CENTRAL 5 PDF Medical Imaging Procedures

 ❖ Thoracic Spine AP Technical factors: Cassette size: 14*17 80-90 kVp SID: 100 cm Respiration: suspend expiration Basic Patient Position: The patient lies supine on the table midline aligned to the midline of the table, the ASISs and the acromio clavicular joints ar...

 ❖ Thoracic Spine AP Technical factors: Cassette size: 14*17 80-90 kVp SID: 100 cm Respiration: suspend expiration Basic Patient Position: The patient lies supine on the table midline aligned to the midline of the table, the ASISs and the acromio clavicular joints are equidistant from the table ensuring the midsaggital plane is at 90 degrees to the table. The neck is extended to avoid superimposition of the mandible on the upper thoracic spine, flexion of the hips and knees may help for stability ASIS AND ACROIMIO CLAVICULAR ‫ال‬, ‫هال بدنا نشرح الوضعية هال بكون المريض متمدد على الطاولة‬ ‫الرقبة مثنية لحتى ما يصير عنا سوبرامبوزشن بين الفك السفلي من الفم‬,‫ عمتساويات بالمساغة على الميدسجيتل بالن‬JOINT. ‫هال ممكن نثني الركبة والوركين لحتى يساعد على استقرار وثبات المريض‬, THORACIC SPINE ‫مع الجزء العلوي من‬ Central Ray: The vertical central ray is centered in the midline to T7 midway between the xiphisternum and the sternal angle. Anatomy Demonstrated: Thoracic vertebra, medial ends of ribs. Evaluation of the Image: Limits of the examination, superiorly C7 inferiorly L1, laterally 5 cm of the proximal ends of the ribs. The sterno clavicular joints should be projected symmetrically, the spinous processes are projected over the centers of the vertebral bodies. the intervertebral joints should be visible ‫هون بيحكيلنا عن حدود الي الزم تظهر بالصورة تمام يعني بس‬ ‫اخد الصورة شو األجزاء يلي الزم تبان‬ ‫هاي اتطلعو عليها لالحتياط ولوو انو الدكتور حكى ما بجيب اناتومي‬  ❖ Thoracic Spine Lateral Technical factors: Cassette size: 14*17 85-95 kVp SID: 100 cm Respiration: suspend expiration Basic Patient Position: The patient lies on one side on the table, mid-sagittal plane parallel to the table top and mid coronal plane midline aligned to the midline of the table, the hips and knees flexed to support the patient and minimise movement, raising the arms well above the head maximises visualisation of the upper vertebrae. ‫ الوركين والركب مثنية لحتى نقلل الحركة‬UPPER VERTEBRAE ‫هال بيحكيلنا بكون المريض متمدد اديه فوق راس لحتى نشوف ال‬ Evaluation of the Image: Limits of the examination, superiorly the upper border of C7, inferiorly the lower border of L1, laterally the medial part of the ribs. The intervertebral joint spaces and the spinous processes should be visible ❖ Positioning considerations: → In AP of spine knees should be flexed to position the spine closer or parallel to the film ‫الزم نقني الركبتين مشان يصير العمود الفقري أقرب للفيلم‬ → PA has advantage over AP: 1. Better to visualize the intervertebral disks 2. Reduces lower female ovarian dose 25-30% compared with AP %30-25 ‫ بنسبة‬Lower female ovarian ‫ على‬Dose ‫وبقل‬ Intervertebral discs ‫ في تصوير‬AP ‫ أفضل من‬PA → Disadvantage Increase magnification because of increasing OID OID ‫ولكن تكمن سلبيته ب زيادة التكبيربسبب زيادة‬  ❖ Collimation: Good collimation and using of lead mat which is positioned behind the patient in Lat spine reduce the scatter radiation reaching the IR ‫الزم يكون‬Collimation ‫استخدام‬ Scatter ‫ توضع خلف المريض لتقليل‬Lead mat ‫مزبوط ويتم‬ ❖ AP Lumbar spine: Indications for imaging: Congenital abnormalities, trauma, pain, metastasis's ‫ ورم خبيث‬، ‫ األلم‬، ‫ الصدمة‬، ‫يتم تصويرها في حاالت التشوهات الخلقية‬ Exposure factors: 75-80 kV 35*43 Exposure is made on suspended expiration Basic Patient Position: The patient lies supine on the table midline aligned to the midline of the table, the hips and knees flexed 45 degrees to reduce the lumbar curve, the ASISs are equidistant from the table ensuring the midsaggital plane is at 90 degrees to the table. ‫ درجة لحتى‬45 ‫بكون المريض مستلقي على ظهره وبثني ركبتيه وببعدهم عن بعض‬ Lumber curve ‫يقلل من ال‬ Central Ray: The vertical central ray is centered in the midline at the level of L3 at the lower costal margin, if the sacrum and SI joints are required ,the vertical central ray may be centered in the midline at the level of the iliac crests. ‫ اذا كان‬lower costal margin‫ عند‬L3‫المركز بكون عند الميدالين على مستوى‬ ‫ بكون المركز عند الميدالين على مستوى‬SI joints ‫ و‬sacrum‫مطلوب تصوير‬ iliac crests  ❖ Lumbar Spine Lateral: Exposure factors: 85-95 kV 35*43 Lead mat is used Exposure is made on suspended expiration Basic Patient Position: The patient lies on the table with their long axis in line with the long axis of the table, a line at a tangent to the third lumbar vertebra should be in line with the midline of the table. The hips and knees are flexed for stability and the hands are placed on a pillow in front of the patients face. Ensure the line of the spinous processes are parallel to the table if not use pads to adjust the position. ‫بكون المريض مستلقي على جنب وبثني الركبتين أو بعمل ( كروس ) بأرجله‬ Central Ray: The vertical central ray is centered in line with the highest point of the iliac crest at a point midway between the lower costal margin and the iliac crest of the raised side. iliac crest ‫بكون المركز على أعلى نقطة ب‬ ‫ من الجانب المرتفع‬Iliac crest ‫ و‬lower costal magin ‫وهي النقطة يلي بين‬ ❖ Lumbar Spine Posterior oblique: Exposure factors: 75-80 kV 35*43 Exposure is made on suspended expiration  Basic Patient Position: From supine position the patient is rotated 45 degrees with the side to be imaged raised, and supported on pads, with the hips and knees slightly flexed to aid stability. ‫ درجة بحيث يكون الجانب ال ُمراد‬45 ‫بكون المريض مستلقي وبنعمله دواران‬ ‫تصويره باألعلى مع ثني الركبتين شوي‬ Central Ray: The vertical central ray is centered to a point midway between the lower costal margin and the iliac crest on the raised side in the mid clavicular line iliac crest ‫ و‬lower costal margin ‫بكون المركز عند النقطة يلي بين‬ Midclavicular line ‫من الجانب المرتفع في‬ ❖ Hyperflexion and hyperextension of LS: Exposure factors: 85-95 kV 35*43 Lead mat is used Exposure is made on suspended expiration CR: lower costal margin ‫هاي الوضعية مابنستخدمها في حاالت الديسك النها رح تكون مؤلمة ع المريض‬