Med Term, Chapter 20 - Radiology and Nuclear Medicine

angiography

X-ray image (angiogram) of blood vessels and heart chambers is obtained after contrast is injected through a catheter into the appropriate blood vessel or heart chamber.

cholangiography

X-ray imaging after injection of contrast into bile ducts done via ERCP or intraoperative cholangiography post gallbladder or biliary tract surgery

pyelography

X-ray imaging of the renal pelvis and urinary tract contrast injected into vein (intravenous pyelography) or through catheter placed in urethra, bladder, or ureter into renal pelvis (retrograde pyelography)

PET/CT scan

combinesPETandCTtechniquestoproduceamoreaccurate image than PET or CT alone. It is often used to detect cancer and metastases, especially to determine if the cancer is responding to treatment.

CT

computed tomography

Gadolinium

contrast agent most commonly used for MRIs enhances vessels and tissues, increases sensitivity for lesion detection, helps differentiate between normal and abnormal tissues and structures

Decub

decubitus—lying down

urography

describes the process of recording x-ray images of the urinary tract after the introduction of contrast.

What is SPECT typically used for?

detecting liver tumors, detecting cardiac ischemia, and evaluating bone disease of the spine

coronary angiography

determines the degree of obstruction of the arteries that supply blood to the heart

DI

diagnostic imaging

DICOM

digital image communication in medicine—standard protocol for transmission between imaging devices (e.g., CT scans and PACS workstations)

DSA

digital subtraction angiography

how will thyroid carcinomas appear on a thyroid scan?

does not concentrate radioiodine well and is seen as a "cold" spot on the scan

pharmaceut/o

drug

radiopharmaceutical (term meaning)

drug that is connected to a radionuclide for scanning and treating... radionuclide + drug ex: radiotracer

ECHO

echocardiography

EUS

endoscopic ultrasonography

what is the purpose of gel when using an ultrasound transducer/probe?

ensure good transmission of sound waves

sentinel lymph node

first lymph node to receive lymph drainage from a tumor

18F-FDG

fluorodeoxyglucose— radiopharmaceutical used in PET scanning

side effects of iodine-containing contrast substances

flushing, nausea, warmth, or tingling sensations to severe, life-threatening reactions characterized by airway spasm, hives, laryngeal edema treat with epinephrine, corticosteroids, antihistamines

-opaque

obscure

MRI is contraindicated for people with _______

pacemakers, metallic implants powerful magnet can alter position and functioning of such devices

technetium Tc 99m Sestamibi (Cardiolite) scan

radiopharmaceutical is injected intravenously and traced to heart muscle. An exercise tolerance test (ETT) is used with it for an ETT-MIBI scan

radiolabeled compound

radiopharmaceutical; used in nuclear medicine studies.

-gram

record

pyelogram

record of the renal pelvis

hysterosalpingogram

record of the uterus and fallopian tubes

angiogram (term meaning)

record of the vessels

radiofrequency ablation

removal of tumors and tissues (liver, kidney, adrenals) under guidance of CT or fluoroscopy

is/o

same

double-contrast study

both a radiopaque and a radiolucent contrast medium. For example, the walls of the stomach or intestine are coated with barium and the lumen is filled with air. These radiographs show the pattern of mucosal ridges.

C-spine

cervical spine

x-rays

invisible waves of energy that are produced by an energy source, such as an x-ray machine or a cathode ray tube useful in diagnosis and treatment of disease

thyroid scan

iodine radionuclide, usually iodine-123 (I-123), is administered orally, and the scan reveals the size, shape, and position of the thyroid gland. Alternatively, radioactive technetium can be administered intravenously. Hyperfunctioning thyroid nodules (adenomas) accumulate higher amounts of radioactivity and are termed "hot." Thyroid carcinoma does not concentrate radioiodine well and is seen as a "cold" spot on the scan.

-graphy

process of recording

SPECT

single photon emission computed tomography—radioactive substances and a computer are used to create 3D images

tagging

Attaching a radionuclide to a chemical and following its path in the body.

fluorodeoxyglucose

18F-FDG most commonly used in PET scans

CT vs MRI

CT - bony structures, solid masses 1. bones 2. chest lesions and pneumonia 3. bleeding in the brain from head trauma and ruptured arteries MRI - soft tissues that have more water molecules 1. spinal cord and brain tumors 2. joints, tendons, and ligaments 3. liver masses 4. head and neck lesions

ultrasound transducer/probe

Handheld device that SENDS AND RECEIVES ultrasound signals.

gamma rays

High-energy rays emitted by radioactive substances in tracer studies.

