Aquifer Learning Objectives – Questions With
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Terms in this set (281)
CT reconstruction Reprocessing of data Requires software
Change display in real time. Different ways of
displaying the information, for example lung
window vs. bone window. All levels below window
CT Windows look black and all levels above window look white.
Why hemorrhage looks different in brain vs.
abdomen. Narrow windows means able to see more
subtle changes
Density on CT is Houndsfield units
measured in
Computer model shows 256, but we can only see about 17 shades of grade
how many shades of grey
Window is How many Houndsfield units within the
Window vs. level
256 shades of grey. Level is Where is the window
definition
centered.
Older: 9, 8, 7 usually appropriate and usually not
ACR Appropriateness
appropriate is 1, 2, 3. Newer: usually appropriate in
older vs. newer
green.
Demonstrate how to
effectively utilize the ACR
AC website to select
appropriate imaging.
List the indications for Factors that influence the decision to obtain a CXR
imaging in patients with include patient age (over 40) and underlying
suspected chest medical conditions (heart disease, COPD, smoker,
infections. diabetes, dementia, risk of aspiration, etc.).
, Follow up 6-8 weeks CXR in all patients > 40 years,
Explain why and when
hx recurrent pneumonia, immunocompromised,
follow-up imaging is
current/former smokers, patients who symptoms do
recommended in patients
not resolve. Symptoms resolve before radiographic
with pneumonia.
signs resolve. Main reason is rule out a mass.
Portable imaging studies cannot be done with grids
(which decrease scatter radiation and improve
image quality). It is often difficult to detect subtle
findings (like Kerley B lines) on portable chest
Explain the use and
radiographs. difficult for the technologist to position
describe some of the
the patient properly. Many lines, tubes, drains, etc.
technical limitations of
Obese patients require longer exposure which
portable radiographs in
causes motion artifact and scatter radiation. Often
the ICU.
cannot achieve proper penetration with portable in
obese patients. (Many processes—pneumothorax,
pleural effusions, free peritoneal air, etc.—are easier
to diagnose in the upright position.).
Low -> high: extremity radiograph, chest radiograph,
head CT, barium enema, CT chest/abd/pelvis. CXR
and extremities are low dose. High dose: fluoro, GI
Classify common
studies, cardiac cath, biliary procedures,
radiological procedures
angiography, CT angiography (3 CT scans), spine,
into low, medium, and
IVP, arteriography, nuclear cardiology. Radiation
high radiation dose to
sensitive targets: bone marrow, thyroid, lens of eye,
patients.
gonads, female breast, GI tract, fetus, children. 10
CTs increase cancer rate by 1%. 1000 mSv = 8% fatal
cancers.
Factors that affect risk for radiation: age (young),
female sex, area imaging, body habitus. Technical
Identify simple strategies factors: type of exam, frequency exams, slice
to reduce radiation dose thickness, fluoro time. Reduce risk: reduce imaging
to patients. in children, use Ultrasound and MRI more in
children, decrease frequency of re-imaging.
Fractionation reduces risk by 50%.
Illustrate on a chest
radiograph the anatomic
locations of the lobes
and fissures of the lungs.
, Air bronchograms are formed when something fills
the alveoli but leaves air within the bronchi, which
then appear black against the white of the
consolidated parenchyma. Air bronchograms are
Define the term "air pathognomonic for consolidation or airspace
bronchogram" and opacification (note, no disease called "airspace"),
explain the significance but not for any particular etiology. The alveoli can
of this sign. be filled with fluid (pulmonary edema, ARDS), pus
(pneumonia), blood (pulmonary hemorrhage),
malignant cells (bronchoalveolar carcinoma—now
called a subtype of adenocarcinoma), or
proteinaceous fluid (alveolar proteinosis).
