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Anatomy Dep:
Imagin
g.
Objective
Principle of device used for visualization ?
How each device works ?
What each device can visualize ?
Beyond scope
Indications of each of them in diseases
Medical imaging
Visual representations
Inside of body ( anatomy )
Function of organs or tissues ( physiology )
Overview of
imaging
techniques based
on underlying
principle
Each of the
principles more
in detail ,
Other rare
medical imaging
techniques
Future of
medical imaging
Overview
What is radiation ?
Radiationis energy
It comes from a source
Travels through some material or through space.
Examples :
Light, heat and sound are types of radiation
Forms of Radiation?
Character of radiation
Determined by
Wavelength or its frequency
Energy it bears
http://eeae.gr/en/radiation/radiation-all-around-us
Ionizing Radiation
Electromagnetic waves with
energy for electrons to
become detached from atoms
and molecules
Cause
change in structure ionization
Electrically charged
Examples
X rays, gamma rays, electrons,
protons and neutrons , radon
gas ( naturally occurring )
Concentration is measured
US scale : milli rem
Int: Sys : Sv ( Sieverts ) and mSv ( milliSv)
1 Sievert = 100 millirem
Non-ionizing Radiation
Less energy than ionizing
radiation
Limited to generating light or
heat.
http://eeae.gr/en/radiation/radi
ation-all-around-us
Natural radiation
Naturally occurring radiation is found
in the food we eat, the water we drink
and the construction materials used in
our buildings,
Terrestrial radiation also comes from
soils enriched in naturally occurring
uranium and natural forms of energy.
Overview of X-Ray
based imaging techniques
The CT Setup
X-ray production ,
attenuation and
capturing
In Cross sectional
scanning
(tomography )
Valuable in Emergencies
!!
Example of 2D vs 3D
(Conventional X-ray vs CT)
Conventional radiography
2D
Only one image of same area
CT
3D
Tube rotation can give multiple images of same area
Assimilated to give a 3D visualization
Mammography
X-ray of breast
Detailed X-ray
Used for screening of
breast cancer
MASS
CALCIFICATIO
N
ASYMMETRIC
BREAST
FINDINGS
INTRAMAMMA
RY
LYMPHNODE
TUBULAR
DENSITY
ARCHITECTUR
AL
DISTORTION
OTHER
ASSOCIATED
FINDINGS
Angiography
X-ray of Vessel
Contrast is added
Fluoroscopy
X-ray for moving parts
During medical
procedures
Monitor viewed
Overview Molecular
Imaging based techniques
If Pregnant Do inform
radiopharmaceutical use
Positron ejection: Seen in target tissues , they act with surrounding elections and
produce gamma rays
Combined Modalities
Effective dose
Different body tissues have different sensitivity to
radiation
Different body parts have different risk depending up on
composure
Overview of other
common types of
Imaging
Ultrasound imaging
(sonography)
High-frequency sound waves
used to image ( no ionizing
radiation )
Live imaging
Detailed look
X-rays
What is X-ray
There are different ones , its all radiation produced by
unstable nuclei of atoms
alpha (),
beta () and
gamma ()
X-ray tube
Vacuum tube converting electric power to X-rays
Accelerating of electrons from cathode(-) to anode(+) using
electric power
Electrons give up energy at cathode
Most of them as heat and
Some as X-rays ( bremstrolling / breaking radiation )
CAT scanners
Airport luggage scanners,
X-ray crystallography
Material and structure
analysis, and for industrial
inspection.
Anode rotation ,
Less anode pitting / less heat concentration
History
Accidental discovery by
Wilhelm Rntgen
8th Nov 1895
Nobel in physics
1901
http://nobelprize.org/nobel_prizes/physics/laureates/1901/rontgen-bio.html
Rntgen W. Ueber eine neue Art von Strahlen. Sitzungsberichte der
Wuerzburger Physik.-medic. Gesellschaft, Wuerzburg, 1895.
