DOCSLIB.ORG

MY9700684 High Resolution CT in Diffuse Lung Disease

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
MY9700684 High Resolution CT in Diffuse Lung Disease MY9700684 CH2 - CHEST High Resolution CT in Diffuse Lung Disease dependent lung collapse is often seen in both normals and abnormals, and having scans in both positions allows us to differentiate this finding from true W. Richard Webb pathology. Patients with suspected obstructive disease have scans performed at 1 cm intervals from the lung Dept of Radiology, University of California of San apices to bases in the supine position only. Francisco, San Francisco The use of HRCT following expiration, or dynamic ultrafast high-resolution CT (DUHRCT) in which a The development of high-resolution CT (HRCT) in rapid series of ultra, fast HRCT scans are obtained recent years has revolutionized our ability to detect during a forced inspiratory and expiratory maneuvers, and characterize diffuse pulmonary disease. Using can demonstrate dynamic morphologic and lung HRCT, lung morphology can be assessed in detail. attenuation changes associated with airways obstruc- tion." HRCT TECHNIQUE High-resolution CT techniques attempt to optimize NORMAL HRCT FINDINGS the demonstration of lung architecture.14 The use of Structures as small as 0.2 to 0.3 mm can be seen on thin collimation (1-2 mm) and image reconstruction HRCT images; this level of resolution allows the with a high-resolution algorithm are essential in imaging of lung anatomy at the level of the secondary obtaining HRCT.' Additional modifications of pulmonary lobule.2'1213 Within the peripheral lung, technique can improve image quality further, but are interlobular septa measuring 100 |jm or 0.1 mm in not necessary. These include increasing the kVp or thickness are at the lower limit of HRCT resolution,13 mA scan settings in order to reduce image noise, and but nonetheless can sometimes be seen on HRCT targeting image reconstruction to a small field of scans performed in vitro.12 These are better seen view.2-5"* within the peripheral lung than in the central lung, as septa are better developed in this location. On clinical The average skin radiation dose associated with HRCT HRCT in normal patients, a few interlobular septa can scans has been compared to that of conventional CT.9 often be seen, but they tend to be inconspicuous.8 Using a scan technique of 120 kVp, 200 m A, 2 sec, the Numerous clearly defined interlobular septa are mean skin radiation dose was 4.4 mGy for 1.5 mm usually abnormal. HRCT scans at 10 mm intervals, 2.1 mGy for scans at 20 mm intervals, and 36.3 mGy for conventional 10 The central portion of the 'secondary lobule, referred mm scans at 10 mm intervals. Thus, HRCT scanning to as the lobularcore orcentrilobular region,14contains at 10 and 20 mm intervals, as is done in clinical the pulmonary artery and bronch iolar branches which imaging, results in 12% and 6%, respectively, of the supply the lobule. The pulmonary artery supplying a radiation dose associated with conventional CT. secondary lobule measures approximately 1 mm in diameter, while intralobular acinar artery branches Recently, the utility of "low-dose" HRCT (120 kVp, measure 0.5 mm in diameter, vessels of this size are 20 mA, and 2 second scan time) has been evaluated.10 easily seen using HRCT. The visibility of bronchi or Image quality is generally not as good as with standard bronchioles on HRCT is determined by their wall HRCT technique, but low-dose scans may be adequate thickness rather than their diameter. As an appro- ximation, the thickness of the wall of a bronchus or for the follow-up of patients with an established 15 diagnosis. bronchiole measures from 1/6 to l/10th of its diameter. Thus, for a 1 mm bronchiole supplying a secondary lobule, the thickness of its wall measures approxi- Most patients who have HRCT in our institution for mately 0.15 mm; the wall of a terminal bronchiole the diagnosis of suspected restrictive lung disease or measures only 0.1 mm in thickness, and that of an who have diffuse lung disease of unknown type, have acinar bronchiole only 0.05 mm. Bronchioles are scans performed at 2 cm intervals from lung apices to below the resolution of HRCT technique for a tubular bases in both the supine and prone positions. Some 45 ABNORMAL HRCT FINDINGS occurring in relation to small arterial or bronchiolar Numerous pathologic studies have shown that HRCT branches or in the periphery of acini.712 This finding accurately depicts lung anatomy and pathology. is most common can be seen in patients who have Generally speaking, HRCT findings of lung disease fibrosis, and is visible as a fine network of lines.7'12 can be considered in 4 groups or categories, which reflect the histologic abnormalities present. These Honeycombing reflects extensive fibrosis with lung are 1) reticular opacities, 2) nodular opacities, 3) destruction, and results in a cystic, reticular appear- increased lung opacity, and 4) decreased lung opac ity ance on HRCT which is characteristic.12-24 When or cystic opacities. honeycombing is