posteroanterior view

PA view commonly requested chest x-ray view x-rays travel from a posteriorly placed source to an anteriorly placed detector

recumbent

Lying down (may be prone or supine).

lateral decubitus

Lying down on the side (with the x-ray beam horizontally positioned).

gamma camera

Machine to detect gamma rays emitted from radiopharmaceuticals during scanning for diagnostic purposes. used to determine the distribution and localization of the radiopharmaceutical in various organs, tissues, and fluids

magnetic resonance imaging (MRI)

Magnetic field and radio waves produce SAGITTAL, CORONAL (frontal), AXIAL (cross-sectional) images of the body. Hydrogen protons are aligned and synchronized by placing the body in a strong magnetic field. Then the hydrogen molecules relax when the magnetic field is shut down. The rates of alignment and relaxation vary from one tissue to the next, producing a sharply defined picture

how is the size and development of a fetus measured?

Measurements of the head, abdomen, and femur are made from ultrasound images obtained in various fetal planes

radiology

Medical specialty concerned with the study of x-rays and their use in the diagnosis of disease. It includes other forms of energy, such as ultrasound and magnetic waves. Also called diagnostic radiology.

nuclear medicine

Medical specialty that uses radioactive substances (RADIONUCLIDES) in the diagnosis of disease.

technetium 99m

Tc-99m pure gamma emitter with a half-life of 6 hours. Its properties make it the most frequently used radionuclide in diagnostic imaging.

bone scan

Technetium-99m (Tc-99m) is used to label phosphate substances and then is injected intravenously. The phosphate compound is taken up preferentially by bone, and the skeleton is imaged in 2 or 3 hours. Waiting 2 to 3 hours allows much of the radiopharmaceutical to be excreted in urine and allows for better visualization of the radioactive material remaining in the skeleton. The scan detects infection, inflammation, or tumors involving the skeleton, which appear as areas of high uptake on the scan

thallium scan

Thallium-201(TL-201) is injected intravenously to evaluate MYOCARDIAL PERFUSION A high concentration of TL-201 is present in well-perfused heart muscle cells, but infarcted or scarred myocardium does not take up any thallium, showing up as "cold spots." If the defective area is ischemic, the cold spots fill in (become "warm") on delayed images (obtained later).

IVP

intravenous pyelogram

abduction

movement away from the midline of the body

radiographer

someone who assists in performing diagnostic x-ray procedures

contrast studies

Radiopaque materials (contrast media) are injected to obtain contrast with surrounding tissue when shown on the x-ray film.

ventilation-perfusion studies

Radiopharmaceutical is INHALED (ventilation) and INJECTED intravenously (perfusion) followed by imaging its passage through the respiratory tract.

uptake

Rate of absorption of a radionuclide into an organ or tissue.

small bowel follow through

SBFT traces the passage of barium in a sequential manner as it passes through the small intestine.

ultrasonography (term meaning)

Sound waves are BEYOND the normal range of those that a human can hear.

angiogram

AKA arteriogram x-ray image of blood vessels and heart chambers obtained through contrast injection of iodine containing-material

radiologic technologist

Allied health care professionals who work with physicians in the fields of radiology and nuclear medicine

why are people asked to consume a lot of water prior to ultrasounds?

Because water is an excellent conductor of the ultrasound beams, patients are requested to drink large quantities of water before examination so that the urinary bladder will be distended allows for better viewing of the pelvic and abdominal organs

digital subtraction angiography

DSA X-ray image of contrast-injected blood vessels is produced by taking two x-ray pictures (the first without contrast) and using a computer to subtract obscuring shadows from the second image.

scintigraphy

Diagnostic nuclear medicine test using RADIOPHARMACEUTICALS and GAMMA CAMERAS to create images.

ultrasonography (US, U/S)

Diagnostic technique that projects and retrieves INAUDIBLE high-frequency sound waves as they ECHO OFF parts of the body. ultrasound waves move through body tissues and detect interfaces between tissues of different densities

computed tomography (CT)

Diagnostic x-ray procedure whereby a CROSS SECTIONAL image of a specific body segment is produced. Newer CT scanners can create 3D images as well multiple views of the body created using a computer after beaming x-rays through the body at multiple angles

How are MRIs performed in relation to use of contrast?

Done with and without contrast if contrast is used- gadolinium (Gd)

endoscopic retrograde cholangiopancreatography

ERCP procedure by which contrast is injected into the common bile duct for cholangiography

scan

Image of an area, organ or tissue of the body obtained from ultrasonography, radioactive tracer studies, computed tomography, or magnetic resonance imaging.

x-ray positioning

In order to take the best picture of the part of the body being radiographed, the patient, detector, and x-ray tube must be positioned in the most favorable alignment possible.

radiopaque

Obstructing the passage of x-rays. Radiopaque structures appear WHITE on the x-ray images.

what do nuclear medicine studies depict?

