Radiographic Techniques PDF

Radiographic techniques  Lungs , AP ,lateral , apical view , shown structure, interpretation system, lordotic position  :BY Ahmed Jasem Abass  MSC of Medical Imaging Antero-posterior – erect  This projection is used as an alternative to the PA erect...

Radiographic techniques  Lungs , AP ,lateral , apical view , shown structure, interpretation system, lordotic position  :BY Ahmed Jasem Abass  MSC of Medical Imaging Antero-posterior – erect  This projection is used as an alternative to the PA erect projection when the medical condition makes it difficult or unsafe for the patient to stand or sit for the basic projection. For the latter, the patient is usually supported sitting erect on a trolley against a vertical Bucky  Position of patient and image receptor  The patient may be standing or sitting with their back against the image receptor, which is supported vertically with the upper edge of the receptor above the lung apices.  The median sagittal plane is adjusted at right-angles to the middle of the receptor.  The shoulders are brought downward and forward, with the backs of the hands below the hips and the elbows well forward, which has the effect of projecting the scapulae clear of the lung fields. Antero-posterior – erect  Direction and location of the X-ray beam  The collimated horizontal beam at right-angles to the sternum and centred midway between the sternal notch and the xiphisternum.  The exposure is taken on normal full inspiration.  Radiological considerations  This projection moves the heart away from the image receptor plane, increasing magnification and reducing the accuracy of assessment of heart size. Antero-posterior – erect Antero-posterior – supine  Position of patient and image receptor  The patient lies in supine position, the cassette is carefully positioned under the patient’s chest with the upper edge of the cassette above the lung apices (C7 prominence) to ensure that the lung fields are included on the image.  The median sagittal plane is adjusted at right-angles to the middle of the receptor, and the patient’s pelvis is checked to ensure that it is not rotated.  The arms should be beside the trunk the head is supported on a pillow, with the chin slightly raised.  Direction and location of the X-ray beam  The collimated vertical beam at right-angles to the sternum and centred midway between the sternal notch and the xiphisternum. Antero-posterior – supine Antero-posterior – semi-erect  This semi-recumbent position is adopted as an alternative to AP erect projection when the patient is too ill to stand or sit erect without support. 35 × 43 cm CR cassette is selected.  Position of patient and image receptor  The patient is supported in a semi-recumbent position facing the X-ray tube. The degree to which they can sit erect will be dependent on their medical condition.  The image receptor is supported against the back, with its upper edge above the lung fields.  The median sagittal plane is adjusted at right-angles to and in the midline of the image receptor.  Rotation of the patient is prevented by the use of foam pads.  The arms are rotated medially with the shoulders brought forward to bring the scapulae clear of the lung fields. Antero-posterior – semi-erect  Direction and location of the X-ray beam  The collimated horizontal beam is first directed at right angles to the image receptor and then angled caudally centred midway between the sternal notch and the xiphisternum.  The degree of caudal angulation are (5–10°). This will ensure maximum visualization of the lung fields and that the clavicles do not obscure the lung apices. Antero-posterior – semi-erect Lateral (Figs 7.17a–7.17d)  A supplementary lateral projection may be useful in certain clinical circumstances for localizing the position of a lesion and demonstrating anterior mediastinal masses not shown on the PA projection. However, it is now normal practice to undertake a CT examination if a lesion has been identified.  Lateral radiographs are not taken as part of a routine examination of the lung fields, because of the additional radiation patient dose. 35 × 43 cm CR cassette used. Lateral  Position of patient and image receptor  The erect patient is turned to bring the side under investigation in contact with the image receptor.  The median sagittal plane is adjusted parallel to the image receptor.  The arms are folded over the head or raised above the head to rest on a horizontal bar support.  The mid-axillary line is coincident with the middle of the Bucky, and the receptor is adjusted to include the apices and the lower lobes to the level of the 1st lumbar vertebra.  Direction and location of the X-ray beam  The collimated horizontal beam is directed at right- angles to the middle of the image receptor coincident with the midaxillary line. Lateral Lateral Apices  Opacities obscured in the apical region by overlying ribs or clavicular shadows may be demonstrated by modification of the PA and AP projections.  Direction and location of the X-ray beam  With the patient in the position for the PA projection, the collimated beam is angled 30° caudally and centred over the 7th cervical spinous process coincident with the sternal angle.  With the patient in the position for the AP projection, the central ray is angled 30° cranial towards the sternal angle. Apices Apices Lordotic  This technique may be used to demonstrate right middle- lobe collapse or an inter-lobar pleural effusion. The patient is positioned to bring the middle-lobe fissure horizontal.  Position of patient and cassette  The patient is placed for the postero-anterior projection.  Then clasping the sides of the vertical Bucky, the patient bends backwards at the waist.  The degree of dorsiflexion varies for each subject, but in general it is about 30–40 degrees.  Direction and centring of the X-ray beam  The horizontal ray is directed at right-angles to the cassette and towards the middle of the film. Lordotic Thank You