Term
| 2 things required for MRI |
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Definition
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Term
| Contraindications for MRI |
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Definition
pacemaker
some stents
breast tissue expanders
Body piercings in area being scanned
inability to lay still for 30-60 min |
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Term
| What are some advantages to MRI? |
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Definition
Bony and soft tissue visualized
allows for visualization of very small structures (1mm)
non-invasive
no radiation
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Term
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Definition
length exams
uncomfortable positions
undetectable impants are harmful
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Term
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Definition
masses/tumors
joints/musculoskeletal
vascular |
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Term
| What are some advantages of open vs. traditional MRI |
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Definition
Traditional - more efficient - shorter and requires less equipment
open - better for obese/claustrophobic people |
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Term
| Things to consider when scanning a pregnant pt |
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Definition
Never use contrast
Don't scan for "typical" pregnancy complaints
things to image: stroke, mass |
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Term
| When would you do a chest MRI? |
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Definition
| if there is a mass that can't otherwise be imaged. |
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Term
| What is the one MRI exam that requires pt prep? |
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Definition
| MRCP to assess bile ducts - NPO for 4 hours before test |
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Term
What are three instances when you would use contrast in MRI?
Three with no contrast? |
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Definition
Contrast: Mass, cancer, infection
No contrast: pain, kidney failure, pregnancy |
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Term
| What is the difference between a T1 and T2 image? |
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Definition
T1 - lighter contrast. Assses bony anatomy
T2 - darker. assesses patholgy. bright areas indicate fluid infiltraiton |
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Term
| what are some soft tissue pelvic exams to image using MRI? |
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Definition
female anatomy
rectal exam
prostate exam |
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Term
| How does nuclear radiation work? |
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Definition
| emit no radiation but absorb radiaiton from the pt |
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Term
Average time for nuc med exam
Prep? |
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Definition
20 min avg. up to 3 hours
prep can take hours to days, depending on the radioactive substance used |
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Term
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Definition
kidney fxn
blood flow across heart
lungs
gallbladder fxn
bones (fx, infection, inflammation, arthritis, tumor)
cancer
GI bleeding
infection
thyroid fxn |
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Term
| What are two therapies to relieve pian from end-stage cacner? |
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Definition
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Term
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Definition
use F18 FDG (radioactive sugar)
nothing to eat or drink
lay in a dark room for 45 min before exam so there's as little brain activity as possible
used to identify cacner and the response to therapy |
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Term
| Bone scans are done for what 3 types of Cancer? |
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Definition
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Term
| Why is FDG used to image cancer in PET? |
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Definition
| malignant tumors tend to have increased number of glucose transporter proteins and increased glycolytic enzyme levels so they exhibit increased FDG uptake compoared to normal cells. |
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Term
| SPECT (single photon emission tomography) and NM sestamibi (Mibi or lexiscan) or stress test (as sub for Mibi) are used for what kind of imaging? |
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Definition
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Term
| Gated imaging (NM MUGA) is used to what kind of imaging? |
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Definition
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Term
| SPECT NM 201 thallium and PET 18F-FDG are used for what kind of imaging? |
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Definition
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Term
| 6 indications for stress test |
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Definition
Coronary artery disease
Degree of stenosis and impact on regional perfusion
assessment of ischemia v. scarring (risk assessment for MI)
pre-op for major surgery
monitoring (CHF, post-treatment for revascularization)
chest pain (most common) |
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Term
| Differences between treadmill and chemical stress imgaing |
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Definition
Treadmill - immediate results
NPO prior to test
Chemical: 1 1/2 hour wait
pt should eat prior to chemical test |
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Term
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Definition
No nitroglycerin
no tobacco or caffeine bc they affect the same receptors and the tracers
No theophylline derivates
IV access necessary |
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Term
| Contraindications to physical stress test |
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Definition
physical limitations
neurological impairment
meds that preclude adequate stress levels (Ca channel blockers, beta blockers)
Unstable angina
acute MI within 2-4 days
uncontroled systemic or pulmonary HTN
life threatening arrhythmias
severe mitral or aortic stenosis
left bundle branch block |
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Term
| Contraindications to chemical stress test |
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Definition
history of bronchospasm
pulmonary disaese (asthma or pulm HTN)
systemic HypOtension (<90)
severe mitral disease
2nd or 3rd degree AV block
Exception: Ino/chronotropic (Dobutimine), which has same contraindications as treadmill test |
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Term
Interpretation of stress test results:
1. If blood flow is evenly distributed on both rest and stress images, then _____
2. If we see hypoperfusion on the stress test, which fill in on the rest, then ____
3. If we see hypoperfusion on both stress and rest, then __-_ |
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Definition
normal
ischemia (reversible)
scar or infarct |
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Term
What are V/Q scans done for?