Silhouette sign occurs when the air in the lung is
replaced with something of similar radiographic
density of soft tissue (pneumonia, pleural effusion,
etc.). This can be commonly seen in pneumonia. If
vertebrae appear more white on lateral projection,
there may be consolidation in a lower lobe (positive
"spine sign"). If you look at a normal lateral CXR and
Define the "silhouette
run your eyes down the spine, the vertebral bodies
sign" and "spine sign" on
should stay lucent (darker) before your eye
chest radiographs and
intersects the diaphragm. (A few crossing vessels
explain how they can be
are okay.) If the vertebral bodies appear more
used to localize
dense (whiter) before you are at the level of the
abnormalities.
diaphragm, and part of one of the diaphragms is
obscured (there is that silhouette sign again), then
this is the "spine sign"—a sign of a lower lobe
pneumonia. pneumonia in either the RLL or LLL can
be next to the lower thoracic spine and result in a
lateral radiograph that will cause the thoracic spine
to become "whiter"
Determine the lobar
location of typical
bacterial pneumonias on
chest radiographs
, Recognize the typical Upright: pleural effusion blunting of costophrenic
appearance of a pleural angle with meniscus appearnce. When completely
effusion when the patient supine may track and form apical cap. To confirm
is upright, semi-erect, pleural effusion do ipsilateral decubitus positioning
and supine and a side of concern down. Hydropneumothorax is
hydropneumothorax. diagnosed with air fluid level.
Image guidance helpful when effusions are small,
Explain when image
loculated, or patient high risk for pneumothorax
guidance can help in the
such as with concurrent emphysema. Sometimes in
drainage of pleural
morbidly obese patients image guidance is
collections.
requested
Describe two Kerley B lines suggests mycoplasmas. Fungal can
radiographic features that cause wedge or mass like lesions +/- cavitation.
would suggest an Bilateral, ground glass.
atypical pneumonia.
"Ground glass" is a radiology descriptive term (used
Compare and contrast
in both chest radiographs and CT imaging) to
the terminology "ground
indicate that blood vessels are not obscured, as
glass" and "consolidation"
would be the case in alveolar lung opacities.
on CT and chest
Consolidation: blood vessels are obscured on CT
radiographs.
and airbronchograms more common
Lingula consolidation will Left heart border
obscure
RML consolidation ill Right heart border
obscure
HIV, CD4 180, bilateral, Pneumocystic pneumonia
diffuse GGOs
How much radiation is CT 150 x radiation
of chest abd and pelvic
compared to single PA
CXR?
Insightful Solutions
Save
Terms in this set (281)
CT reconstruction Reprocessing of data Requires software
Change display in real time. Different ways of
displaying the information, for example lung
window vs. bone window. All levels below window
CT Windows look black and all levels above window look white.
Why hemorrhage looks different in brain vs.
abdomen. Narrow windows means able to see more
subtle changes
Density on CT is Houndsfield units
measured in
Computer model shows 256, but we can only see about 17 shades of grade
how many shades of grey
Window is How many Houndsfield units within the
Window vs. level
256 shades of grey. Level is Where is the window
definition
centered.
Older: 9, 8, 7 usually appropriate and usually not
ACR Appropriateness
appropriate is 1, 2, 3. Newer: usually appropriate in
older vs. newer
green.
Demonstrate how to
effectively utilize the ACR
AC website to select
appropriate imaging.
List the indications for Factors that influence the decision to obtain a CXR
imaging in patients with include patient age (over 40) and underlying
suspected chest medical conditions (heart disease, COPD, smoker,
infections. diabetes, dementia, risk of aspiration, etc.).
, Follow up 6-8 weeks CXR in all patients > 40 years,
Explain why and when
hx recurrent pneumonia, immunocompromised,
follow-up imaging is
current/former smokers, patients who symptoms do
recommended in patients
not resolve. Symptoms resolve before radiographic
with pneumonia.
signs resolve. Main reason is rule out a mass.
Portable imaging studies cannot be done with grids
(which decrease scatter radiation and improve
image quality). It is often difficult to detect subtle
findings (like Kerley B lines) on portable chest
Explain the use and
radiographs. difficult for the technologist to position
describe some of the
the patient properly. Many lines, tubes, drains, etc.
technical limitations of
Obese patients require longer exposure which
portable radiographs in
causes motion artifact and scatter radiation. Often
the ICU.
cannot achieve proper penetration with portable in
obese patients. (Many processes—pneumothorax,
pleural effusions, free peritoneal air, etc.—are easier
to diagnose in the upright position.).
