Lecture 17: Imaging of Head and Neck Flashcards Preview

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Flashcards in Lecture 17: Imaging of Head and Neck Deck (17)
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1

What are indications for an x-ray?

Trauma

Degenerative Diseases

Post-Operative

2

What is fluoroscopy?

What can you use as contrast?

Continuous X-ray radiation that creates a moving x-ray

Contrast: Barium, Iodine

3

What are the three types of flouroscopy discussed?

Barium Swallow

Angiography

Myelography

4

What is a swallow test?

Use contrast and fluoroscopy to evaluate esophagus while swallowing

Example: Zenker's Diverticulum 

5

What is angiography used for?

What are its pros and cons?

Evaluate peripheral vasculature in case of aneurysms, vascular malformations, fistulae, stenting, thrombosis, etc 

Pros

  • Fast
  • Diagnostic and Therapeutic

Cons

  • Invasive and Radiation 
  • Contrast

6

What is myelography?

Imaging that involves spinal needle into spinal canal and use of contrast

Indications:

  • Anesthesia
  • Spinal Stenosis
  • Nerve Root Compression
  • Spinal Block

7

What will look white in a CT scan?

What will look black?

White: anything hyperdense

  • Bone
  • White Matter
  • Muscle
  • Gray Matter
  • Hemorrhage

Black: anything hypodense

  • Fat 
  • Air

8

When do you use CT?

Detecting Large Pathology

  • Skull and verebrae trauma
  • Anything to do with ventricles
  • Intracranial masses
  • Hemorrhage, Ischemia
    • stroke
  • Calcification 

9

When is contrast indicated for a CT, and when is it not indicated?

  • Contrast Indicated:
    • Neoplasm
    • Infection
    • Vascular disease
    • Inflammatory disease
  • No Contrast
    • Trauma
    • To rule out hemorrhage
    • Hydrocephalus
    • Dementia
    • Epilepsy

10

What is CT contrast made of?

 

What does it tell you?

Iodine (based)

Tells if Blood Brain Barrier is intact since contrast can't cross it

11

Why might one prefer a CT angiography over a fluoroscopy angiography?

 

Why might one prefer fluoroscopy?

CT angiography is not invasive, because — unlike fluoroscopic angiography — you don't have to inject contrast directly into the artery. In CT angiography the contrast is administered via an IV bolus.

Also in CT angiography, you can evaluate blood vessels from the heart to the point of interest, unlike fluoroscopic angiography - which is more distal.

All that said, fluoroscopy angiography has a higher resolution.

12

What will look white in a MRI scan?

What will look black?

White: anything hyperintense

Black: anything hypodense 

13

When do you use MRI?

  • Further evaluation of CT findings
  • Tumors
  • INfections
  • Joint Imaging 
    • TMJ

14

What is bright and dark in T1 MRI?

What is it good for?

CSF is dark, white matter is light.

 

Good for anatomy.

15

What is bright and dark in a T2 MRI?

What is it good for?

T2 = CSF is bright, white matter is dark.

(T2 = too bright)

Good for pathology

16

What is a T2 FLAIR good for?

Visualizing edema.

-Can remove CSF fluid

 

(FLuid Attenuated Inversion Recovery)

17

When would an MRI be preferable to a contrast CT?

If blood (and therefore contrast) cannot get to the area - such as in ischemic areas..