present, normal lung architecture is distorted, and secondary lobules are difficult or RETICULAR OPACITIES impossible to recognize. The cystic spaces of honey- Thickening of the interstitial fiber network of the lung combing can range from several mm to several cm in by fluid, fibrous tissue, or because of interstitial diameter, and are characterized by thick, clearly infiltration by cells, results in an increase in reticular definable, fibrous walls. lung opacities as seen on HRCT. Reticular interstitial abnormalities can often be characterized accordi ng to Centrilobular opacities2327 can reflect their relation to secondary lobular structures. peribronchovascular interstitial thickening such as occurs in patients with fibrosis or interstitial infiltra- Interlobular septal thickening occurs in patients tion, or can reflect bronchiolar abnormalities. For with a variety of interstitial lung diseases, and in the example, centrilobular (peribronchiolar) abnormali- presence of interstitial fluid, fibrosis, or cellular ties have been reported as early HRCT findings in infiltration. In the peripheral lung, thickened septa patients with asbestosis28 andsilicosis,29 and can also measure 1-2 cm in length and are often seen extend- be seen in patients with pulmonary edema, ing to the pleural surface; in the central lung, the sarcoidosis1930 histiocytosis X ,31 and hypersensitivity thickened septa can outline lobules which are 1-2.5 pneumonitis [32]. In some of these conditions, the cm in diameter and appear polygonal in shape. Such presence of centrilobular abnormalities reflects visible lobules commonly contain a central dot-like peribronchiolar inflammation or air-space disease. In or branching artery. patients with small airways diseases such as panbronchiolitis,26cystic fibrosis,27andbronchiolitis, Septal thickening can be smooth, nodular, or irregular centrilobular opacities and bronchiolar wall thicken- in contour in different pathologic processes. Pulmo- ing have been seen. On HRCT, centrilobular nary edema results in smooth septal thickening; abnormalities can appear as an abnormal prominence Iymphangitic spread of tumor characteristically results of the centrilobular artery or bronchiole because of in smooth, nodular, or "beaded" thickening,1"8 while peribronchovascular interstitial thickening or as a "beaded septa" or septal nodules can also be seen in nodular opacity. The appearance of "tree-in-bud" is patients with sarcoidosis and coal workers often indicative of airways disease or inflammation, pneumoconiosis."'22 Septal thickening is not common as in cystic fibrosis or endobronchial spread of TB.33 in patients with interstitial fibrosis, except for those with sarcoidosis and asbestosis;23 when visible, septal NODULES thickening due to fibrosis is often irregular in Nodules as small as 1-2 mm in diameter can be appearance. detected on HRCT in patients with a variety of diseases. Nodules can be "perilymphatic", random, When interlobular septa are visible, and lobules are or centrilobular in distribution in different diseases well outlined, it is important to note whether the and recognizing one of these distributions can be lobules are normal in shape and appearance or whether important in differential diagnosis.34 "Perilymphatic" they are distorted. Thickened septa without nodules affect the peribronchovascular, interlobular architectural distortion is characteristic of edema, septal, subpleural, and centrilobular interstitial com- Iymphangitic spread, or infiltration, while distortion partments, and are usually due to sarcoidosis, which strongly suggests fibrosis. tends to have a peribronchovascular and subpleural predominance,"'2230'35"37 silicosis and coal-worker's Intralobular interstitial thickening represents an penumoconiosis, which predominates in the 2 121 29 38 abnormality of the intralobular interstitium, perhaps subpleural and centrilobular regions, " ' - and 46 lymphangitic spead of tumor, which is typically abnormalities which can be precisely characterized peribronchovascular and septal.'"39 Nodules with a and localized on HRCT.12-24'54 Honeycomb cysts are random distribution are most typical of milary often peripheral in location, and are characterized by tuberculosis" and hematogenous metastases.40 thick, clearly definable walls. Centrilobular nodules, often reflect bronchiolar or peribronchiolar abnormalities,41 and can be seen in Emphysema is accurately diagnosed using HRCT, silicosis and coal-worker's pneumoconiosis,29 and this technique is more sensitive than conven- asbestosis,42 endobronchial spread of tuberculosis1 W3 tional CI or plain radiographs
Load more

Recommended publications
  • ICD~10~PCS Complete Code Set Procedural Coding System Sample