Low -> high: extremity radiograph, chest radiograph,
head CT, barium enema, CT chest/abd/pelvis. CXR
and extremities are low dose. High dose: fluoro, GI
Classify common
studies, cardiac cath, biliary procedures,
radiological procedures
angiography, CT angiography (3 CT scans), spine,
into low, medium, and
IVP, arteriography, nuclear cardiology. Radiation
high radiation dose to
sensitive targets: bone marrow, thyroid, lens of eye,
patients.
gonads, female breast, GI tract, fetus, children. 10
CTs increase cancer rate by 1%. 1000 mSv = 8% fatal
cancers.
Factors that affect risk for radiation: age (young),
female sex, area imaging, body habitus. Technical
Identify simple strategies factors: type of exam, frequency exams, slice
to reduce radiation dose thickness, fluoro time. Reduce risk: reduce imaging
to patients. in children, use Ultrasound and MRI more in
children, decrease frequency of re-imaging.
Fractionation reduces risk by 50%.
Illustrate on a chest
radiograph the anatomic
locations of the lobes
and fissures of the lungs.
, Air bronchograms are formed when something fills
the alveoli but leaves air within the bronchi, which
then appear black against the white of the
consolidated parenchyma. Air bronchograms are
Define the term "air pathognomonic for consolidation or airspace
bronchogram" and opacification (note, no disease called "airspace"),
explain the significance but not for any particular etiology. The alveoli can
of this sign. be filled with fluid (pulmonary edema, ARDS), pus
(pneumonia), blood (pulmonary hemorrhage),
malignant cells (bronchoalveolar carcinoma—now
called a subtype of adenocarcinoma), or
proteinaceous fluid (alveolar proteinosis).
Silhouette sign occurs when the air in the lung is
replaced with something of similar radiographic
density of soft tissue (pneumonia, pleural effusion,
etc.). This can be commonly seen in pneumonia. If
vertebrae appear more white on lateral projection,
there may be consolidation in a lower lobe (positive
"spine sign"). If you look at a normal lateral CXR and
Define the "silhouette
run your eyes down the spine, the vertebral bodies
sign" and "spine sign" on
should stay lucent (darker) before your eye
chest radiographs and
intersects the diaphragm. (A few crossing vessels
explain how they can be
are okay.) If the vertebral bodies appear more
used to localize
dense (whiter) before you are at the level of the
abnormalities.
diaphragm, and part of one of the diaphragms is
obscured (there is that silhouette sign again), then
this is the "spine sign"—a sign of a lower lobe
pneumonia. pneumonia in either the RLL or LLL can
be next to the lower thoracic spine and result in a
lateral radiograph that will cause the thoracic spine
to become "whiter"
Determine the lobar
location of typical
bacterial pneumonias on
chest radiographs
, Recognize the typical Upright: pleural effusion blunting of costophrenic
appearance of a pleural angle with meniscus appearnce. When completely
effusion when the patient supine may track and form apical cap. To confirm
is upright, semi-erect, pleural effusion do ipsilateral decubitus positioning
and supine and a side of concern down. Hydropneumothorax is
hydropneumothorax. diagnosed with air fluid level.
Image guidance helpful when effusions are small,
Explain when image
loculated, or patient high risk for pneumothorax
guidance can help in the
such as with concurrent emphysema. Sometimes in
drainage of pleural
morbidly obese patients image guidance is
collections.
requested
Describe two Kerley B lines suggests mycoplasmas. Fungal can
radiographic features that cause wedge or mass like lesions +/- cavitation.
would suggest an Bilateral, ground glass.
atypical pneumonia.
"Ground glass" is a radiology descriptive term (used
Compare and contrast
in both chest radiographs and CT imaging) to
the terminology "ground
indicate that blood vessels are not obscured, as
glass" and "consolidation"
would be the case in alveolar lung opacities.
on CT and chest
Consolidation: blood vessels are obscured on CT
radiographs.
and airbronchograms more common
Lingula consolidation will Left heart border
obscure
RML consolidation ill Right heart border
obscure
HIV, CD4 180, bilateral, Pneumocystic pneumonia
diffuse GGOs
How much radiation is CT 150 x radiation
of chest abd and pelvic
compared to single PA
CXR?
