introduction to medical imaging jeff benseler, d.o
TRANSCRIPT
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Introduction to Medical Introduction to Medical ImagingImaging
Jeff Benseler, D.O.Jeff Benseler, D.O.
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ObjectivesObjectives
Medical Imaging: What to expect in Medical Imaging: What to expect in your first 2 years at OUHCOMyour first 2 years at OUHCOM
Overview: How do x-rays create an Overview: How do x-rays create an image of internal body structures?image of internal body structures?
What are the advantages of CT, MRI What are the advantages of CT, MRI and Ultrasound?and Ultrasound?
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Medical Imaging (Radiology)
Nearly all medical disciplines utilize medical imaging
As you move from block to block we will learn: How each modality works to create an
image of internal body structures Selecting the best imaging tests for a given
clinical presentation Develop a stepwise repeatable pattern of
evaluating medical images
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Method for learning medical image interpretation
Most blocks will contain recorded presentations
These recordings last approximately 10 to 30 minutes each
Most blocks will have 2 to 4 recordings to view before the live class
The recordings can be viewed and reviewed as needed anytime 24/7
In class, we will learn by interpreting unknown cases
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Questions about medical imaging
Please feel free to contact me with questions
My preferred contact method is email
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What are x-rays?
No mass No mass No charge No charge Energy Energy
X-rays are a typeof electromagneticenergy
Objective 2
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How do x-rays passing How do x-rays passing through the body create an through the body create an
image?image? X-rays that pass through the body X-rays that pass through the body
render the image dark (black)render the image dark (black) X-rays that are totally blocked X-rays that are totally blocked
render the image light (white)render the image light (white) Air = low atomic # = x-rays get Air = low atomic # = x-rays get
through = image is dark (black)through = image is dark (black) Metal = high atomic # = x-rays Metal = high atomic # = x-rays
blocked = image is light (white)blocked = image is light (white)
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5 Basic Radiographic 5 Basic Radiographic DensitiesDensities
AirAir FatFat Soft tissue/fluidSoft tissue/fluid MineralMineral MetalMetal
1.
2.
3.
4.
5.
Name these radiographic densities.
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Optimal environment for Optimal environment for visual perception visual perception
Dedicated source of light (5 to 9 Dedicated source of light (5 to 9 mega pixel monitors)mega pixel monitors)
Darkened environment (like a movie Darkened environment (like a movie theater)theater)
Limit distractionLimit distraction
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X-ray viewing station
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Can you recognizeshapes and density?
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Find the pathologyWhat clues do you have?
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Medical Imaging InterpretationMedical Imaging Interpretation3 basic steps3 basic steps
First learn how each modality creates an image First learn how each modality creates an image of internal body structuresof internal body structures
Next, be able to accurately label normal Next, be able to accurately label normal anatomy (body structures)anatomy (body structures)
Then, search for structures that don’t belong Then, search for structures that don’t belong and for body structures that are abnormal in and for body structures that are abnormal in size, shape, position and/or densitysize, shape, position and/or density
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History: 11 year old twistinginjury of the foot
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Proximal
Distal
1.
2.
3.
Word bank: epiphysis, metaphysis, diaphysis, cortex, medullary cavity
Naming the parts of a long bone
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Review: What are the 5 basic Review: What are the 5 basic radiographic densities from radiographic densities from
black to bright white?black to bright white? AirAir FatFat Soft tissue/fluidSoft tissue/fluid Bone/mineralBone/mineral MetalMetal
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Summary for objective 2: Summary for objective 2: How do How do x-rays create an image of internal x-rays create an image of internal
body structures?body structures?
X-rays pass through the body to X-rays pass through the body to varying degreesvarying degrees
Higher atomic number structures Higher atomic number structures block x-rays better, example boneblock x-rays better, example bone
Lower atomic number structures Lower atomic number structures allow x-rays to pass through, example: allow x-rays to pass through, example: air in the lungsair in the lungs
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Objective 3Advantages of CT, MRI and
Ultrasound
These modalities are cross sectional imaging
Cross sections are like slices
X-ray studies are a 2 dimensional representation of 3 dimensional structures can result in undesirable overlapping densities and artifacts
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CT
Advantages Eliminates
overlapping densities Excellent resolution Excellent for
detecting intracranial bleeding
Excellent in the neck, chest and abdomen
Excellent for evaluating fractures
Disadvantages More expensive
than x-ray and ultrasound
Much more radiation
Dense bone (petrous ridge for example) and metal cause severe artifacts
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CT scan of the abdomenX-rays used skin
What density is this?
air
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MRI Advantages
No overlapping artifact
Excellent resolution Very good at
detecting fluid Excellent for imaging
the brain, spine and joints
No radiation Multiple imaging
tests within the same study (T1, T2, IR, GE)
Disadvantages Very expensive Patients cannot
have a pacemaker or ferromagnetic material
Slower to acquire images
(approximately 45 minutes)
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Ultrasound Advantages
No radiation Portable Instantaneous (real
time) Excellent for cysts and
fluid Doppler ultrasound is
excellent to assess blood flow
Excellent for newborn brain, thyroid, gall bladder, female pelvis, scrotum, pregnancy
Disadvantages Does not work well in
large or obese patients Resolution less than CT
and MRI Air or bowel gas
prevents visualization of structures
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Ultrasound of thegall bladder showinga gall stone
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X-rays, CT, MRI and ultrasound help us see into the
body
Internal body structures are composed of varied material (fat, muscle, bone, gland) or contain air, water or minerals that “show up” differently on each type of imaging test.
Each modality has its own advantages allowing us the choose the best one for each medical circumstance.
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What an excellent medical student at your level can
do:
Be able to describe how x-rays can create an image of internal body structures
Recognize and label the 5 basic densities on an x-ray
Be familiar with the advantages for CT, for MRI and for ultrasound