Unit 2-Principles of Imaging Part 2: CT, MRI; Intro to Fractures

1. fragment avulsion, 2. double density, 3. malalignment of bone

label: double density, fragment avulsion, malalignment of bone

There is less radiation exposure with getting a tomographic view with the CT scan.--CT scans have more radiation exposure as they image the body with multiple cuts.; CT imaging can get multiple tomographic cuts of the spine to visualize degeneration of the bones/vertebrae at different levels.; X-ray imaging is a projection-type image, and fractures within the joint maybe difficult to see due to overlap.; X-ray imaging is a projection-type image, and fractures may be hidden as they overlap each other.

CT scanning is a good way to get a tomographic view of bone. X-ray radiographs only give a projection view of the bone. The advantages of seeing bone in a tomographic view with a CT scan include all of the following EXCEPT: Improved visualization of fractures and loose bone within the joint without overlapping projections. Improved visualization of bony fragments without overlapping projections. Improved visualization of degenerative changes in the vertebrae of the spine. There is less radiation exposure with getting a tomographic view with the CT scan.

III: There is a fracture through the growth plate and epiphysis

Classify which type of Salter Harris fracture is shown in his image. (I, II, III, V?)

IV: There is a fracture through the growth plate, the epiphysis, and the metaphysis.

Classify which type of Salter Harris fracture is shown in his image. (II, VII, I, IV)

II: There is a fracture through the growth plate and the metaphysis, but the epiphysis is intact.

Classify which type of Salter Harris fracture is shown in his image. (VI, II, VIII, III)

Advantages: better for visualizing pathologies; better for visualizing soft tissues; better for visualizing fluids; no Xray/ionizing radiation Disadvantages: tighter tube (more claustrophobic), uses magnet (contraindicated if patient has hardware)

Consider the advantages and disadvantages of using MR imaging. What are some of the advantages of using MR imaging? What are some of the disadvantages of using MR imaging?

a. It is a fat-sensitive MR image.

Figure 1 and 2 are of the same knee. The white arrows are pointing to the normal fat pad of the knee. The red arrows are pointing to the swelling from the patellofemoral area. Which of the following about Figure 1 is true? a. It is a fat-sensitive MR image. b. The image had a long TR and TE. c. It is a fluid-sensitive MR image. d. It is a T2-weighted MR image.

Xray, Fluoroscopy, CT use Xray beam; MRI uses magnets and body's hydrogen nuclei

For the following types of imaging modalities answer the following: Does it produce a projection or tomographic image? Is it typically a static or dynamic image? Does it use an X-ray beam? [yes or no} Xray: Fluoroscopy: MRI: CT Scan:

Distal third of shaft complete overriding with medial displacement and oblique

How would you describe this tibial fracture? Consider anatomic site, type, alignment, and direction of the fracture line.

1. extra articular 2. intra-articular 3. extra-articular

Is the fracture intra-articular or extra-articular? (1, 2, 3)

1. lucent line 2. linear region of sclerosis

Label: lucent line or linear region of sclerosis?

1. Avulsion 2. Compression 3. Depression

Match the following images (1, 2, 3) to the fracture special feature. (Compression, Avulsion, Depression)

Myelography: Contrast is injected to evaluate the spinal cord with projection imaging. Ionizing radiation is utilized. CT Myelography: Contrast material is injected to evaluate the spinal cord with tomographic imaging. Ionizing radiation is involved. MR Myelography: No contrast material is injected to evaluate the spinal cord with tomographic imaging. No ionizing radiation is involved.

Match the following imaging modality to the correct description. Myelography: CT Myelography: MR Myelography: -Contrast material is injected to evaluate the spinal cord with tomographic imaging. Ionizing radiation is involved. -Contrast is injected to evaluate the spinal cord with projection imaging. Ionizing radiation is utilized. -No contrast material is injected to evaluate the spinal cord with tomographic imaging. No ionizing radiation is involved.

1. XRay radiograph 2. CT scan 3. CT Scan with bone window

Please match the numbered image to the image descriptor.: (1, 2, and 3)--XRay Radiograph, CT Scan,. CT scan with windowing

1, 4, 3, 2

Put the MRI processes in sequential order.: 1. A magnetic field that aligns the hydrogen protons is applied. 2. Receivers in the scanner record the energy as it is released. 3. The radiofrequency pulse is then removed. The protons release their energy (and return to a relaxed state) at different rates depending on the type of tissue they are in. 4. A radiofrequency pulse is applied perpendicular to the magnetic field. The protons in tissue absorb the energy created by the pulse.

1. CT 2. MR 3. CT 4. MR

The figure on the left is a T1-weighted (fat-sensitive) MR image, and the figure on the right is a CT arthrogram. What are the differences between these two images? 1. The bony cortex is bright on the [CT or MR] image. 2. There is better definition of the muscular soft tissue in the [CT or MR] image. 3. The dense soft tissue of the capsule and patellar retinacula are bright on the [CT or MR] image. 4. The fat tissue is bright on the [CT or MR] image.

Right Eye

This is a CT scan. It is a coronal view of the head. The yellow arrow is pointing to the eye of the patient imaged on this tomographic image. Which eye is it pointing to? R or L?

R eye

This is a CT scan. It is an axial view of the head. The yellow arrow is pointing to the eye of the patient imaged on this tomographic image. Which eye is it pointing to? R or L eye?

Advantages: for small or complex fractures, multiple body parts (trauma), degenerative spinal changes, option to use windowing, infection, vascular, pre-operative planning, 3D printing, or if MRI is contraindicated (metal hardware) Disadvantages: more expensive, more radiation exposure to patient

What are some of the advantages of using CT imaging? What are some of the disadvantages of using CT imaging?

2, 4, 8

Which numbers on this image are growth plate lines?