Other Imaging Modalities How

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Other Imaging Modalities How When

• For Nottingham SCRUBS 26th August 2006
• Presented by Mathew

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Other Imaging Modalities

• Ultrasound
• CT
• MRI
• Contrast Studies
• Isotope Studies
• Others Intravenous Urograms, etc

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Ultrasound

• No radiation, Non invasive
• Easily available
• Especially good for obs gynae, renal,
  cardiac
• Particularly suited to imaging soft tissues
• The major disadvantage is that the resolution of
  images is often limited as
• Ultrasound is reflected very strongly on passing
  from tissue to gas, or vice versa.
• Ultrasound does not pass well through bone

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Ultrasound
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Ultrasound
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Ultrasound image
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Ultrasound image

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Ultrasound image - Longitudinal view

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Pathologies

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• Gallstones

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• Liver metastasis

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CT
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Principle of CT
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CT

• High radiation, but extremely useful
• 1st line investigation in many settings
• Contrast non contrast scans
• Head ,neck, chest, abdomen, pelvis
• Not very good for , characterization of some
  tumours

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CT

• With contrast
• Oral and i.v
• Contrast delineates structures better
• vessels from l.n
• bowel from rest (if oral contrast given)
• Without contrast
• Acute bleeds
• Renal stones

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CT abdo anatomy noncont/cont
PIC 3

• Non-contrast

With contrast
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CT head anatomy noncont/cont

• Non-contrast

With contrast
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Pathology
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• Liver mets

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• RCC

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• Sub-dural

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• Brain tumour

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MRI

• Advantages
• NO IONISING RADIATION
• Better evaluation of diseased tissue (2)
• Evaluating tumours, cysts, and bulging or
  herniated discs in the spine
• Diagnosing strokes in their earliest stages
• Diagnosing multiple sclerosis (MS)
• Diagnosing tumours of the pituitary gland and
  brain

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MRI

• Contraindications/limitations
• Cardiac pacemaker
• Ferromagnetic metals foreign bodies,
  defibrillators, met heart valves, ear implants
• Not good for imaging bones

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• Brain sac

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• Spine sac

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Barium swallow

• Visualises the inner lumen the pharynx
  oesophagus
• Good for picking up mass lesions, strictures,
  reflux disease, HH
• Where OGD is contraindicated

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Barium swallow
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Barium swallow
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Barium meal

• Visualises stomach and duodenum the same way

PIC 7
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Barium follow through (SBM)

• Small bowel
• Indications
• malabsorption syndromes,
  neoplasm
• Disadvantages
• time consuming, not direct
  visualisation

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Barium follow through (SBM)
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Barium enema

• Large bowel
• Advantages
• - neoplasms, polyps,
  divericula
• - good for failed
  colonoscopies

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Barium enema
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Isotope scans

• Bone scans
• Cardiac scans
• Renal scans
• Lung scans
• Thyroid, parathyroid scans
• SPECT
• PET

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Bone scan

• Identifies new areas of bone growth or breakdown

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Bone scans
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Perfusion scan
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PET scan
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PET scan
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IVU
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IVU

• P renal pelvis
• B Bladder

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Angiograms

• Cerebral
• Pulmonary
• Renal
• Peripheral

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CerebralAngiogram
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Pulmonary Angiogram
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PulmonaryAngiogram
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RenalAngiogram
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PeripheralAngiogram
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3D