This radiological examination ppt is particularly made for B.Sc OTT Students

1. MEGHANA C
DOTT, BOTT, M.Sc Med.Biochemistry
RADIOLOGICAL EXAMINATION

2. RADIOLOGICAL EXAMINATIONS
I. TYPES OF RADIOLOGIC EQUIPMENT
& ACCESSARIES
II. RADIOLOGIC DIAGNOSTIC
PROCEDURES
III. INTERVENTIONAL RADIOLOGY

3. TYPES OF RADIOLOGIC EQUIPMENT &
ACCESSARIES
1. Contrast media
2. Radiolucent gasses
3. Radiologic tabel
4. Cassete
5. Fixed x-ray equipment
6. Portable x-ray machine
7. Fluroscope
8. Image intensifier
9. Mobile c-arm image intensifier
10.Computerized digital subtraction processor

4. RADIOLOGIC DIAGNOSTIC
PROCEDURE
LIST OF RADIOLOGIC DIAGNOSTIC PROCEDURES
CARRIED OUT FOR RADIIOLOGIC EXAMINATIONS
1. Chest x-rays
2. Mammography
3. Steriotactic core breast tissue biopsy
4. Computed tomography
5. Ventriculography
6. Arthrography
7. Angiography & arteriography
8. Bronchography
9. Cholangiography
10. Myelography
11. Git x-ray studies
12. Urography
13. Incidental x-ray films

5. CHEST X-RAYS
An x-ray study of the chest
may be the part of the
admission procedure to rule
out un suspected pulmonary
diseases that would
contraindicate the use of
inhalational anaesthetic
agents

6. MOMMOGRAPHY
 A technique for projecting an x-
ray image of soft tissue of the
breast
 mammography is the most
effective screening method for
rear diagnosis of small, palpable
breast tumours
 This procedure may be some
what painfull for the woman ,
because compression of breast
is need for radioloogic imaging.

7. STERIOTACTIC CORE BREAST TISSUE
BIOPSY
 Imaging equipment is used
to steriotactically isolate
breast lesions that may not
be palpable.
 Percutanious needle
biopsies are performed
with the patient under local
anaesthesia.

8. VENTRICULOGRAPHY
 Ventricuclogrphy is the study
of the ventricles after
injections of a directly into the
lateral ventricles of the brain.
 If intracranial pressure
Becomes too great after gas
injection, a needle can be
inserted to remove the gas
 It can be used in patients with
signs of increased intra
cranial presure as a result of
Blockade of csf cerebrospinal
fluid circulation.

9. COMPUTED TOMOGRAPHY
 The x-ray beam moves back & forth across the body to project cross-sectional images this
technique is refered to as computed tomogaphy(ct), computed axial tomography (cat) or simply
scanning.
 It produces a highly contrasted, detailed study of normal & pathologic anatomy
 The exact size & location of lesiion in the brain media stainum & abdominal organs are identified
 Ct scan become an invasive procedure when a radiopaque contrast medium is used to examine
the git.
 Needle aspration can be performed under direct ct visualization
 Ct exposes the patient to ionizing radiations.
 Ct exposes the patient to allergic reactions to contrast medium, if used.
 To ensuure the proper use of this complex equuipment & t protect the patient from
unnecessary/excess radiation this procedure is done under the supervision of the quqlified
radiologist.

11. ARTHROGRAPHY
 Arthrogaphy is the study of
joint aftr the use of the gas
or cntrast medium into it.
 Through injection of the dye
or gas iinjury to cartilage or
ligaments can be visualized
 Arthrography can beusefull
in knee arthrogram.

12. ARTHROGRAPHY

13. ANGIOGRAPHYAND
ARTERIOGRAPHY
 Angiography is the study of the circulatory system after
injectiion of the radiopaque to permit visualization of
the venous blood vessell system.
 These procedure are usefull in the diffferential
diagnosis of arteriovenous malformations,
aneurysms,tumours, vascular accidents, or other
circulatory abnormalities caused either by traumatic
injury or by an acquired structural diseases.
 Angiography is also used at the time of the surgical
procedure to identify the exact location of some types
of lesions in the extremities brain, thoracic &
abdominal cavity .

14. BRONCHOGRAPHY
 Study of the tracheobronchial tree.
 This is donebyinstallation of a contrast
medium to aid in the diagnosis of the
bronchiectasis, cancer, tuberculosis, and
lung abscessor to detect a foreign body
 The location of a lesion can be determined
and the surgical procedure planned
accordiinngly.

15. CHOLANGIOGRAPHY
Radiography of the biliary ductus after injection or the administration
of the contrast medium, orally intravenously or percutaniously.
PREOPERATIVE COLANGIOGRAPHY:
In addition to pre operative x-ray diagnostic studies some surgeons
request request radiologic studies in conjunction with cholecystectomy
or cholilithotomy to identify gallstones in the biliary tract.
OPERATIVE CHOLANGIOGRAPHY
Cholangiography performed during a surgical
Procedure on the gall bladder.
Here surgeons include the cholangiography at the time of surgical
procedure in patients in whom they suspect stones might be present in
the bile duct.
The basic difference between pre operative & intra operative
cholangiography is the sit e of administration.
For pre operative cholangiography the contrast medium is injected iv through
percutaneous veinpuncture.
For intra operative cholangiography medium is directaly injection to bile duct.

16. GASTROINTESTINAL X-RAY
STUDIES
 Studies are performed to identify lesions
in the mucosa of the GI tract, such as an
ulcer, tumour or stricture.
 Barium sulphate is swallowed by the
patients or instilled by enema to be
studied.

