Lecture 4 Imaging Techniques in Chest, Heart, Abdomen, and Pelvis PDF

Lecture 4 Imaging Techniques in Chest, Heart, Abdomen, and Pelvis Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo University 1  Introduction As physiotherapists, understanding various imaging techniques is crucial for comprehensive...

Lecture 4 Imaging Techniques in Chest, Heart, Abdomen, and Pelvis Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo University 1  Introduction As physiotherapists, understanding various imaging techniques is crucial for comprehensive patient care. Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 2 University  1. Ultrasonography Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 3 University  1.1 Ultra Sonography Basic Principles - Review Uses high- frequency sound waves to create real-time images Different tissues have varying acoustic properties, creating contrast in images Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 4 University Ultrasonography – Chest & Heart Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 5 University  1.2 Ultrasonography Applications in Physiotherapy – Chest and Heart Evaluation of pleural effusions: Guides thoracentesis and monitors treatment progress Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 6 University  1.2 Ultrasonography Applications in Physiotherapy – Chest and Heart Evaluation of pleural effusions: Guides thoracentesis and monitors treatment progress Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 7 University  1.2 Ultrasonography Applications in Physiotherapy – Chest and Heart Echocardiography for cardiac function: Ejection fraction Valve function Chamber sizes Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 8 University  1.2 Ultrasonography Applications in Physiotherapy – Chest and Heart Echocardiography for cardiac function: Ejection fraction Valve function Chamber sizes Evaluation of Pericardial effusions Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 9 University  1.2 Ultrasonography Applications in Physiotherapy – Chest and Heart Echocardiography for cardiac function: Ejection fraction Valve function Chamber sizes Evaluation of Pericardial effusions Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 10 University 1.2 Ultrasonography Applications in Physiotherapy – Chest and Heart Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 11 University Ultrasonography – Abdomen & Pelvis Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 12 University 1.2 Ultrasonography Applications in Physiotherapy – Abdomen and Pelvis Identification of abdominal aortic aneurysms: informs exercise prescription and precautions Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 13 University  1.2 Ultrasonography Applications in Physiotherapy – Abdomen and Pelvis Assessment of bladder volume Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 14 University 1.2 Ultrasonography Applications in Physiotherapy – Abdomen and Pelvis Measurement of rectus abdominis diastasis Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 15 University 1.2 Ultrasonography Applications in Physiotherapy – Abdomen and Pelvis A physiotherapist uses ultrasound to assess diaphragm movement in a patient with COPD. The imaging reveals reduced diaphragm excursion. This information is used to tailor breathing exercises and manual techniques to improve diaphragm function. Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 16 University Ultrasonography – Advantages & Limitations Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 17 University 1.3 Ultrasonography Advantages & Limitations - Review Advantages: Real-time imaging: allows dynamic assessment of structures Portable: can be used at bedside or in clinics Cost-effective: compared to MRI and CT No ionizing radiation: safe for repeated use and in pregnancy Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 18 University 1.3 Ultrasonography Advantages & Limitations - Review Limitations: Limited penetration in obese patients: may reduce image quality Difficult to image air-filled structures: limits chest imaging Highly operator-dependent: requires skill and experience for accurate interpretation Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 19 University  2. Magnetic Resonance Imaging (MRI) Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 20 University 2.1 MRI Basic Principles - Review Uses strong magnetic fields and radio waves Excellent soft tissue contrast: superior for assessing muscles, ligaments, and nerves Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 21 University MRI – Chest & Heart Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 22 University 2.2 MRI Applications in Physiotherapy – Chest and Heart Evaluation of cardiac structure and function: Myocardial viability assessment Congenital heart defects Cardiac masses Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 23 University 2.2 MRI Applications in Physiotherapy – Chest and Heart Evaluation of cardiac structure and function: Myocardial viability assessment Congenital heart defects Cardiac masses Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 24 University 2.2 MRI Applications in Physiotherapy – Chest and Heart Evaluation of cardiac structure and function: Myocardial viability assessment Congenital heart defects Cardiac masses Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 25 University 2.2 MRI Applications in Physiotherapy – Chest and Heart Evaluation of cardiac structure and function: Myocardial viability assessment Congenital heart defects Cardiac masses Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 26 University 2.2 MRI Applications in Physiotherapy – Chest and Heart Assessment of thoracic spine and chest wall soft tissues: Intervertebral disc pathologies Spinal cord compression Chest wall tumors Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 27 University 2.2 MRI Applications in Physiotherapy – Chest and Heart Assessment of thoracic spine and chest wall soft tissues: Intervertebral disc pathologies Spinal cord compression Chest wall tumors Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 28 University 2.2 MRI Applications in Physiotherapy – Chest and Heart Assessment of thoracic spine and chest wall soft tissues: Intervertebral disc pathologies Spinal cord compression Chest wall tumors Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 29 University MRI – Abdomen & Pelvis Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 30 University 2.2 MRI Applications in Physiotherapy – Abdomen and Pelvis Detailed imaging of abdominal organs: liver, kidneys, pancreas Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 31 University 2.2 MRI Applications in Physiotherapy – Abdomen and Pelvis Evaluation of pelvic floor disorders: Pelvic organ prolapse Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 32 University 2.2 MRI Applications in Physiotherapy – Abdomen and Pelvis Assessment of sacroiliac joints Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 33 University 2.2 MRI Applications in Physiotherapy – Abdomen and Pelvis Assessment of sacroiliac joints Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 34 University 2.3 Clinical Scenario A physiotherapist uses MRI findings to plan a rehabilitation program for a patient with low back pain. The MRI reveals a L4-L5 disc herniation with nerve root