focal increase of soft tissue size in the musculoskeletal radiograph?
1. intra-capsular
2. extra-capsular
what are the four main causes of diffuse increase in soft tissue size in the musculoskeletal radiograph?
1. trauma
2. impaired lymphatics
3. vasculitis
4. cellulitis
what are three causes of intra-capsular soft tissue swelling?
1. effusion
2. synovitis
3. joint-associated tumor
what are three causes of extra-capsular soft tissue swelling?
1. trauma
2. neoplasia
3. cellulitis
what are three landmarks to assess intra-capsular soft tissue swelling in the stifle joint?
1. patellar ligament
2. infrapatellar fat pad
3. fascia of the gastrocnemius muscle
what is one common rule-out for severe extra-capsular soft tissue swelling proximal-plantar to the hock joint?
common calcaneal tendonitis
what are the three types of soft tissue opacity abnormalities in the musculoskeletal radiograph?
1. gas
2. mineral
3. fat
what is gas in the soft tissue called, and what are five rule-outs for this in the musculoskeletal radiograph?
- emphysema
1. puncture
2. iatrogenic
3. gas-producing organism
4. vacuum phenomenon (in the joints)
5. tracheal/esophageal perforation
what are the three types of mineral opacity abnormalities in the soft tissue in the musculoskeletal radiograph?
1. intra-articular
2. structured
3. unstructured
what are four rule-outs for an intra-articular mineral opacity of the soft tissue in the musculoskeletal radiograph?
1. joint mouse
2. avulsion fragment
3. synovial osteochondroma
4. chondrocalcinosis
what are four rule-outs for a structured mineral opacity of the soft tissue in the musculoskeletal radiograph?
1. normal structure (e.g. sesamoid bone)
2. fracture fragment
3. myositis ossificans
4. neoplasia
what are four rule-outs for an unstructured mineral opacity of the soft tissue in the musculoskeletal radiograph?
1. dystrophic mineralization
2. neoplasia
3. calcinosis cutis/circumscripta
4. metastatic mineralization
what is a common type of fat opacity abnormality of the soft tissue in the musculoskeletal radiograph? what are two rule-outs?
- lipoma
1. infiltrative lipoma
2. liposarcoma
what is a common etiology for metastatic mineralization?
elevated Ca:P ratio
what is a normal structured mineral opacity in the soft tissue of the elbow?
sesamoid in the supinator muscle
what are the two major categories of bone loss?
1. focal
2. osteopenia
what are the three radiographic presentations of focal osteolytic bone loss in increasing order of aggressiveness?
1. geographic
2. moth-eaten
3. permeative
what are two types of generalized osteopenia?
1. osteoporosis
2. osteomalacia
in focal bone loss, what three things should be evaulated in the musculoskeletal radiograph to determine the severity of focal bone loss?
1. type (geographic, moth-eaten, permeative)
2. zone of transition
3. cortical destruction
how does the appearance of the zone of transition correspond with aggressiveness of the lesion?
aggressiveness: long > intermediate > short
what are the two main types of osteogenesis in the musculoskeletal radiograph?
1. generalized
2. focal
what are the two main types of focal osteogenesis in the musculoskeletal radiograph?
1. endosteal
2. periosteal
what are the six types of periosteal reactions in the musculoskeletal radiograph in order of increasing aggressiveness.
1. solid, smooth
2. solid, irregular
3. lamellar
4. interrupted, spiculated
5. interrupted, sunburst
6. interrupted, amorphous
what is the difference between an osteogenesis with well-defined margins versus poorly defined margins
well defined → inactive
poorly defined → active
what are four causes of endosteal sclerosis?
1. panosteitis
2. infarct
3. trauma
4. neoplasia
what attaches the periosteum to the bone cortex?
Sharpey's fibers
how can the "age" of a periosteal reaction be classified?
by the opacity of the reaction (especially the margins)
what are four causes of solid periosteal reactions?
1. trauma
2. osteomyelitis
3. hypertrophic osteodystrophy
4. neoplasia (-)
why would a periosteal reaction have a lamellar appearance
it indicates a cyclic or intermittent process
what is the cause of spiculation in a periosteal reaction?
orientation of osteogenesis along Sharpey's fibers
how does the appearance of spicules in a periosteal reaction correlate with its aggressiveness?
long, thin is more aggressive than short, thick.
what are two causes of interrupted periosteal reactions?
1. neoplasia
2. osteomyelitis
what are four basic rule-outs for a monostotic aggressive bone lesion?