Radiographic Contrast
Influenced by
Radiation Quality (KVP)
Film Contrast
Radiographic object
(Patient)
Fat = 6.46
Water = 7.51
Muscle = 7.64
Bone = 12.31
Contrast agents
Enhance thecontrastof
structures orfluidswithin
the body in medical
imaging
Denser than normal tissue
Absorbs more rays
Positive contrast
(AIR OR CO2)
(all others)
Radiolucent
Radiopaque
Black on film
White on film
IODINE
WATER SOLUABLE
GI TRACT
Z# 53
Hystosalpingography (HSG)
Contrast media showing
Uterus and uterine tubes
To check fertility use oil or
water based contrast
Myelogram
Look for problems in the
spinal canal,
spinal cord,
nerve roots,
other associated tissues
Contrasts
Pantopaque
Metrizamide (Amipaque) , the first
low-osmolar contrast medium
Sialogram / Ptyalogram.
Dx a blocked salivary
gland or duct in your
mouth.
Cerebral angiogram /
arteriogram
Finds blockages in the
blood vessels of your head
and neck
Lymphangiogram
ERCP
Endoscopic Retrograde Cholangiopancreatography
Used for colangiography
Therapeutic also
MRCP
Magnetic Resonance Cholangiopancreatography
MRCP is becoming a more
viable imaging technique,
as MRI technology
improves.
MRCP is gradually
replacing PTC and ERCP
for diagnostic purposes
RGU or ASU
Radio Diagnosis Ascending Urethrogram
Urethra evaluation for
strictures
CT contrast
Oral/Rectum
Barium or Iodine
IV: Iodine
Positrons
Gamma rays
Positron is antimatter of electron
Particle of matter with the same
mass as an electron
But opposite charge.
Nuclear Magnetic
Resonance
Magnetic Resonance
Magneticdipole
Cause Protons to align
Protons are all aligned all over the body , and relaxation cause
release of energy from each proton
More proton there is more the radiation
(T1 /Spin-latex/Longitudinal)
Relaxation MRI
(T2/ Spin-Spin/Transverse)
Relaxation MRI
Closed MRI
More tesla than open MRI
( magnetic field power )
As tesla increase the
resolution increases
Closed MRI
Lower tesla
Used in claustrophobics
and is cost effective
machine
MRI contrast
Gadolinium
There are many other
contrasts also but used
less frequently , only in
specific condition
Gadolinium
z# 64
Gadolinium
On its own gadolinium is
toxic to the human body,
But when coated in a
special chelating agent, it
is safe to use
Ultrasonography
Ultrasound
Ultrasounds arehigh
frequency sound waves
above audible sound
Ultrasound devices have
frequencies from 20kHz up
to several gigahertz.
Medical ultrasound(also
known asdiagnostic
sonographyor
ultrasonography )
Cons
Patient physique and corporation
Structures behind bone and air difficult to visulalize
Obstetric ultrasound
Practice of examining
pregnant women using
ultrasound is called so
Doppler
Used to estimate your
blood flow through blood
vessels by bouncing highfrequency sound waves
(ultrasound) off circulating
red blood cells
NSG ( Neurosonography )
Intracranial assessment of
preterm neonate as
fontanels are not closed
early
Elastography
Based on ultrasound
Maps the elastic properties of
soft tissue.
Elasticity can change in
healthy from unhealthy tissue
for specific organs/growths
E.g.: cancerous tumours will
often be harder than the
surrounding tissue,
Photoacoustic imaging
Hybrid biomedical imaging
modality based on the
photoacoustic effect.
Combines the advantages of
optical absorption contrast with
ultrasonic spatial resolution
May be useful in : tumor
angiogenesis monitoring, blood
oxygenation mapping, functional
brain imaging, and skin melanoma
detection, etc.
Infrared
Functional near-infrared
spectroscopy
FNIR technique is non
invasive
NIRS ( near infrared
spectro-scopy ) is used
for the purpose
offunctional neuroimagingand has been
widely accepted as abrain
imagingtechnique.
Temperature
Thermography
Used for breast imaging.
Based on the principle
that metabolic activity
and vascular circulation
Not established as a
standard
FUTURE