Anatomical aspects of radiology anatomy, differential diagnosis and the basis of pathology and radiology
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Anatomical aspects of radiology anatomy, differential diagnosis and the basis of pathology and radiology
- 1. Anatomy Seminars 2004/2005 MFDS Anatomical Aspects of Radiology (Anatomy, Differential Diagnosis and the Basis of Pathology and Radiology) Professor Peter Abrahams 23 November 2004 Clinical Dental Sciences
- 2. AIMS • • • • • • REDUCE RADIATION INTRODUCE “GOLD STANDARD” STRUCTURES –MODERN TECHNIQUE “BEST VALUE” – SOCIETY AT LARGE STIMULATE DISCUSSION INTRODUCE RCR GUIDELINES
- 3. IMAGES • • • • • DO I NEED IT ? DO I NEED IT NOW ? DID SOMEONE DO IT BEFORE ? HAVE I EXPLAINED THE PROBLEM ? BEST TECHNIQUE / VIEW ?
- 4. MEDICO - LEGAL • • • • • CLINICAL GROUNDS ONLY ? ALTER MANAGEMENT ? NOTE KEEPING- JUSTIFICATION ? RCR GUIDELINE ADVICE “DO SOMETHING” –PROTECTION
- 5. RADIATION EXPOSURE Examination limbs CXR. equivalent 0.5 Natural radiation 1 day CXR 1 3 LUMBAR 65 7 months BA MEAL 150 16 months BA ENEMA 350 3.2 yrs CT. ABD/PEL 500 4.5 yrs
- 7. H Fish-bone
- 8. LUMP
- 10. Barium swallow, Phanrygeal pouch due to Killian’s Dehiscence, Known also as Zenker’s Diverticulum. NB. HIGH Tone in Cricopharygeus muscleThis spasm causes the Pouch Cricopharygeus Pouch
- 11. * * Parotid sialogram with strictures-*
- 12. Plain Xray- stone Stone Submandibular- Wharton’s Duct stone
- 14. A f A f f Normal sinuses with AIR “A” Blocked sinuses with Fluid “f”
- 16. Coronal CT nasal cavity carcinoma NB Bone T
- 17. T Axial CT Lymphoma of Maxillary Sinus
- 18. T T Coronal T1 wt + Gadolinium Bony erosions in bilateral Glomus Jugulare Tumours
- 19. IC IC IC EC CC CC= Common Carotid IC= Internal Carotid EC= Ext. Carotid CC DSA-Tumour CC DSA- post embolisation
- 20. IC EC Carotid DSA, Arterial phase NB IC / EC displacement Late arterial pathological Vasculature= highly vascular tumour
- 21. Saturday night knife -fight in St. Vincent W.I.- two days later patient complains of lump in root of neck, just above clavicle and an “orange “under his arm.What does this angiogram show?
- 22. * *= ? * =? Lymphadenopathy (Bilateral) Posterior Triangles *
- 23. Presented with lump in neck above clavicle and Typical facial appearance
- 24. Normal Parotids Parotid Pleomorphic Adenoma Axial T2 wt
- 25. * * *
- 26. Radionuclide thyroid scan- Multinodular Goitre
- 27. Sinogram
- 29. Thyroid MRI & DSA
- 30. PARATHYROID Adenoma Radionuclide Parathyroid Thallium - 201 Scan Iodine-123 Subtraction Scan NB. No Iodine uptake by Parathyroid
- 31. ULTRASOUND •• REGIONAL ANATOMYREGIONAL ANATOMYeg. abdominal pain eg. abdominal pain •• NO RADIATION ? harm NO RADIATION ? harm •• CHEAP & MOBILE CHEAP & MOBILE •• BUT OPERATOR BUT OPERATOR •• POOR HARD COPY POOR HARD COPY
- 32. D.S.A. •• VENOUS (IV DSA) VENOUS (IV DSA) •• CAPILLARIES CAPILLARIES •• ARTERIAL via venous (IA DSA) ARTERIAL via venous (IA DSA) MANUAL SUBTRACTION MANUAL SUBTRACTION •• ? MRI for FUTURE ANGIO ? MRI for FUTURE ANGIO
- 33. C.T. SCANS •• •• •• •• BONE DEFINITION 1mm. slice BONE DEFINITION 1mm. slice SPEED SPEED 3D POTENTIAL 3D POTENTIAL SPIRAL CT SPIRAL CT •• BUT RADIATION 400 CXR BUT RADIATION 400 CXR •• AXIAL ONLY-usually cf. ENT AXIAL ONLY-usually cf. ENT
- 34. M.R.I. SCANS •• •• •• •• •• •• REGIONAL ANATOMY REGIONAL ANATOMY ALL PLANES ALL PLANES SOFT TISSUES SOFT TISSUES 1.Brain 2.Muscles 1.Brain 2.Muscles TISSUE PLANES TISSUE PLANES NO RADIATION ? harm. NO RADIATION ? harm. •• BUT.......COST BUT..... COST 3. IVD 3. IVD
- 35. DOCTOR’S Guide to Radiology Making the best use of Department of Clinical Radiology" Royal College of Radiologists , UK “Guidelines for Doctors” 5th Ed. 2003