1. primary bone tumor
2. metastatic bone tumor
3. fungal osteomyelitis
4. bacterial osteomyelitis
what are three basic rule-outs for polyostotic aggressive bone lesion?
1. metastatic neoplasia
2. fungal osteomyelitis
3. bacterial osteomyelitis
what is the frequency range of diagnostic ultrasound?
2-20 MHz
in ultrasound, what is the name of the device that produces and captures a sound wave?
transducer or probe
in what three ways is ultrasound attenuated?
1. reflection (the basis of ultrasound)
2. heat
3. scatter
what causes reflection of a sound wave?
the interface between two tissues with different acoustic impedance
how does acoustic impedance relate to tissue density?
acoustic impedance = speed of sound x tissue density
what determines the amplitude of a reflected sound wave?
the greater the density difference at the interface between the tissues, the greater the amplitude
what is acoustic shadow?
produced by the attenuation of sound waves thorough dense matter, an acoustic shadow is non-information about the structures underlying that dense matter
what is acoustic enhancement?
an area of increased intensity in the ultrasound image that is below an area of less density. As opposed to acoustic shadow, this is real information (not non-infromation). For example, enhancement of liver parenchyma under the gall bladder
what are the two image display modes in ultrasound?
B-mode (brightness mode) - gives you a 2D image
M-mode (motion mode) - gives you a 1D image with time on the horizontal axis
what are the two types of ultrasound transducers?
1. linear array
2. sector/wedge
in an ultrasound, compare why you would choose a linear array transducer or a sector/wedge transducer
- linear array: wider image, large contact area
- sector/wedge: smaller contact area
why would you choose a low-frequency transducer? a high frequency?
- low: better tissue penetration, but lower resolution
- high: better resolution, but not as good tissue penetration
why does a higher frequency transducer provide better resolution?
because the smaller pulse width will reflect off of smaller structures at their interfaces
how do you choose the frequency of an ultrasonic probe?
use the highest frequency that will allow adequate penetration of the body part of interest
what is used to enhance the quality of an ultrasound through the skin
a gel between the probe and skin
in ultrasound, what is the term used to describe:
- a darker spot?
- a brighter spot?
- two spots of the same brightness?
- complete blackness
- a darker spot: hypoechoic
- a brighter spot: hyperechoic
- two spots of the same brightness: isoechoic
- complete blackness: anechoic
what are the six echogenicities in ultrasound in order from hyperechoic to hypoechoic (of structures in the abdomen)?
- renal sinus (fat)
- prostate
- spleen
- liver
- renal cortex
- renal medulla
how is a longitudinal ultrasound image oriented on the screen?
- cranial to the left, caudal to the right
- dorsal at the bottom, ventral at the top
how is a transverse ultrasound image oriented on the screen?
- right side to viewer's left, left side to viewer's right
- ventral at the top, dorsal at the bottom
what is primary and secondary occupational radiation exposure?
- primary: directly in the beam
- secondary: scatter/leakage
what is the occupational exposure limit in rem per year for
- whole body
- hands/feet
- fetal dose
- whole body: 5 rem per year
- hands/feet: 50 rem per year
- fetus: 500 mrem for entire gestational period
what is the official unit of radiation exposure? what does it describe?
the Roentgen, which is the amount of ionized radiation caused by EM radiation exposure
what is the SI unit of absorbed dose? what is the old unit? what is the conversion?
- SI: Gray
- old: rad
- 1 GY = 100 rad
how are different types of ionizing radiation taken into account when measuring the biological effect of absorbed dose? what is the unit of thie absorbed dose equivalent
radiation dose equivalent = absorbed dose x QF, where QF is a quality factor

unit is the Sievert, Sv = 100 rem
what are the two basic processes of radiation damage to DNA?
- direct effect: direct damage to the DNA molecule
- indirect effect: formation of free radicals (e.g. OH radical) that react with DNA
what are the three end-results of DNA damage by radiation?
1. mutation, which may take years or generations to propagate
2. cell death
3. DNA repair with reverse transcriptase
in general, which cells are most sensitive to ionizing radiation?
poorly differentiated, rapidly dividing cells (e.g. bone marrow, GI epithelium, gonads)
what are the two classifications of effects of radiation exposure
1. deterministic - e.g., "x amount of radiation will cause a burn"
2. stochastic - e.g. "it only takes one random ionization event to cause a tumor"
in what three body systems does acute radiation syndrome manifest the most?