17. MYELOGRAPHY
 Lesions in the spinal canal are studied by
the myelograph.
 It helpfull to localize a filling defects,
spinalcord tumour.

18. UROGRAPHY
 Urography is the radiologic study of the urinary
tract.
 Urographic studies are described as follows.
 1.cystography
 2.Cystourethrography
 3.Intravenous pyelography (IVP):study of the
structure of the urinary tract and kidney
functions.
 4.Retrogradepyelography: the study of the shape
and position of the kidney & ureter.
 Retrograde pyelography is used to visualize the
renal pelves.
 Voiding cystourethrography:the study of contour
& patiency of the urethra.

19. INCIDENTAL X-RAY FILMS
 An unanticipated need for an x-ray films
occurs when a sponge, needle, or
instrument is taken during wound closure.
 A x ray film will confirm wether the items is
still in the patient.

20. INTERVENTIONAL RADIOLOGY
 Invasive procedures performed under radiological control.
Examples:
a) balloon angioplasty
b) Coronary angioplasty stent placement
c) Inferior vena cava fitter placement.
Cardiac catheterization, angioplasty & stent placement are
Performed in a interventional radiology department.

21. FOLLOWING ARE SOME OF THE
INTERVENTIONAL RADIOLOGY
TECHNIQUES
1. Magnetic Resonance Imaging (MRI)
2. Ultrasonography
3. Plethysmography
4. Endoscopy
5. Nuclear medicine studies
 Radionuclide
 Total body scanning
 PET Scan
 Scintigraphy
 Lymphoscintigraphy (lymph node mapping)

22. MRI is based on the magnetic properties of the hydrogen
in the body
Unlike CT Scan MRI does not use radiations
The patients lies flat inside a large electromagnet
MRI looks at both the body’s structure & functions.
It distinguishes between fat, muscles, compact bone &
bonemarrow, brain & spinal cord, fluid filled cavities,
ligaments
& tendons and blood vessels.
MAGNETIC RESONANCE IMAGING
(MRI)

23. THE MAJOR APPLICATIONS OF
MRI ARE AS FOLLOWS
1. Detection of tumours
2. Inflammatory diseases
3. Infections
4. Abscesses
5. Used in the evaluation of the function of
central nervous system, cardiovascular
system, & other organs.

24.  MRI paramagnetic IV Contrast media, such
as like gadopentetate,are sometimes used to
localize tumours in the central nervous
system.
 MRI paramagnetic IV contrast media
(GADOPENTETATE) do not contain iodine,
and allergic reactions are rare.
 The magnetic field can cause ferromagnetic
components of implants, such as
pacemakers & cochlear implants, to
malfunctions.

25.  The magnetic field will also disable
metallic device in the area, such as
cardiac monitors, infusions pumps &
wristwatches.
 Some patients feel a sense of
claustrophobia in a conventional MRI
Machine.
 MRI is used during selected neurosurgical
procedures.
 Dedicated MRI Interventional rooms
permit the use of MRI during the actual

26. ULTRASONOGRAPHY
 Ultrasonography is a technique uses
ehoes of the ultrasound pulses to
delineate objects or areas of different
density in the body.
 Ultrasonography uses sound waves to
produce images on a screen, which allows
medical providers to view internal
structures of the body.
 The basic component of any diagnostic
ultrasound system is its specialized

27.  The transducer converts electrical
impulses to ultrasonic waves at
afrequency greater than 1 million cycles
per second.
 These ultrasonic frequencies are
transmitted into tissues through a
transducer placed on skin.
 Water soluble gel is placed to the skin to
maintain air tight contact between the skin
and the transducer, because ltrasonic
waves does not travel well through air.

28.  Ultrasound is not effective in the presence
of bone or gas in the gastrointestinal tract.
 The image can be recorded on video
tapes or printed to provide a permanent
record known as echogram or sonogram.
 Ultrasonogrphy does not expose the
patient to radiation & contrast medium.

29. ADVANTAGES OF
ULTRASONOGRAPHY
 Whether used as a preoperative or intra-
operative diagnostic technique ultrasonography
is ;
1. Ultrasonography is rapid, painless, non invasive
procedure.
2. Ultrasonography distinguishes between fluid-
filled & solid masses.
3. Ultrasonography is less time consuming
procedure.
4. Ultrasonography requires less tissue
manipulation than do other intraoperative
diagnostic procedure.
5. Ultrasonography does not exposes the patient

30. USES OF
ULTRASONNOGRAPHY
 Ultrasonography is a useful adjunct in the diagnosis of
the followings;
1. Space occupying lesions in the neonatal brain:- the
ECHOENCEPHALOGRAM will show a shift of the
brain caused by tumour
2. Ultrasound can distinguish between a cystic & a solid
tumour mass in the kidney, pancrea liver ovaries &
testies.
3. Ultrasonography is the best imaging technique in the
patients gallbladder diseases.

31. Emboli (air, blood, fat)
• Ultrasonography is particularly useful in
the early diagnosis of pulmonary
embolism.
• Ultrasonography is useful to determine
the need for a caesarean section (c-
section) if the head is too large for
vaginal delivery.
• Ultrasonography is also used to
determine the position of the fetes &

32.  Ultrasonography is used to identify the
gender and to detect foetal abnormalities.
 ECHOCARDIOGRAPHY: (ultrasonic
cardiography).
Cardiac defects like structural defect,
insufficient valvular movement, and blood
flow volumes within the heart chambers &
myocardium can be detected by this
diagnostic technique known as
ECHOCARDIOGRAPHY.

33. DOPPLER STUDIES
 The Doppler ultrasonic velocitydetector
emits a beam of 5-10 megahertz (mh2)
the is directed through the skin into the
blood stream.
 Doppler originally