PHYSIOLOGIC BEHAVIOR of an organ rather than specific anatomy

radiolucent

Permitting the PASSAGE OF X-RAYS. Radiolucent structures appear BLACK on x-ray images.

positron emission tomography (PET)

Positron-emitting radioactive substances given intravenously create a CROSS-SECTIONAL image of cellular metabolism based on local concentration of the radioactive substance. PET scans give information about metabolic activity.

in vitro

Process, test, or procedure is performed, measured, or observed OUTSIDE a living organism, often in a test tube.

in vivo

Process, test, or procedure is performed, measured, or observed WITHIN a living organism. given directly to the patient to evaluate the function of an organ or to image it

radioactive iodine uptake study

RAIU performed to assess the function of the thyroid gland (such as hyperthyroidism). The patient is given radioactive iodine (in this case, I-131), also called radioiodine, in liquid or capsule form, and then a sensor is placed over the thyroid gland. It detects gamma rays emitted from the radioactive tracer, which is taken up by the thyroid more readily than by other tissues.

radioimmunoassay

RIA Test combines RADIOACTIVE CHEMICALS and ANTIBODIES to detect minute quantities of substances in a patient's blood detect hormones and drugs in a patient's blood example of in vitro procedure in nuclear medicine tests

radiopharmaceutical

Radioactive drug (radionuclide plus chemical) that is administered safely for diagnostic and therapeutic purposes; a radiotracer. An example is technetium 99m, which combines with albumin (for lung perfusion) and DTPA (for renal imaging).

radioisotope

Radioactive form of an element substance; radionuclide.

radionuclide

Radioactive form of an element that gives off energy in the form of radiation; radioisotope.

single photon emission computed tomography (SPECT)

Radioactive tracer is injected intravenously and a computer reconstructs a 3D image based on a composite of many views.

radioiodine use apart from RAIU study

Radioiodine also is used to treat hyperthyroidism, thyroid nodules, or thyroid cancer. After the patient swallows the I-131, it is absorbed into the bloodstream and then travels to the thyroid gland, where it destroys overactive thyroid tissue.

tracer studies

Radionuclides are used as tags, or labels, attached to chemicals and followed as they travel through the body.

iodine compounds

Radiopaque fluids containing up to 50% iodine are used in angiography, cholangiography, digital subtraction angiography, hysterosalpingoangiography, myelography, pyelography

interventional radiology

Therapeutic or diagnostic procedures performed by a radiologist usually under fluoroscopy or CT guidance Examples are needle biopsy of a mass and drainage of an abscess

half-life

Time required for a radioactive substance to lose half its radioactivity by disintegration.

ionization

Transformation of electrically neutral substances into electrically charged particles. X-rays cause ionization of particles within tissues.

upper GI series

UGI involves oral ingestion of barium sulfate so that the esophagus, stomach, and duodenum can be visualized

myelography

X-ray imaging of the spinal cord after injection of contrast agent into the subarachnoid space surrounding the spinal cord usually is performed in patients who cannot undergo MRI obtain CT myelography afterward

hysterosalpingography

X-ray record of the endometrial cavity and fallopian tubes is obtained after injection of contrast material through the vagina and into the endocervical canal determines patency of fallopian tubes

oblique view

X-rays travel in a slanting direction at an angle from the perpendicular plane. Oblique views show regions or structures ordinarily hidden and superimposed in routine PA and AP views.

echo-

a repeated sound

radiographers

aid physicians in administering diagnostic x-ray procedures

sonographer

aid physicians in performing ultrasound procedures.

radioactivity particles and rays

alpha particles, beta particles, gamma rays gamma rays are used as a diagnostic label to trace the path and uptake of chemical substances in the body

Angio

angiography

AP

anteroposterior

nuclear medicine technologists

attend to patients undergoing nuclear medicine procedures and operate devices under the direction of a nuclear physician