    ICD~10~PCS Complete Code Set Procedural Coding System Sample Table.of.Contents Preface....................................................................................00 Mouth and Throat ............................................................................. 00 Introducton...........................................................................00 Gastrointestinal System .................................................................. 00 Hepatobiliary System and Pancreas ........................................... 00 What is ICD-10-PCS? ........................................................................ 00 Endocrine System ............................................................................. 00 ICD-10-PCS Code Structure ........................................................... 00 Skin and Breast .................................................................................. 00 ICD-10-PCS Design ........................................................................... 00 Subcutaneous Tissue and Fascia ................................................. 00 ICD-10-PCS Additional Characteristics ...................................... 00 Muscles ................................................................................................. 00 ICD-10-PCS Applications ................................................................ 00 Tendons ................................................................................................ 00 Understandng.Root.Operatons..........................................00
    [Show full text]
  • Assessment of Bronchiectasis by Computed Tomography
    Thorax: first published as 10.1136/thx.40.12.920 on 1 December 1985. Downloaded from Thorax 1985;40:920-924 Assessment of bronchiectasis by computed tomography IM MOOTOOSAMY, RH REZNEK, J OSMAN, RSO REES, MALCOLM GREEN From the Departments of Diagnostic Radiology and Chest Medicine, St Bartholomew's Hospital, London ABSTRACT Computed tomography and bronchography were used to assess the distribution of bronchiectasis in 15 lungs from eight patients with clinical features of the disease. Of the 36 lobes adequately displayed by bronchography, 22 were found to have bronchiectasis and 14 were found to be normal by both techniques. Cystic disease was readily identified by computed tomography but the cylindrical and varicose types of bronchiectasis could not be distinguished. Segmental local- isation was less accurate, with agreement between computed tomography and bronchography in 116 out of 130 segments. It is concluded that with a modern high resolution scanner computed tom- ography provides a useful method of assessing lobar distribution in bronchiectasis. The incidence of bronchiectasis in the United King- placing bronchography in a substantial number, dom has decreased since the advent ofantibiotic treat- Muller et al found correspondence in only about half ment and the decline in severe respiratory disease in the lungs studied. childhood. Nevertheless, it still occurs as the result of The purpose of this study is to assess the place of severe pulmonary infections and in association with modern high resolution computed tomography scan-copyright. immune deficiency, cystic fibrosis, and other condi- ners in the clinical management ofpatients with bron- tions. chiectasis and to investigate the accuracy with which The disease is defined as irreversible abnormal di- lobar and segmental disease and the type of disease latation of the bronchi and has been classified by present can be predicted.
    [Show full text]
  • Role of High-Resolution CT in Diagnosis, Regional Distribution and Characterize Bronchiectasis Morphologically
    International Journal of Radiology and Diagnostic Imaging 2021; 4(1): 166-170 E-ISSN: 2664-4444 P-ISSN: 2664-4436 www.radiologypaper.com Role of high-resolution CT in diagnosis, regional IJRDI 2021; 4(1): 166-170 Received: 30-11-2020 distribution and characterize bronchiectasis Accepted: 05-01-2021 morphologically Priyanka Patil Specialist Radiologist, Department of Radiology, Priyanka Patil, Gururaj Bangari, Veeresh Hanchinal and Rahul Shirol Gadag Institute of Medical Sciences, Malasamudra, Karnataka, India DOI: http://dx.doi.org/10.33545/26644436.2021.v4.i1c.180 Gururaj Bangari Abstract Assistant Professor, Background: Bronchiectasis causes physical, social, and financial strain on affected patients and Department of Radiology, results in a significant negative effect on the quality of life of the patient. SDM College of Medical Objectives: This study was undertaken to find the role of HRCT in diagnosis, regional distribution and Sciences and Hospital, characterize bronchiectasis morphologically. Dharwad, Karnataka, India Method: A prospective study of sixty patients was done in whom clinically bronchiectasis was Veeresh Hanchinal suspected and were subjected to HRCT examination. Bronchiectasis was assessed in terms of Associate Professor, localization, regional distribution and morphological forms. Department of Radiology, Results: The mean age for all patients included in the study was 50.7 ± 12.09. The mean age of the Gadag Institute of Medical male patients was 51.56 ± 12.09 and the mean age of the female patients was 50.16 ± 12.23Out of a Sciences, Malasamudra, total of 60 patients there were 23 (38%) males and 37 (62%) females. 18 patients (30%) had unilateral Karnataka, India disease & 42 (70%) had disease in both lungs.
