Term
| What type of contrast is used for CT? MRI? Enteric? |
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Definition
CT- iodinated
MRI- gadolinium
Enteric- Barium, gastrograffin, etc. |
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Term
| Is shellfish allergy a contraindication to CT contrast? |
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Definition
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Term
| What does contrast nephrotoxicity occur with? What is it defined as ? |
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Definition
-occurs with iodinated IV (CT) contrast
-defined as serum creatinine increase of 25% if baseline creatinine is less than 1.5 mg/dL or greater than 1.0 mg/dL if baseline serum creatinine is greater than 1.5 mg/dL, when either occurs within 72 hours of administration |
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Term
| With MRI contrast there is no __________, but there is a risk of ___________/__________/_____________. what is this condition seen with? |
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Definition
nephrotoxicity
nephrogenic systemic fibrosis
seen with certain types of gadolinium in pt's with renal insufficiency |
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Term
| is contrast needed? what is the usual rule in CT and MRI studies? |
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Definition
no easy answer
most CT studies with be either or, but both usually not needed
in MRI, if contrast is given there will almost always be non contrast images obtained as well |
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Term
| When working up cancer, in what areas of the body is CT contrast extremely helpful and where is it not as necessary? |
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Definition
-extremely helpful/necessary in the abdomen
-not as necessary in the chest (more helpful is lesion is more central)
-necessary to pick up mets in the brain, but will see more than a couple of mm mass without contrast usually |
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Term
| when working up an infection, when is contrast necessary? (soft tissue and bone) |
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Definition
-soft tissue infxn: helps better define structures
-bone infxn: not necessary to evaluate for osteomyelitis usually |
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Term
| Is contrast needed in a CTA of the chest? to visualize an aortic aneurysm? a CTA of the head and neck? |
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Definition
yes
not needed- but necessary to characterize
yes, but not for MRI |
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Term
| which absorbs a greater amount of X-ray bone or air? describe bone and air in radiographic terms |
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Definition
-bone absorbs more X-ray than air- it is radio dense or radiopaque (white on X-ray)
-air absorbs little to no X-ray- it is radiolucent (black on X-ray) |
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Term
| What are the five basic densities? |
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Definition
air
fat
fluid or soft tissue
calcium
metal |
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Term
| define isoechoic, hyperechoic, and anechoic |
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Definition
-iso: light gray to medium gray signal return
-hyper: (echogenic or sonodense) very bright, heavy signal return
-an: (sonolucent) dark, without echo return |
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Term
| Signal intensity of MRI depends on tissue content of _______ and on sequence T1 or T2, explain this |
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Definition
H20
T2 H20 is BRIGHT
T1 H2O is DARK |
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Term
| When looking at ulcers on radiographs- what is hamptons line and what is an ulcer mound? |
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Definition
-hamptons line: a thin straight line at the neck of the ulcer in profile view which represents the thin rim of undermined gastric mucosa
-ulcer mound- a smooth, sharply delineated soft tissue mass surrounding a benign tumor |
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Term
| What type of scans are useful for determining differences in function between kidneys? |
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Definition
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Term
| On a cardiac US, velocity increases as diameter ________, so if the velocity is high it is characteristic of some sort of _________ |
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Definition
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Term
| MRI is a cost effective measure for radiographing what major joint |
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Definition
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Term
| Magnetic Resonance Angiography is (easier/Harder) to rest than a CTA? |
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Definition
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Term
| LW says in a perfect world, if a pt comes in with acute sx of stroke get them to an _____ machine- results will are easier to read and you get a dx faster |
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Definition
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Term
| Define gestalt and aunt minnie |
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Definition
-gestalt: the visual recognition of figures and whole forms- not a collection of simple lines and curves
-aunt minnie: something one has seen before and is instantly recognizable |
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Term
| The diaphragm usually runs across which thoracic vertebrae on a lateral film? |
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Definition
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Term
| in osteoporosis the bone will appear more ______ than normal on film |
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Definition
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Term
| osteomalacia in adults is synonymous to ________ in children |
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Definition
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Term
| in osteomalacia bones have ________ ends |
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Definition
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Term
| an air-fluid or fat-fluid level will be visible only if the X-ray beam is ________, regardless of the position of the patient |
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Definition
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Term
| on which view of the chest, PA or AP, are the scapulas more lateral? |
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Definition
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Term
| on a lateral view of the chest, the vertebrae should get ________ as you move from superior to inferior |
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Definition
| darker-- if they don't this is known as the spine sign |
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Term
| Based on the following factors for a technically adequate chest radiograph- describe what should be seen: penetration, inspiration, rotation, magnification, angulation |
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Definition
-should be able to see spine through heart
-should at least 8-9 posterior ribs
-spinous process should fall equidistant between the medial ends of the clavicles
