Lec10 Imaging

7/26/2019 Lec10 Imaging

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Ruedeekorn Suwannanon ,


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Investigation-Test

Symptoms and Signs do not lead to diagnosis

Invasive

Cost

Time

Change the management


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Functional

Functional

--


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Iodinate contrast agent ()


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Cerebral

Angiogram


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Safty of radiation imaging and


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Safty of radiation imaging and

iodinate contrast media

Natural radiation

Diagnostic imaging test

X-rays (plain flim, fluoroscopy,

IVP, intervention under

fluoroscopy or CT guidance)

CT scan Nuclear medicine study


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Effective dose

Dose : Millisievert (mSv)

Background radiation exposure : 3 mSv per year

Diagnostic imaging?

For this procedure: * Your approximate effectiveradiation dose is:

Comparable to natural backgroundradiation for:

** Additional lifetime risk of fatalcancer from examination:

ABDOMINAL REGION:


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Computed Tomography (CT)-Abdomen and

Pelvis

10 mSv 3 years Low

Computed Tomography (CT)-Abdomen and

Pelvis, repeated with and without contrast

material

20 mSv 7 years Moderate

Computed Tomography (CT)-Colonography 10 mSv 3 years Low

Intravenous Pyelogram (IVP) 3 mSv 1 year LowRadiography (X-ray)-Lower GI Tract 8 mSv 3 years Low

Radiography (X-ray)-Upper GI Tract 6 mSv 2 years Low

BONE:

Radiography (X-ray)-Spine 1.5 mSv 6 months Very Low

Radiography (X-ray)-Extremity 0.001 mSv 3 hours Negligible

CENTRAL NERVOUS SYSTEM:

Computed Tomography (CT)-Head 2 mSv 8 months Very Low

Computed Tomography (CT)-Head, repeated

with and without contrast material

4 mSv 16 months Low

Computed Tomography (CT)-Spine 6 mSv 2 years Low

CHEST:

Computed Tomography (CT)-Chest 7 mSv 2 years Low

Computed Tomography (CT)-Chest Low Dose 1.5 mSv 6 months Very Low

Radiography-Chest 0.1 mSv 10 days Minimal

DENTAL:

Intraoral X-ray 0.005 mSv 1 day Negligible

HEART:

Coronary Computed Tomography Angiography

(CTA)

12 mSv 4 years Low

Cardiac CT for Calcium Scoring 3 mSv 1 year Low

MEN'S IMAGING:

Bone Densitometry (DEXA) 0.001 mSv 3 hours Negligible

NUCLEAR MEDICINE:

Positron Emission Tomography Computed

Tomography (PET/CT)

25 mSv 8 years Moderate

WOMEN'S IMAGING:

Bone Densitometry (DEXA) 0.001 mSv 3 hours Negligible

Mammography 0.4 mSv 7 weeks Very Low


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Idionate contrastmedia safety

Contrast allergy and adverse reaction

Contrast induced nephropathy (CIN)**


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MRI contrast agent

Is it safe?


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Safty of MRI and gadolinium contrast agent

MRI

1. No radiation

2. High tissue contrast3. Claustrophobia

4. Timing

5. Prenancy ?

Gadolinium contrast

agent

1. No iodine

2. SE and adverse

reaction : unusal

3. Cross placenta (cat C

by FDA)

4. NSF***

( h i i fib i )


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NSF (Nephrogenic systemic fibrosis)

Feature Description

Distribution Distal lower extremities > lower thighs > lower abdomen >


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Distribution Distal lower extremities > lower thighs > lower abdomen >upper extremities

Appearance Swelling, skin induration, skin-colored or erythematous papules with apeaudorange appearance, skin thickening with a woody texture

Systemic involvement Skeletal muscle, myocardium, lungs, kidneys, testes, dura mater

Time course From a few days to 3 months after exposure (median 25 days)


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Pi l t i ff t


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Piezoelectric effect


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Possible biochemistry

Not histology


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Documents

Lec10 Imaging