    [Show full text]
  • CT Versus Bronchography in the Diagnosis and Management of Tracheobronchomalacia in Ventilator Dependent Infants
    ADC-FNN Online First, published on April 27, 2005 as 10.1136/adc.2004.062604 Arch Dis Child Fetal Neonatal Ed: first published as 10.1136/adc.2004.062604 on 27 April 2005. Downloaded from CT versus bronchography in the diagnosis and management of tracheobronchomalacia in ventilator dependent infants + Mok Q#, Negus S*, McLaren CA*, Rajka T#, Elliott MJ , Roebuck DJ* & McHugh K* + #Paediatric Intensive Care Unit, Cardiothoracic Unit and *Department of Radiology Great Ormond Street Hospital for Children, London, United Kingdom. Address for correspondence: Quen Mok, Pediatric Intensive Care Unit, Great Ormond Street Hospital for Children, London WCIN 3JH copyright. United Kingdom Tel: +44 20 7813 8213 Fax: +44 20 7813 8206 Email: [email protected] http://fn.bmj.com/ on September 28, 2021 by guest. Protected 1 Copyright Article author (or their employer) 2005. Produced by BMJ Publishing Group Ltd (& RCPCH) under licence. Arch Dis Child Fetal Neonatal Ed: first published as 10.1136/adc.2004.062604 on 27 April 2005. Downloaded from Abstract Aim: To assess the relative accuracy of dynamic spiral computed tomography (CT) compared to tracheobronchography, in a population of ventilator dependent infants with suspected tracheobronchomalacia (TBM). Setting: Pediatric intensive care unit in a tertiary teaching hospital Patients and methods: Infants referred for investigation and management of ventilator dependence and suspected to have TBM were recruited into the study. Tracheobronchography and CT were performed during the same admission by different investigators who were blinded to the results of the other investigation. The study was approved by the hospital research ethics committee and signed parental consent was obtained.
    [Show full text]
  • Prestenotic Bronchial Radioaerosol Deposition: a New Ventilation Scan Sign of Bronchial Obstruction
    Prestenotic Bronchial Radioaerosol Deposition: A New Ventilation Scan Sign of Bronchial Obstruction Soo-Kyo Chung, Hak-Hee Kim and Yong-Whee Bahk Departments of Radiology and Nuclear Medicine, Kangnam St. Mary's Hospital, Catholic University Medical College, Seoul, Korea; and Department of Radiology, Samsung Cheil General Hospital, Seoul, Korea and tumor. Nor does it directly indicate obstruction as a This study was performed to assess the diagnostic usefulness of 99mTc-phytate aerosol scan does. aerosol ventilation scanning in bronchial obstruction and bronchial In the course of the recent ventilation scan studies on stenosis. Methods: Seven patients of bronchial obstruction and one bronchial obstruction using 99mTc-phytate aerosol, we observed patient with stenosis were studied. In each patient, obstruction was confirmed by bronchography, bronchoscopy and/or CT scan. Ven a previously unrecognized interesting phenomenon. It was tilation scanning was performed using the 99mTc-phytate aerosol characterized by an intense, short, segmental aerosol deposition generated by a BARC jet nebulizer. Scan manifestations were in the immediate prestenotic bronchus, accurately pointing to assessed in correlation with those of plain chest radiography, obstruction and stenosis. The aerosol-deposited bronchus ap bronchography, CT scan and/or bronchoscopy. Results: In every peared to be slightly dilated and clubbed and was accompanied patient, the ventilation scan showed characteristic intense aerosol by a scan defect in the distal lung. deposition in a short, slightly dilated, clubbed, bronchial segment immediately proximal to obstruction or stenosis. Typically, it was METHODS accompanied by a distal airspace deposition defect. Conclusion: We studied five men (age 31-69 yr) and two women (age 61 and Intense, segmental, bronchial aerosol deposition with distal lung 69 yr) with eight lesions.
