Radiology & Medical Imaging

 Percutaneous Transhepatic Cholangiography ( PTC ) PTC is an x-ray procedure that involves direct-inject of contrast medium in the bile duct. These are the ducts that carry bile from the liver to the gallbladder and small intestine In this procedure, a thin needle is directly inserted through the skin into the liver to reach the bile duct. Indications Contraindication Equipment Patient Preparation Procedure Aftercare Complication                 Indications ERCP procedure is failed  Strictures in the bile duct Suspected bile duct obstruction Billary system delineation in the presence of intra and extrahepatic biliary calculi Cause of Jaundice Suspected tumor Anatomic evaluation of complications of ERCP                     Contraindications Suspected pregnancy Allergic to contrast medium Bleeding tendency Gross Ascites - Fluid in the abdominal cavity Sever infection at the puncture site Chronic liver disease Billary tract sepsis            Equipment Fluoroscopic unit with spot film ligh

 Ultrasound of the aorta The anatomy of the abdominal aorta runs from the aortic hiritis to the bifurcation it has three major anterior branches the celiac axis at t12 the sma at l1 the ima at l2 it has multiple paired branches of which the most significant is the renal arteries at t2 the gonadal arteries and there are four paired lumber arteries this these are the gonadal arteries the celiac artery and the sma arise from the anterior aspect of the proximal aorta, this is the select axis and this is the sma in one to three percent of patients the celiac artery and the sma arise from a common trunk this is the common trunk coming off here and giving off the celiac.  Aorta technique The abdominal aorta technique measures the aorta and common iliac arteries from the outer diameter in the ap and transverse planes. Doppler tips Doppler tips aliasing is a marker of stenosis the doppler spectrum should be obtained from the site of aliasing or turbulent flow in this case from the origin of the

Sialography The disease of the salivary glands they would inject contrast in order to be able to kind of see because at the site the salivary glands don't show up on a regular x-ray and so you have to get some contrast in there and a lot of times they use just a tiny little amount of oil-based contrast. The parotid is the submandibular  also called the submaxillary and then the  sublingual and these glands. Indications: Detection of calculi, foreign body Detect the extent of destruction of the gland Detection of fistulae and strictures Diagnosis swelling and inflammation Demonstration of tumor Selection of biopsy site  Stones in saliva  glands there could be strictures which  that's anytime you've got one of these  ducts that are being clamped off by either  deposition of some kind of detritus in  the gland you know this is causing it to  get narrower or there could be a growth  near the gland that's cutting it off and  what would happen here is that somebody  would hav

 Contrast Media side effects The contrast media had some negative effect on one or more organs let us look at seven common organ systems where contrast media exhibits its toxic effects Vascular toxicity Soft tissue toxicity cardiovascular Toxicity hematological changes Nephrotoxicity Neurotoxicity Thyrotoxicosis Vascular toxicity is the toxic effect of contrast media on the blood vessels contrast media can negatively affect the two main types of blood vessels the veins and the arteries for the venous system many contrast agents are given intravenously through the veins and if you've ever received an injection you would agree that pain can be experienced at the site of injection another toxic effect that contrast has on the venous system is stasis because the flow of blood is slow in the venous system a stagnancy or stasis of the contrast media can occur in this, the contrast does not move through the vein it accumulates in one place which would cause pain that commonly occurs in th

Lung ultrasound is really four positions Position one and you kind of slide down position two and you slide down position three which is kind of the right upper quadrant review analogous to your faster view and then you know the position for the contralateral side a left upper quadrant view and the reason why the bowels come into play or you know the abdominal content is that on this kind of upright upper and left upper quadrant views you're gonna be using the liver and spleen respectively as your acoustic window to try to look above the diaphragm there so some technical considerations what does long actually look like on ultrasound. Lung on ultrasound and you're correct you really can't see along with an ultrasound but if you know the artifacts then the addition of artifacts or the subtraction of artifacts or you know a change in the artifacts might potentiate some pathology  Common ultrasound artifacts lines are normal things you would see on altars and lung sliding is a

Ultrasound criteria of appendix ultrasound  >6mm Noncompressible structure  Pain with transducer pressure Presence of free fluid Signs of obstruction  The criteria again are going to be an appendix that's enlarged greater than 6 millimeters it is a non-compressible structure the people will have pain with transducer pressure there may be the presence of free fluid and there may be signs of obstruction or ileus so the way that we scan. we can use the linear probe if the patient size allows us and we can start by mowing the lawn at the edge of the liver or we can start down by the iliac crest if we start at the edge of the liver we're going to look for the gas in the colon as seen in this scan right here and we will follow that down until we see a tubular noncompressible structure and here we also see hyperechoic fat suggesting inflammation or stranding around the appendix just deep to the appendix we will see in this clip the iliopsoas muscle right here you can see the muscle

 T he different types of Doppler  ultrasound  The differences  between the different types  of Doppler imaging commonly used in  radiology.  Pulse wave Doppler  ultrasound: When you use pulse wave Doppler ultrasound you are measuring frequency  shifts within  a narrowly defined doppler gate or  sample  that doppler gate tends to be only a  tiny fraction  of your field of view, you want to place  that doppler gate in the center of the  vessel of interest  and recognize that you are only  measuring frequency shifts  between these two little parallel lines  those frequency shifts are then recorded  to generate a waveform and that waveform  is a reflection of the relative change  in velocity  over the cardiac cycle when we angle  correct  for the direction of flow relative to  our ultrasound beam  we can then generate velocity  measurements  that is accurate when angling correction  is accurate. Spectral wave  doppler ultrasound image  The importance of the  different lines  or markings on