CHAPTER 20 Radiology and Diagnostic Imaging Radiology and
- Slides: 52
CHAPTER 20 Radiology and Diagnostic Imaging
Radiology and 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 2
Radiology and Diagnostic Imaging Overview • X-rays – 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 3
PROCEDURES AND TECHNIQUES Radiology and Diagnostic Imaging
Angiocardiography (Cardiac Catheterization) • Pronounced – (an-jee-oh-kar-dee-OG-rah-fee) – (CAR-dee-ak kath-eh-ter-ih-ZAY-shun) • Defined – 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 circulatory system to the heart 5
Angiography • Pronounced – (an-jee-OG-rah-fee) • Defined – Series of X-ray films allowing visualization of internal structures after the introduction of a radiopaque substance 6
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 7
Renal Angiography • Pronounced – (REE-nal an-jee-OG-rah-fee) • Defined – X-ray visualization of internal anatomy of the renal blood vessels (blood vessels of the kidney) after injection of a contrast medium 8
Arteriography • Pronounced – (ar-tee-ree-OG-rah-fee) • Defined – X-ray visualization of arteries following the introduction of a radiopaque contrast medium into the bloodstream through a specific vessel by way of a catheter 9
Arthrography • Pronounced – (ar-THROG-rah-fee) • Defined – 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 10
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 11
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 12
Bronchography • Pronounced – (brong-KOG-rah-fee) • Defined – Bronchial examination via X-ray following the coating of the bronchi with a radiopaque substance 13
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 14
Cholangiography (Percutaneous Transhepatic) • Pronounced – (koh-lan-jee-OG-rah-fee) – (per-kyoo-TAY-nee-us trans-heh-PAT-ik) • Defined – Examination of 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 15
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 16
Cholecystography (Oral) • Pronounced – (koh-lee-sis-TOG-rah-fee) • Defined – Visualization of the gallbladder through X-ray following the oral ingestion of pills containing a radiopaque iodinated dye 17
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 18
Computed Axial Tomography (CT, CAT) • Pronounced – (kom-PEW-ted AK-see-al toh-MOG-rahfee) • Defined – Painless, noninvasive diagnostic X-ray procedure using ionizing radiation that produces a cross-sectional image of the body 19
Computed Axial Tomography 20
Voiding Cystourethrography • Pronounced – (VOYD-ing sis-toh-yoo-ree-THROG-rahfee) • Defined – X-ray visualization of the bladder and urethra during the voiding process, after the bladder has been filled with a contrast material 21
Digital Subtraction Angiography (DSA) • Pronounced – (DIJ-ih-tal sub-TRAK-shun an-jee-OG-rahfee) • Defined – X-ray images of blood vessels only, appearing without any background, due to the use of a computerized digital video subtraction process 22
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 23
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 24
Hysterosalpingography • Pronounced – (his-ter-oh-sal-ping-OG-rah-fee) • Defined – X-ray assessment of uterus and fallopian tubes by injecting a contrast material into these structures 25
Lymphangiography • Pronounced – (lim-fan-jee-OG-rah-fee) • Defined – X-ray assessment of lymphatic system following injection of a contrast medium into lymph vessels in the hand or foot 26
Magnetic Resonance Imaging (MRI) • Pronounced – (mag-NET-ik REZ-oh-nans IM-ij-ing) • Defined – Noninvasive scanning procedure that provides visualization of fluid, soft tissue, and bony structures without the use of radiation 27
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 28
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 29
Positron Emission Tomography Scan (PET) • Pronounced – (POZ-ih-tron ee-MISH-un toh-MOG-rah-fee) • Defined – Noninvasive diagnostic imaging method that demonstrates the biological function of the body before anatomical changes take place • Scan produces computerized radiographic images of the body structures when radioactive substances are administered to the patient – Substances are inhaled or injected 30
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 31
Radiation Therapy • Pronounced – (ray-dee-AY-shun THAIR-ah-pee) • Defined – 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 32
Radiation Therapy • Radiation therapy – Destroys rapidly multiplying cells regardless of whether they are cancerous – Goal is to reach maximum tumor control with no, or minimal, normal tissue damage – May be delivered by teletherapy (external) – May be delivered by brachytherapy (internal) 33
Radioactive Iodine Uptake • Pronounced – (ray-dee-oh-AK-tiv EYE-oh-dine UP-tayk) • Defined – 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 34
Scanning (Bone, Brain, Liver, Lungs) • Pronounced – (SCAN-ing) • Defined – Scanning is the process of recording emission of radioactive waves, using a gamma camera (scanner) • After an intravenous injection of a radionuclide material into the particular part of the body being studied 35
Scanning (Bone, Brain, Liver, Lungs) • Defined – Image of the area being studied is displayed by recording concentration or collection of a radioactive substance specifically drawn to that area 36
Scanning • Bone – 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 37
Scanning • Brain – Nuclear scanning of cranial contents two 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 38
Scanning • Liver – 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 39
Scanning • Lung – 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 has inhaled radioactive material 40
Scanning • Spleen – 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 41
Single-Photon Emission Computed Tomography (SPECT) • Pronounced – (single FOH-ton ee-MISH-un kom-PEW-ted toh-MOG-rah-fee) • Defined – Nuclear imaging procedure that shows how blood flows to tissues and organs • Tracking of radioactive material allows physician to see perfusion of blood to tissues and organs 42
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 progression of barium through small intestines 43
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 44
Ultrasonography (Ultrasound) • Pronounced – (ull-trah-son-OG-rah-fee) • Defined – Procedure in which sound waves are transmitted into 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 45
Ultrasonography • Abdominal ultrasound – Use of reflected sound waves to provide reliable visualization of the liver, gallbladder, bile ducts, pancreas, kidneys, bladder, and ureters 46
Ultrasonography • Pelvic ultrasound – Noninvasive procedure that uses highfrequency 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 47
Ultrasonography • 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 48
Venography • Pronounced – (vee-NOG-rah-fee) • Defined – Technique used to prepare an X-ray image of veins – Veins are injected with a radiopaque contrast medium – Phlebography 49
X-rays • Pronounced – (ECKS-rays) • Defined – 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 50
X-rays • Chest X-ray – Visualization of interior of chest – Provides diagnostic information about: • Tumors, inflammation, accumulation of fluid, accumulation of air, bone fractures, diaphragmatic hernia, size of heart, calcification, placement of centrally located intravenous access devices 51
X-rays • 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 52
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