1. CNS
2. GI
3. bone marrow
what is the predominant cause of death from bone marrow syndrome caused by acute radiation exposure?
sepsis
what is the term used to describe the effects of radiation toxicity not attributed to acute radiation exposure?
chronic low-level radiation injury
what is the most important syndrome caused by chronic low-level radiation injury?
cancer
what are the three basic ways to reduce exposure to radiation?
1. exposure time
2. distance
3. shielding
what is the equation to calculate radiation exposure when you change the distance from the source?
E2 = E1 x (D1/D2)^2
what is required by Virginia state law regarding persons holding animal or cassette during exposure?
a log of the person's name, date, and procedure
what type of badge is currently used to monitor radiation exposure?
a photoluminescent badge (phosphorescence)
comment on where radiation badges should be worn
- outside apron/thyroid shield
- pregnant workers wear 2 badges: one outside apron, one over the abdomen
how do you calculate the maximum accumulative dose for an occupational worker?
MAD = age in years x 1 rem
what are three basic causes of an agressive joint lesion in a musculoskeletal radiograph?
1. joint associated tumor (mono-articulated)
2. septic arthritis
3. erosive polyarthritis
what is the proper marker positioning for an oblique radiographic view of the skull?
for the side that is tilted upwards, the marker should go on top of the film. for the side of the face that is tilted downwards, that marker goes on the bottom
what skull view is used to view the arcades of the teeth?
open mouth oblique views
how do the teeth of young versus old dogs appear in a musculoskeletal radiograph?
younger animals have larger pulp cavities
what is the dental formula for cats (deciduous and permanent)?
deciduous: dI3/3 dC1/1 dP3/2
permanent: i3/3 C1/1 P3/2 M1/1
what is the dental formula for dogs (deciduous and permanent)
deciduous: dI3/3 dC1/1 dP3/3
permanent: I3/3 C1/1 P4/4 M2/3
the radiolucent line surrounding the tooth in an x-ray is what?
periodontal membrane
the radioopaque layer of bone below the periodontal membrane in an x-ray of the tooth is what?
lamina dura
what two views are used to view the nasal cavity? explain how each view is constructed
1. intra-oral DV: film in mouth; DV; slow-speed screen or envelop film
2. open mouth VD: dog laying in dorsal recombancy; mouth propped open; beam goes VD
what positioning technique is used to view the frontal sinus in an x-ray?
rostrocaudal projection: beam goes directly parallel to top of head
what three views are useful for examining the ear? what does each view highlight?
1. DV for external ear canal and petrous temple bone
2. open mouth rostro-caudal for the tympanic bullae
3. oblique lateral views for separating the bullae
how do the tympanic bullae of cats differ from dogs?
cats' tympanic bullae have two compartments (lateral and medial)
congenital malformation and enlargement of the foramen magnum. what is the name of this condition and how does it appear on a radiograph?
- occipital dysplasia
- appears as a "keyhole" instead of a circle
on a radiograph of the horse limb, where is the marker placed for a
- lateral view?
- oblique view?
both are placed lateral
in the horse carpus, what is the best bony landmark and what is its position?
accessory carpal bone, oriented lateral on the palmar side
what is the best view to see the intermediate carpal bone in the horse
flexed lateral
how does the accessory capral bone appear differently in a DLPMO versus a a DMPLO in the horse?
since the accessory carpal bone is lateral and palmar, the bone will protrude out the side of the image in a DLPMO and be overlapped by the carpus in a DMPLO.
in the carpus, how do the medial and lateral splint bones articulate differently with their corresponding distal carpal bones?
C2 and MC2 (medial) overlap completely
C4 and MC4 (lateral) overlap 50%
what three soft tissue structures of the horse carpus can be viewed with a skyline view?
1. extensor carpi radialis
2. common digital extensor
3. lateral digital extensor
in the horse tarsus, what is the best bony landmark and what is its position?
the calcanean tuber, oriented lateral on the palmar side
what soft tissue structure runs between the calcanian tuber and the sustentaculum tali? what is the best view to see this?
- deep digital flexor tendon
- skyline view
what must be done before a radiograph of the foot of a horse?
it must be cleaned and play-doh placed in the sulci of the frog and central sulcus
what view would you choose to evaluate a horse's foot width, collateral cartilages, and periphery of the navicular bone?
0-degree DP
which view is best for the horse's distal phalanx structures and the distal border of the navicular bone?
60-degree DP
in the horse, which view is good to assess rotation of the distal phalanx, remodeling of the navicular bone, and DJD?
lateral view
what view is best to see the flexor eminance/process/cortex of the navicular bone?
navicular skyline
in a radiograph of the horse's foot, a notch in the toe portion of P3
crena marginalis