compression Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 35 University MRI – Advantages & Limitations Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 36 University 2.4 Advantages and Limitations Advantages: Excellent soft tissue contrast: superior for musculoskeletal assessment Multiplanar imaging: allows visualization in any plane No ionizing radiation: safe for repeated use Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 37 University 2.4 Advantages and Limitations Limitations: Expensive: may limit accessibility Time-consuming: sequences can take 30-60 minutes Contraindicated in patients with certain metal implants or claustrophobia Motion artifacts can degrade image quality Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 38 University 2.4 Advantages and Limitations Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 39 University  3. Computed Tomography (CT) Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 40 University 3.1 Basic Principles Uses X-rays to create cross- sectional images Excellent for bone and lung imaging due to high contrast between air, soft tissue, and bone Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 41 University CT – Chest & Heart Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 42 University 3.2 Applications in Physiotherapy – Chest & Heart Evaluation of lung parenchyma and airways Normal Lungs Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 43 University 3.2 Applications in Physiotherapy – Chest & Heart Evaluation of lung parenchyma and airways: Chronic obstructive pulmonary disease (COPD) Bronchiectasis Interstitial lung diseases Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 44 University 3.2 Applications in Physiotherapy – Chest & Heart Evaluation of lung parenchyma and airways: Chronic obstructive pulmonary disease (COPD) Bronchiectasis Interstitial lung diseases Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 45 University 3.2 Applications in Physiotherapy – Chest & Heart Evaluation of lung parenchyma and airways: Chronic obstructive pulmonary disease (COPD) Bronchiectasis Interstitial lung diseases Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 46 University CT – Abdomen & Pelvis Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 47 University 3.2 Applications in Physiotherapy – Abdomen & Pelvis Assessment of abdominal organs and vasculature Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 48 University 3.2 Applications in Physiotherapy – Abdomen & Pelvis Assessment of abdominal organs and vasculature: Liver cirrhosis Renal stones Abdominal aortic aneurysms Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 49 University 3.2 Applications in Physiotherapy – Abdomen & Pelvis Assessment of abdominal organs and vasculature: Liver cirrhosis Renal stones Abdominal aortic aneurysms Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 50 University 3.2 Applications in Physiotherapy – Abdomen & Pelvis Assessment of abdominal organs and vasculature: Liver cirrhosis Renal stones Abdominal aortic aneurysms Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 51 University 3.2 Applications in Physiotherapy – Abdomen & Pelvis Evaluation of bony pelvis and hip joints Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 52 University 3.2 Applications in Physiotherapy – Abdomen & Pelvis Evaluation of bony pelvis and hip joints: Fractures Femoroacetabular impingement Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 53 University 3.2 Applications in Physiotherapy – Abdomen & Pelvis Evaluation of bony pelvis and hip joints: Fractures Femoroacetabular impingement Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 54 University CT – Advantages & Limitations Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 55 University 3.3 CT – Advantages & Limitations Advantages: Rapid acquisition: useful for trauma and acute conditions Excellent for bone and lung imaging: superior to MRI for these structures Less motion artifact compared to MRI: better for patients who can't remain still Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 56 University 3.3 CT – Advantages & Limitations Limitations: Ionizing radiation exposure: limits repeated use, especially in young patients Limited soft tissue contrast compared to MRI: less useful for muscle and ligament assessment Potential for contrast-related complications: allergic reactions or kidney damage Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 57 University  4. Comparative Analysis of Imaging Modalities Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 58 University  Feature Ultrasonography MRI CT Radiation None Ionizing radiation Soft Tissue Good Excellent Moderate Contrast Bone Imaging Limited Good Excellent Real-time Yes No Imaging Cost Low High Moderate Speed Fast Slow Fast Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 59 University 5. Practice Questions Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 60 University Practice Questions 1. Which imaging modality is best suited for real-time assessment of diaphragm movement in patients with COPD? a) CT b) MRI c) Ultrasonography d) X-ray Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 61 University Practice Questions 2. What is a major advantage of MRI over CT in imaging the chest and abdomen? a) Faster acquisition time b) Better bone imaging c) No ionizing radiation d) Lower cost Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 62 University Practice Questions 3. Which of the following is NOT a common application of ultrasonography in chest imaging? a) Evaluation of pleural effusions b) Assessment of diaphragm movement c) Echocardiography d) Visualization of lung parenchyma Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 63 University Practice Questions 4. Which imaging modality is most appropriate for evaluating coronary artery calcium scoring? a) Ultrasonography b) MRI c) CT d) PET scan Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 64 University Practice Questions 5. What is a significant limitation of ultrasonography in abdominal imaging? a) High cost b) Radiation exposure c) Limited penetration in obese patients d) Poor soft tissue contrast Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 65 University Practice Questions 6. Which of the following conditions is best evaluated using CT imaging? a) Pelvic floor muscle dysfunction b) Myocardial viability c) Bronchiectasis d) Rotator cuff tear Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 66 University Practice Questions 7. What is the primary advantage of CT over MRI in imaging the lungs? a) Better soft tissue contrast b) No radiation exposure c) Faster acquisition time d) Superior visualization of air-filled structures Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 67 University Practice Questions 8. Which imaging modality would be most appropriate for assessing sacroiliac joint dysfunction in a pregnant patient? a) CT b) MRI c) Ultrasonography d) X-ray Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 68 University Practice Questions 8. Which imaging modality would be most appropriate for assessing sacroiliac joint dysfunction in a pregnant patient? a) CT b) MRI c) Ultrasonography d) X-ray Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 69 University Answers Question Answer 1 c 2 c 3 d 4 c 5 c 6 c 7 d 8 c Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 70 University