    [Show full text]
  • Answer Key Chapter 1
    Instructor's Guide AC210610: Basic CPT/HCPCS Exercises Page 1 of 101 Answer Key Chapter 1 Introduction to Clinical Coding 1.1: Self-Assessment Exercise 1. The patient is seen as an outpatient for a bilateral mammogram. CPT Code: 77055-50 Note that the description for code 77055 is for a unilateral (one side) mammogram. 77056 is the correct code for a bilateral mammogram. Use of modifier -50 for bilateral is not appropriate when CPT code descriptions differentiate between unilateral and bilateral. 2. Physician performs a closed manipulation of a medial malleolus fracture—left ankle. CPT Code: 27766-LT The code represents an open treatment of the fracture, but the physician performed a closed manipulation. Correct code: 27762-LT 3. Surgeon performs a cystourethroscopy with dilation of a urethral stricture. CPT Code: 52341 The documentation states that it was a urethral stricture, but the CPT code identifies treatment of ureteral stricture. Correct code: 52281 4. The operative report states that the physician performed Strabismus surgery, requiring resection of the medial rectus muscle. CPT Code: 67314 The CPT code selection is for resection of one vertical muscle, but the medial rectus muscle is horizontal. Correct code: 67311 5. The chiropractor documents that he performed osteopathic manipulation on the neck and back (lumbar/thoracic). CPT Code: 98925 Note in the paragraph before code 98925, the body regions are identified. The neck would be the cervical region; the thoracic and lumbar regions are identified separately. Therefore, three body regions are identified. Correct code: 98926 Instructor's Guide AC210610: Basic CPT/HCPCS Exercises Page 2 of 101 6.
    [Show full text]
  • Complete Draft Code Set Table of Contents
    Draft 2012 Procedural Coding System ICD~10~PCS Complete Draft Code Set Table of Contents Introduction . 1 Eye 080–08Y . 75 The ICD-10 Procedure Coding System (ICD-10-PCS) . 1 Ear Nose and Sinus 090–09W . 86 Introduction . 1 Respiratory System 0B1–0BY . 99 General Development Principles . 1 Mouth and Throat 0C0–0CX . 112 ICD-10-PCS Structure . .. 1 Gastrointestinal System 0D1–0DY . 123 ICD-10-PCS Format . 1 Hepatobiliary System and Pancreas 0F1–0FY . 141 Medical and Surgical Section (0) . 2 Endocrine System 0G2–0GW . 150 Obstetrics Section . 5 Skin and Breast 0H0–0HY . 155 Placement Section . 5 Subcutaneous Tissue and Fascia 0J0–0JX . .166 Administration Section . 6 Muscles 0K2–0KX . 181 Measurement and Monitoring Section . 6 Tendons 0L2–0LX . 189 Extracorporeal Assistance and Performance Section . 7 Bursae and Ligaments 0M2–0MX . .197 Extracorporeal Therapies Section . 7 Head and Facial Bones 0N2–0NW . 207 Osteopathic Section . 7 Upper Bones 0P2–0PW . 217 Other Procedures Section . 8 Lower Bones 0Q2–0QW . 227 Chiropractic Section . 8 Upper Joints 0R2–0RW . 237 Imaging Section . 8 Lower Joints 0S2–0SW . 249 Nuclear Medicine Section . 9 Urinary System 0T1–0TY . 262 Radiation Oncology Section . 9 Female Reproductive System 0U1–0UY . 272 Physical Rehabilitation and Diagnostic Audiology Male Reproductive System 0V1–0VW . 284 Section . 10 Anatomical Regions, General 0W0–0WW . 295 Mental Health Section . 10 Anatomical Regions, Upper Extremities 0X0–0XX . 303 Substance Abuse Treatment Section . 10 Anatomical Regions, Lower Extremities 0Y0–0YR . 309 Modifications to ICD-10-PCS . 10 Obstetrics 102–10Y . 315 Number of Codes in ICD-10-PCS . 11 Placement, Anatomical Regions 2W0–2W6 .