When would you order one? |
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Definition
pulmonary perfusion/ventilation
to check for PE
ORder:
unable to do a CT due to:
IV size
patient size
IV contrast allergy
preferred by thte radiologist |
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Term
Prep for thyroid uptake and scan?
What other exam shares this prep? |
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Definition
No thyroid or antithyroid meds
NO CT contrast
Diet: No seafood, vitamins, low iodine
Same prep for parathyroid scan
2 day test |
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Term
What is a HIDA scan?
When do you do one? |
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Definition
Hepatobiliary scan
Done after a negative US or for:
abdominal pain
bloating
nausea
chest pain |
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Term
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Definition
no lasix for 24-48 hours
no enalaprilat for 24-48 hours
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Term
What test uses radioactive scrambled eggs or oatmeal?
What is the prep for this test? |
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Definition
gastric emptying
smoking, meds that affect gastric motility |
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Term
| What are some other nuclear medicine tests? |
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Definition
parathyroid
white blood cell
GI bleed
octeroscans
MIBG
Lymphatic
Cisternograms |
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Term
| The skull is covered by __ on the outer table and __ on the inner table |
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Definition
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Term
| Scattered small vascular channels are found everywhere but are most often seen in the vicinity of the ___. |
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Definition
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Term
| Contents of the jugular foramen |
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Definition
internal jugular vein
internal and external carotid arteries
CN IX-XII
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Term
| Why would you get a plain radiograph of the skull? |
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Definition
penetrating injuries
suspected trauma
destructive lesions
metabolic bone disease
congenital anomalies
suspected sinusitis
reassurance |
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Term
| What are some common PE findings with a blowout fracture? |
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Definition
Periorbital ecchymosis (black eye)
Inability to elevate globe due to herniated inf rectus
vertical diplopia, hypotropia, or hypertropia on affeted side
Hypoasethesia over infraorbital nerve
depression of the globe
enopthalmos |
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Term
| What part of the orbit is most commonly fxed? |
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Definition
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Term
| When would you do an ultrasound or doppler of the head? |
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Definition
cerebrovascular disease
Carotid stenosis/occlusion
intracranial stenosis
cerebral emboli
cerebral vasospasm
arteriovenous malformation
head trauma
cerebral circulatory arrest
diminished vasomotor reactivity
reduced/absent cerebral autoregulation
variations in circle of willis |
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Term
| __ is the gold standard for assessing osteomeatal complex for sinus infections |
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Definition
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Term
| On CT ___ will show as low densities and __ will show as high densities |
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Definition
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Term
| Most common pathological states of the head |
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Definition
trauma
neoplasia
vascular disease
MS
infection
cerebral atrophy
hydrocephalus |
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Term
| Signs and symptoms of a neurologic problem |
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Definition
LOC
abnormal neurologic exam
skull fx |
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Term
| Possible complications of sphenoid and ethmoid sinusitis? |
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Definition
sphenoid - possibility of brain abscess
ethmoid - could go blind |
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Term
| What CT view of head is best for sinusitis? |
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Definition
| coronal - bc you can see air-fluid levels |
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Term
| Cranial MRI is done for what two things primarily |
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Definition
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Term
| MRA is done for what 3 structures? |
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Definition
carotid arteries
vertebral arteries
cerebral arteries |
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Term
| When would you use a conventional scintigraphy with blood-barrier agents? (Nuclear med) |
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Definition
limited CT access
encephalitis
CV disease |
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Term
| When would you do a cerebral perfusion test? (nuclear med) |
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Definition
stroke
dementia
extrapyramidal disorder
brain death |
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Term
| When would you do a cisternography? (nuclear med) |
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Definition
CSF leakage
shunt patency
hydrocephalus dx
measure arachnoid spaces |
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