07 Intro to Radiology
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Transcript of 07 Intro to Radiology
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RadiologyCardioPulmonary Module
Dr. Mary G. Cormier
Professor of RadiologyGeorgetown Medical School
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Outline
Historical perspective
Making images
Basic anatomy
CXRCT
Examples of disease
lung
pleuraheart/pericardium
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HISTORICAL PERSPECTIVE
Wilhelm Konrad Roentgen
Radiology
officially tracesits beginning toWilhelm KonradRoentgensdiscovery (andnaming) of x-rays, 1895
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HISTORICAL PERSPECTIVE
physics professor atUniversity of Wurzburg, inGermany
discovered a new kind of
ray accidentally whileexperimenting with Crookeelectrical tubes
x was the mathematicalsymbol for an unknown
WILHELM KONRAD ROENTGEN
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Making X-RAYS
Electrons from (-)anode areaccelerated to (+)cathodein vacuum tube
Electrons direction alteredby the (+)nucleus
X-RAYs are thereby emittedin all directions
X-RAYS escape through afiltered window
X-rays
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MAKING IMAGES
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X-RAYS
Electromagnetic radiation of a short
wavelength (high energy)
Penetrate materials to a certain degree
Conventional radiology is based on
irradiating the measured object
measuring the intensity of the X-rays
which have been attenuated by the object
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Making a chest radiograph
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Creating a PA CXR
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Creating a lateral CXR
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Making a CT image
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Making a CT image
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Multiplanar capability
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Multiplanar CT images
axial coronal sagittal
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Normal Anatomy
CXR
CT Chest
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Normal CXR
frontal view side view
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Normal frontal CXR
trachea
Pleura
langle
heart
Pulmonary arteries
diaphragm
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Normal bones
Spinous process
ribs
clavicle
Coracoidprocess
vertebrae
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Normal moguls
Aortic arch
Pulmonarytrunk
Left atrium/appendage
Left ventricle
Rightatrium
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Normal Lateral CXR
sternum
heart
diaphragm
Vertebrae
scapulae
trachea
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Axial slice
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Normal axial CT anatomy
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Normal axial CT anatomy
1 8
13
14
15169
10
1211
27
6
543
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Normal axial CT anatomy
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Normal axial CT anatomy
1
12
13 145
6
7118
111
15
16
9
10141
1312
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Normal axial CT anatomy
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Normal cardiac valves (axial
CT)
aortic valve with right (R), left (L), and
noncoronary (N) cuspspulmonary valve with right (R), left (L), and
anterior(A) cusps
http://radiographics.rsnajnls.org/content/vol23/issue90001/images/large/g03oc03g7a.jpeghttp://radiographics.rsnajnls.org/content/vol23/issue90001/images/large/g03oc03g7a.jpeg -
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Normal coronary arteries
(axial CT)
Left main (LM) coronary artery at the level of the ostium, arises from the left
Valsalva sinus, courses posterior to the right ventricular outflow tract(RVOT),
and bifurcates into the left anterior descending (LAD) and the left circumflex
(LCX) branches
Middle segment of the right coronary artery (RCA) and distal segments of the
left anterior descending and left circumflex branches. The latter is seen in the
left atrioventricular groove, in close proximity to the great cardiac vein (GCV).
http://radiographics.rsnajnls.org/content/vol26/issue4/images/large/g06jl23g01a.jpeghttp://radiographics.rsnajnls.org/content/vol26/issue4/images/large/g06jl23g01b.jpeghttp://radiographics.rsnajnls.org/content/vol26/issue4/images/large/g06jl23g01a.jpeg -
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Normal azygos vein
azygos vein arches
forward to join the
SVC (arrow)
right paratracheal
prominence caused by the
azygos vein (arrow)
widening is due to
the azygos vein
(arrow)
azygos vein (arrow)
http://radiographics.rsnajnls.org/cgi/content/full/21/5/1257/F5Dhttp://radiographics.rsnajnls.org/content/vol21/issue5/images/large/g01se02g5c.jpeghttp://radiographics.rsnajnls.org/content/vol21/issue5/images/large/g01se02g5a.jpeghttp://radiographics.rsnajnls.org/content/vol21/issue5/images/large/g01se02g5b.jpeg -
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Examples of disease
Lungpneumonia
tumorpulmonary embolism
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pneumonia
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pneumonia
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baseline
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RUL pneumonia
baseline RUL pneumonia
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RUL pneumonia
baseline RUL pneumonia
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tuberculosis (cavitary)
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tumor
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lung carcinoma
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lung carcinoma
PET scan
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uterus cancer, spread tolungs
2007 2008
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colon cancer, spread tolungs
2006 2008
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possible early neoplasm
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pulmonary embolism
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Pulmonary embolism
Axial: clot in right and
left pulmonary arteries
(arrows)
Coronal: clot in right
pulmonary artery extending
into upper and lower
branches (arrow)
http://radiographics.rsnajnls.org/content/vol21/issue5/images/large/g01se02g11b.jpeghttp://radiographics.rsnajnls.org/content/vol21/issue5/images/large/g01se02g11a.jpeg -
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Normal Pleura
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normal pleura
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Pleural outlines
Minor fissure
Major fissures
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Pleural fissures (LEFT)
LUL
LLL
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Pleural fissures (RIGHT)
RUL
RLLRML
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Normal pleura
http://radiographics.rsnajnls.org/cgi/content/full/21/4/861/F2http://radiographics.rsnajnls.org/content/vol21/issue4/images/large/g01jl24g4x.jpeghttp://radiographics.rsnajnls.org/content/vol21/issue4/images/large/g01jl24g5b.jpeghttp://radiographics.rsnajnls.org/content/vol21/issue4/images/large/g01jl24g5a.jpeg -
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Examples of disease
Pleurapneumothorax
pleural effusionpleural infection (empyema)other
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pneumothorax
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pneumothorax
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Complete L pneumothorax
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L apical pneumothorax
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Pleural effusion
l l ff i
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Large pleural effusion
L i l l ff i
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Layering pleural effusion
L i l l ff i
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Layering pleural effusion
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Pleural infection
(empyema)
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empyema
empyema Chest tube drainage
Pl l i d l
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Pleural micronodules(sarcoidosis)
CT scan demonstrates small nodules in the
lungs and along the minor (arrowhead) and
major (arrow) fissures representing
sarcoidosis
Normal pleura
E l f di
http://radiographics.rsnajnls.org/content/vol21/issue4/images/large/g01jl24g16x.jpeghttp://radiographics.rsnajnls.org/content/vol21/issue4/images/large/g01jl24g5a.jpeghttp://radiographics.rsnajnls.org/content/vol21/issue4/images/large/g01jl24g5a.jpeghttp://radiographics.rsnajnls.org/content/vol21/issue4/images/large/g01jl24g16x.jpeg -
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Examples of disease
Heart/PericardiumEnlarged cardiac silhouettePulmonary edemaPericardial effusion
l d di
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enlarged cardiacsilhouette
Normal heart size Enlarged cardiac
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pulmonary edema
l l d
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alveolar edema
l d
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pulmonary edema
baseline 1 day later
pulmonar edema
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pulmonary edema
0000 hrs 0800 hrs
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pericardial effusion
pericardial effusion
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pericardial effusion
Review
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Review
Historical perspective Making images
Basic anatomy
CXR
CT
Examples of disease
lung
pleuraheart/pericardium
The End
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The End