Ba

barium

BE

barium enema

flexion

bending a part of the body

ultra-

beyond

in vitro procedures involve analysis of _____ and _____ samples using radioactive chemicals

blood, urine

CT scanners are highly sensitive in detecting disease in ______ and can provide images of ______ ______ that are impossible to visualize using ordinary x-rays

bones, internal organs

characteristics of x-rays that make them useful in diagnosis and treatment

cause exposure of a photographic plate... turning silver to black ability to penetrate substances to varying degrees (air-->fat-->water in blood and lymph vessels--calcium, metals in bone)... if too dense, the rays don't meet the photographic plate and appear white invisibility... can't be detected by sight, hearing, or touch travel in straight lines... allows for formation of precise shadow images on x-ray plate... can direct rays precisely during radiotherapy scattering of x-rays... Greater scatter occurs with dense objects and less scatter with those substances that are radiolucent ionization... ionize substances through which the rays pass... neutral particles become charged... can kill cancerous cells and stop tumor growth... but can lead to damage in its own way

CXR

chest x-ray (film)

percutaneous transhepatic cholangiography

cholangiography in which alternative route for injection of contrast is via a needle through the skin and into the liver

digital radiography

form of x-ray imaging in which digital x-ray sensors are used instead of traditional photographic film. Thus images can be enhanced and transferred easily, and less radiation can be used than in conventional radiology. most common use: in dental practice, to locate cavities in teeth (dental caries). Other areas examined: digestive, nervous, reproductive, and endocrine systems and the chest and bones

Gd

gadolinium—MRI contrast agent

vitr/o

glass

what can RIA detect in newborn infants?

hypothyroidism

what do bone scans show?

infection, inflammation, tumors involving the skeleton HOT SPOTS on the bone scans use technetium 99m - Tc99m

I-131

isotope of radioactive iodine—used in diagnosis (thyroid scan) and treatment for thyroid cancer

I-123

isotope of radioactive iodine—used in thyroid scans

radioisotope (term meaning)

isotopes of an element have similar structures but different weights and stability A radioisotope (radionuclide) is an unstable form of an element that emits radioactivity.

KUB

kidneys-ureters-bladder (series)—x-ray imaging of these organs WITHOUT contrast medium

LAT

lateral

extension

lengthening or straightening a flexed limb

person with high exposure to x-rays is at risk of...

leukemias, thyroid tumors, breast cancer, other malignancies

viv/o

life

L-spine

lumbar spine

LS films

lumbosacral (spine) films

supine

lying on the back FACE UP

prone

lying on the belly FACE DOWN

MRA

magnetic resonance angiography

MRV

magnetic resonance venography

MR, MRI

magnetic resonance, magnetic resonance imaging

doppler ultrasound and color flow imagining

make it possible to record blood flow velocity (speed). These techniques are used to image major blood vessels to detect obstructions caused by atherosclerotic plaques in patients at risk for stroke.

What can be pinpointed with PET scanning in terms of metabolic activity?

metabolic deficiencies infection, inflammation, and tumor - demonstrate increased metabolic activity... HOT SPOTS

adduction

movement toward the midline of the body

MDCT

multidetector CT scanner

MDCT scanners

multidetector computed tomography scanners produce images in 64, 128, 256, and 320 slices

MUGA

multiple gated acquisition scan Tc-99m is injected intravenously to study the motion of the heart wall muscle and the ventricle's ability to eject blood (ejection fraction)

MUGA

multiple-gated acquisition (scan)— radioactive test to show heart function

neurointerventional radiologists

perform endovascular procedures including intracranial thrombolysis, head, neck, and intracranial tumor embolizations, extracranial angioplasty and stenting intervertebral facet injections, nerve root blocks, and vertebroplasties

vascular interventional radiologists

perform laser treatments for varicose veins and uterine fibroid embolization.

use of perfusion vs. ventilation studies

perfusion - intravenous injection - rely on passage of the radioactive compound through the capillaries of the lungs ventilation - inhalation of gas or aerosol - which fills the air sacs (alveoli)

radiolucent vs radiopaque

permits the passage of X-rays vs. not... appears black on x-ray images vs. appears white

therapeutic

pertaining to treatment, therapy

radiologist

physician who specializes in the practice of DIAGNOSTIC radiology

PACS

picture archival communications system—replacement of traditional films with digital equivalents that can be accessed from several places and retrieved more rapidly

PET

positron emission tomography

PET scan

positron emission tomography radionuclide technique produces images of the distribution of radioactivity (through emission of positrons) in a region of the body. It is similar to the CT scan, but radioisotopes are used instead of contrast and x-rays. The radionuclides are incorporated (by intravenous injection) into the tissues to be scanned, and an image is made showing where the radionuclide is or is not being metabolized

PET/CT

positron emission tomography/ computed tomography—both studies are performed using a single machine

PA

posteroanterior

radionuclide scanning

procedure of making an image by tracking the distribution of radioactive substance in the body

what is the amount of radiopharmaceutical at a given location proportional to?

