Aquifer - Radiology question n answers graded A+ 2023/2024

Aquifer - RadiologyWindow vs. Reconstruction on CT? - correct answer Reconstructions - processing of the raw CT data allows for better resolution of the structures [higher resolution and higher contrast] Reconstruction can be done in 3D (ortho) or in a linear way too (vascular) What is the total range of hounsfield units availabe? - correct answer -1000 (air) to +1000 (metal) [so range is 2000] What does a typical computer display show for greyscale range? What can the human eye actually distinguish? - correct answer 256shades (that means each shade of grey covers ~8HU) The can only distinguish 17 shades of grey What is a good way to check diaphragm flattening? - correct answer Look at the lateral film Diaphragm will be flat like you can set a ruler down on the edge What can a poor inspiration/hypoinflation appear like? - correct answer consolidation or PNA How to look at the lung fields? - correct answer Sweep or a zig zag down the lung field (both in PA and lateral views) look for focal, diffuse, BL asymmetrical, interstital/vasc markings, lucencies (cavity/bullae/PTX), compare upper and lower and L/R zones Middle lower zones Which hilum should always appear higher on the radiograph? - correct answer The LEFT sided hilum should be higher - if its not its pathological What to look for with the heart? - correct answer Size of the heart - the cadiac:thoracic cavity ratio LA LV What mediastinal lines should be observed on PA film? - correct answer R paratracheal line Azygous area Azygoesophageal line Paraaortic line (all the way down) If you can see these you need to figure out the reason why How to look at the bones on Xray? - correct answer Quadrant method [above and below the ribs] (the middle lung section you just also go down the spine looking for abnormalities, mets, or collapse When should you START looking at OLD films? - correct answer AFTER you have COMPLETELY evaluated the new scan What are the ACR appropriateness criteria? - correct answer The aim is to provide continuously updated evidence-based algorithms that ensure the safest, most cost-effective, and most efficient path to radiological diagnosis or intervention matched to specific variants of clinical presentations. Federal LAW requires referring physicians to consult Appropriate Use Criteria (AUC), such as ACR Appropriateness Criteria, prior to ordering advanced imaging services (ADIS), including CT, MR, nuclear medicine, and PET, for Medicare patients. How are appropriateness criteria divided/staged? - correct answer Older appropriateness rating tables used a numerical rating scale: • Usually Appropriate = 9, 8, or 7 • May be Appropriate = 6, 5, or 4 • Usually Not Appropriate = 3, 2, or 1 Newer appropriateness rating tables simply use the three categories: • Usually Appropriate (Green cells in the table) • May be Appropriate (Yellow cells in the table) • Usually Not Appropriate (Red cells in the table) What lobe of lung is seen at the apicies? - correct answer The R and L upper lobes What is the silhouette sign? - correct answer The visual interface between structures of different density. Its actually when a silhouette is LOST that we say its a "silhouette sign" What is spine sign? - correct answer When the combined density of the vertebrae and some source of fluid/consolidation make the vertebrae look MORE dense [just like ice over water accentuates the ice appearing like they have increased density even though they still the same ice] What are cases in which spine sign occur? - correct answer Spine sign - vertebral bodies should be relative lucent (black) above the diaphragm on lateral projection. -Lateral x-ray goes through spine + pneumonia and vertebra will appear whiter (fewer x-rays reach detector since some are absorbed in the pneumonia) - Helpful sign for detection of lower lobe pneumonia. - - Very useful for detecting LLL pneumonia behind the heart. - If vertebral bodies appear more dense (whiter) above the level of diaphragm, and part of one of the diaphragms is obscured → spine sign → sign of lower lobe pneumonia - There are other causes for the spine to appear whiter (such as a blastic bone metastasis). What is the lingula aligned with? - correct answer The left heart border (this is more visible in the lateral view xray)