    [Show full text]
  • Bronchography with Hytrast
    Thorax: first published as 10.1136/thx.19.1.37 on 1 January 1964. Downloaded from iThorax (1964), 19, 37 Bronchography with Hytrast B. T. LE ROUX AND J. G. DUNCAN From the Thoracic Surgical and Radiodiagnostic Departments, The Royal Infirmary, Edinburgh Contrast media which outline tube systems are regarded as satisfactory. In a more critical retro- well established radiodiagnostic adjuncts. Tech- spective evaluation of these bronchograms five niques and media may be changed both to increase years later (le Roux, 1962), it was thought that the margin of safety for the patient and to improve there was justification for dissatisfaction in 45% radiographic contrast. In the radiographic demon- rather than 25% of the bronchograms. Improve- stration of bronchi, early techniques, such as the ment in bronchographic technique had made un- insufflation of barium powder through a broncho- acceptable that which in the past had been scope (Jackson, 1918) and the instillation of oily regarded as adequate. With more general use of suspensions of bismuth, were quickly discarded as the combination of sulphonamide with Lipiodol, dangerous. Iodized poppy-seed oil (Lipiodol) was marketed as Visciodol (Burrascano, 1955 ; Johnson the first practical bronchographic agent (Sicard and Irwin, 1959), the hazards of sensitivity to and Forestier, 1922) and was the only medium sulphonamide, of the formation of methaemo- in general use for many years. The main disadvan- globin, and of widespread bronchial obstruction by tage of Lipiodol was its retention in a too viscid preparation became apparent. long pul- copyright. monary parenchyma in a radio-opaque form, In the attempt to obviate these disadvantages, especially where alveolar spill had occurred, so water-soluble media were prepared.
    [Show full text]
  • The History of Contrast Media Development in X-Ray Diagnostic Radiology
    MEDICAL PHYSICS INTERNATIONAL Journal, Special Issue, History of Medical Physics 3, 2020 The History of Contrast Media Development in X-Ray Diagnostic Radiology Adrian M K Thomas FRCP FRCR FBIR Canterbury Christ Church University, Canterbury, Kent UK. Abstract: The origins and development of contrast media in X-ray imaging are described. Contrast media were used from the earliest days of medical imaging and a large variety of agents of widely different chemical natures and properties have been used. The use of contrast media, which should perhaps be seen as an unavoidable necessity, have contributed significantly to the understanding of anatomy, physiology and pathology. Keywords: Contrast Media, Pyelography, Angiography, X-ray, Neuroimaging. I. INTRODUCTION Contrast media have been used since the earliest days of radiology [1], and developments in medical imaging have not removed the need for their use as might have been predicted. The history of contrast media is complex and interesting and has recently been reviewed by Christoph de Haën [2] . The need for contrast media was well expressed by the pioneer radiologist Alfred Barclay when he said in 1913 that ‘The x-rays penetrate all substances to a lesser or greater extent, the resistance that is offered to their passage being approximately in direct proportion to the specific gravity’ [3]. Barclay continued by noting that ‘The walls of the alimentary tract do not differ from the rest of the abdominal contents in this respect, and consequently they give no distinctive shadow on the fluorescent screen or radiogram.’ Barclay clearly states the essential problem confronting radiologists. The density differences that are seen on the plain radiographs are those of soft tissue (which is basically water), bony and calcified structures, fatty tissues, and gas.
    [Show full text]
  • Virtual Tools for Imaging of the Thorax
    Copyright #ERS Journals Ltd 2001 Eur Respir J 2001; 18: 381–392 European Respiratory Journal Printed in UK – all rights reserved ISSN 0903-1936 SERIES 0THORACIC IMAGING 0 . Edited by P.A. Gevenois, A. Bankier and Y. Sibille Number 6 in this Series Virtual tools for imaging of the thorax G.R. Ferretti, I. Bricault, M. Coulomb Virtual tools for imaging of the thorax. G.R. Ferretti, I. Bricault, M. Coulomb. #ERS Dept of Radiology, Hoˆpital Michallon, Journals Ltd 2001. Centre Hospitalier Universitaire, Gre- ABSTRACT: Helical computed tomography (HCT) allows for volume acquisition of noble Cedex 09, France. the entire thorax during a single apnoea. Combination of HCT acquisition with Correspondence: G.R. Ferretti, Service synchronous vascular enhancement gives rise to HCT angiography (HCTA). Central de Radiologie et Imagerie Me´d- In the last decade, HCT and HCTA have revolutionized the diagnosis of thoracic icale, Centre Hospitalier Universitaire, diseases, modifying many diagnostic algorithms. Because HCT provides for a true Grenoble BP 217, F-38043 Grenoble volume acquisition free of respiratory misregistration, three-dimensional (3D) rendering cedex 09, France. techniques can be applied to HCT acquisitions. Fax: 33 476765901 As these 3D rendering techniques present the HCT information in a different format to the conventional transaxial CT slices, they can be summarized as virtual tools. Keywords: Computed tomography The purpose of this review is to give the readers the most important technical aspects helical computed tomography maximum intensity projection of virtual tools, to report their application to the thorax, to answer clinical and scientific minimum intensity projection questions, and to stress their importance for patient management, clinical decision virtual rendering making, and research.