proportional to the rate at which the gamma rays are emitted

RAIU

radioactive iodine uptake (test)— evaluates the function of the thyroid gland

Tc-99m

radioactive technetium—used in heart, brain, thyroid, liver, bone, and lung scans

RFA

radiofrequency ablation

barium sulfate

radiopaque medium that is mixed in water and used for examination of the upper and lower GI (gastrointestinal) trac

affect of scattering on obtaining x-ray images and the solution

scatter can cause BLURRING (radiographic density that serves no useful purpose) on images grid (containing thin lead strips arranged parallel to the x-ray beams) is placed in front of the image detector to absorb scattered radiation before it strikes the x-ray film

ultrasound transducer emits sound waves in _____, _____ pulses

short, repetitive

SBFT

small bowel follow-through

endoscopic ultrasonography

small ultrasound transducer is attached to the tip of an endoscope that is inserted into the body technique is used by gastroenterologists and pulmonologists to obtain high-quality and accurate detailed images of the digestive and respiratory systems

son/o

sound

advantages of ultrasound imaging

sound waves are not ionizing and do not injure tissues at the energy ranges used for diagnostic purposes

nuclear medicine physician

specializes in diagnostic RADIONUCLIDE SCANNING procedures.

Barium enema

study is a lower GI series that opacifies the lumen (passageway) of the large intestine using an enema containing barium sulfate replaced by endoscopy

TL-201

thallium-201—radioisotope used in scanning heart muscle

What has PET scanning determined for schizophrenics?

that schizophrenics do not metabolize glucose equally in all parts of the brain and that drug treatment can bring improvement to these regions

what can radioimmunoassay monitor in patients with hear disease?

the amount of digitalis in the bloodstream, which is a drug used to treat heart disease

How will a hyper functioning thyroid nodules (adenomas) appear on a thyroid scan?

they accumulate higher amounts of radioactivity and are termed "hot."

T-spine

thoracic spine

how can ultrasonography be used in interventional radiology?

to guide needle biopsy for the puncture of cysts, for placing needles during amniocentesis, and for inserting radioactive seeds into the prostate (brachytherapy)

-lucent

to shine

therapeut/o

treatment

inversion

turning inward

eversion

turning outward

lymphoscintigraphy

type of nuclear medicine imaging provides pictures (scintigrams) of the lymphatic system radio tracer injected under the skin or deeper using a small needle gamma camera takes pictures of an area of the body use this to identify a sentinel lymph node, identify cases of lymph node blockage, evaluate lymphedema

sonogram

ultrasonic echoes are then recorded as a composite picture of the area of the body record produced by ultrasound

hysterosonogram

ultrasound image produced by using sonography on the uterus Saline solution is injected through a catheter inserted into the vagina and cervical canal to the uterus, which is then examined by ultrasound imaging.

US, U/S

ultrasound; ultrasonography

UGI

upper gastrointestinal (series)

computed tomography (term meaning)

use of a computer to obtain records of the body by cutting the body into many slices (cross-sectionally)

what increases the sensitivity of a CT scanner to detect abnormalities?

use of iodine- containing contrast agents, which outline blood vessels and confer additional density to soft tissues.

echocardiography (term meaning)

use of sound waves to produce a record of the heart

echocardiography

use of ultrasound techniques to detect heart valve and blood vessel disorders

fluoroscopy

use of x-rays and a fluorescent screen to produce real-time video images

uses of ultrasonography

used as a diagnostic tool by radiologist neurosurgeons and ophthalmologists to detect intracranial and ophthalmic lesions Cardiologists use ultrasound techniques to detect heart valve and blood vessel disorders gastroenterologists to locate abdominal masses outside the digestive organs. pulmonologists use ultrasound procedures for locating and sampling lesions outside the bronchial tubes. Obstetricians and gynecologists use ultrasound imaging to differentiate single from multiple pregnancies, as well as to help in performing amniocentesis. image benign and malignant tumors determine the size and development of the fetus

digital imaging techniques

used to enhance conventional and fluoroscopic x-ray images A lower dose of x-ray is used to achieve higher-quality images digital images can be sent via networks to other locations

mammography

uses low-dose x-rays to visualize breast tissue

V/Q scan

ventilation-perfusion scan of the lungs (Q stands for rate of blood flow or blood volume)

film badge

what workers exposed to x-rays must wear to detect and record the amount of radiation to which they've been exposed... more exposure = more blackness on badge

radi/o

x-rays

lateral view

x-rays travel from a source located to the right of the patient to a detector placed to the left of the patient.

anteroposterior view

x-rays travel from an anteriorly placed source to a posteriorly placed detector.