-AP films will magnify heart slightly
-clavicle normally has s shape and superimposes on the 3rd or 4th rib |
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Term
| what is important in terms of arms and identifying a pathologic retrosternal space |
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Definition
| if patient cannot lift arms over head, soft issue may fill the clear space and look like pathology |
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Term
| in a left lateral chest xray, which side of the patient is against the the film? |
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Definition
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Term
| which fissures of the lung are seen on the lateral view and which are seen on the frontal view |
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Definition
lateral: both major (oblique) and minor (horizontal)
frontal: minor |
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Term
| when moving down the thoracic spine, each intervertebral disk space becomes slightly _________ than or is equal in height to the one above it |
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Definition
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Term
| how do you tell the difference between the R and L hemidiaphragm on a lateral radiograph?> |
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Definition
-right is usually visible for its entire length
-R is usually taller than the L
-L is seen sharply posteriorly, but is silhouetted by the muscle of the heart anteriorly |
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Term
| what is the most common reason for an obscured retrosternal clear space? |
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Definition
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Term
| which is more easily blunted by a less amount of fluid, the posterior costophrenic angles on a lateral film, or the lateral costophrenic angles on the frontal film? |
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Definition
| the posterior angles on lateral film-- it takes much more fluid to blunt the lateral angles on frontal film |
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Term
| objects farther from the imaging cassette tend to be (more/less) magnified than images closer to the cassette |
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Definition
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Term
| the heart is truer to its actual size in a PA or an AP radiograph of the chest? |
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Definition
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Term
| when naming a film projection, the examination is always named from the point of view of the ___________ |
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Definition
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Term
| when a patient is rotated, you can determine which side he/she is rotated to bc it is the same as the side with the (greater/lesser) distance between clavicle and vertebrae |
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Definition
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Term
| unintentional angulation can be seen by noting the elevation of ___________ |
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Definition
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Term
| give some prime signs of an airway disease on film |
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Definition
-fluffy, hazy
-margins indistinct
-confluent
-air bronchograms (unusual in pulm edema, more usual in pneumonia) |
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Term
| what is the difference between pulmonary edema and pneumonia in regards to how quickly the airways become filled with edema fluid? |
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Definition
-pneumonias usually remain clear of exudate early
-Pulm edema become filled with edema and fluid early |
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Term
| what is the silhouette sign? |
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Definition
| when 2 objects of the same radiographic density are in contact and the difference between the two cannot be deciphered via film |
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Term
| what pathology is sometimes described as having a bat wing or angel wing configuration on film? |
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Definition
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Term
| are air bronchograms usually seen in plum alveolar edema? |
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Definition
| no- because fluid fills not only the airspaces but the bronchi themselves |
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Term
| pulm alveolar edema is usually (uni/bilateral) |
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Definition
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Term
| what are two disease processes that are predominantly reticular interstitial dz? |
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Definition
interstitial edema
pulm fibrosis (including rheumatoid lung) |
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Term
| what is considered the precursor to pulm alveolar edema? what are the 4 key rad findings? |
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Definition
pulm interstitial edema
1. fluid in fissures
2. pleural effusions
3. peribronchial cuffing (fluid in bronchiolar walls)
4. kerley lines (a,b,c,) |
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Term
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Definition
Non-branching, short parallel lines at the lung periphery
? representing interlobular septa / dilated lymphatics or ??
Usually less than 1 cm in length
At right angles to the pleura
Peripherally in contact with the pleura
Observed at the lung bases on the PA radiograph |
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Term
| give 4 characteristics of-noncardiogenic pulmonary edema |
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Definition
1. no pleural collections
2. no kerley B lines
3. primary upper lobe edema
4. normal sized heart |
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Term
| what are two pathologies that are predominantly nodular interstitial diseases? |
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Definition
bronchogenic carcinoma
metastases to the lung |
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Term
| what is an example of a disease that is reticulonodular interstitial? |
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Definition
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Term
| what is the difference between bronchitis and bronchiectasis? |
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Definition
-itis: inflammation of bronchial epithelium (superficial)
-ectasis: inflammation of bronchial wall (entire wall thickness) |
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Term
| give three characteristics of what emphysema looks like on film |
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Definition
1. hyperluscent lungs, especially towards apices
2. flattened hemidiaphragms
3. increased retrosternal clear space on lateral |
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Term
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Definition
| hyperinflation of the apical segment of the left lower lobe interposing itself between the mediastinum and the collapsed left upper lobe. |
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