    [Show full text]
  • Odessa College Health & Sciences Division Radiologic Technology Program Course Syllabus Course Number: Radr 2267 (51.0907
    ODESSA COLLEGE HEALTH & SCIENCES DIVISION RADIOLOGIC TECHNOLOGY PROGRAM COURSE SYLLABUS COURSE NUMBER: RADR 2267 (51.0907) COURSE TITLE: Practicum V - Medical Radiologic Technology/Technician CREDIT HOURS: 2 LECTURE HOURS: 0 LAB HOURS: 20 PREREQUISITES: RADR 2366 or consent of the department chair COREQUISITES: RADR 1191 and RADR 2313 CATALOG DESCRIPTION: Practical, general workplace training supported by an individualized learning plan developed by the employer, college, and student. A health practicum will be an unpaid learning experience. Introduces the student to special clinical rotations. Requires rotating through different work areas. Competencies include: discussion and demonstration of all standard radiographic positions and ability to produce radiographic images on trauma patients, with direct supervision (precompetency) and indirect supervision (postcompetency), to include radiographic image evaluation regarding anatomy, positioning and technical factors (SCANS 1,4,5,8,11) TEXTBOOK: Program Student Handbook, Program faculty The Radiography Procedure and Competency Manual; Anita Biedrzycki SUPPLIES: A fully staffed, well-run facility with equipment and examinations necessary for a well-rounded educational experience. LEARNING OUTCOMES: : As outlined in the learning plan, the student will: A. apply the theory, concepts, and skills involving specialized materials, tools, equipment, procedures, regulations, laws, and interactions within and among political, economic, environmental, social, and legal systems associated with the occupation and the business/industry B. demonstrate legal and ethical behavior, safety practices, interpersonal and teamwork skills, and appropriate written and verbal communication skills using the terminology of the occupation and the business/industry. After completing this clinical practicum, the student should be able to demonstrate competency in: A. operation of general radiologic equipment with direct supervision(pre-competency) and indirect supervision (post-competency).
    [Show full text]
  • EANM Guidelines for Lung Scintigraphy in Children
    Eur J Nucl Med Mol Imaging (2007) 34:1518–1526 DOI 10.1007/s00259-007-0485-3 GUIDELINES Guidelines for lung scintigraphy in children Gianclaudio Ciofetta & Amy Piepsz & Isabel Roca & Sybille Fisher & Klaus Hahn & Rune Sixt & Lorenzo Biassoni & Diego De Palma & Pietro Zucchetta Published online: 30 June 2007 # EANM 2007 Abstract The purpose of this set of guidelines is to help the perfusion studies, the technique for their administration, the nuclear medicine practitioner perform a good quality lung dosimetry, the acquisition of the images, the processing and isotope scan. The indications for the test are summarised. The the display of the images are discussed in detail. The issue of different radiopharmaceuticals used for the ventilation and the whether a perfusion-only lung scan is sufficient or whether a full ventilation–perfusion study is necessary is also addressed. The document contains a comprehensive list of references and Under the Auspices of the Paediatric Committee of the European Association of Nuclear Medicine. some web site addresses which may be of further assistance. G. Ciofetta Keywords Lung scintigraphy. Radiopharmaceuticals . Unità di Medicina Nucleare, Ospedale Pediatrico Bambin Gesù, Rome, Italy Ventilation . Perfusion . Dosimetry A. Piepsz CHU St. Pierre, Purpose Brussels, Belgium I. Roca The purpose of this guideline is to offer the nuclear medicine Hospital Vall d’Hebron, team a helpful framework in daily practice. This guideline Barcelona, Spain deals with the indications, acquisition, processing and S. Fisher : K. Hahn interpretation of lung scintigraphy in children. It should be Klinik für Nuklearmedizin, University of Munich, taken in the context of “good practice” of nuclear medicine Munich, Germany and local regulations.
    [Show full text]