Radiography Fluoroscopy Ultrasound CT scan MRI Angiographic suite Nuclear medicine

Advtg ✓ Cheap ✓ Real time assessment of ✓ Real time imaging ✓ Excellent in delineating soft ✓ Utilize RF pulses with ✓ Real time imaging ✓ For evaluation of
✓ Easy GUT, GUT, reproductive utilizing sound waves tissue – bone interface, magnetic field gradient. No ✓ Gold std but gradually function (kidneys)
✓ Fast organ interventional ✓ Radiation-free multiplanar reconstruction radiation. replaced by CT/MR/DSA.
✓ Useful in ✓ Used in international ✓ Cheap, fast, patient ✓ Excellent bony, solid organs ✓ Excellent soft tissue ✓ Procedure range fr + dealing with radioactive
emergency procedures friendly and bowel evaluation differentiation, great for diagnostic to therapeutic isotopes which is tagged
and skeletal (nephrostomy, PTBD, ✓ Good in (trauma, tumour staging) imaging brain and MSK – endovascular coiling of with pharmaceutical
imaging (#, fistuloplasty) differentiating solid / ✓ Fast scanning with less ✓ Iamges may be acquired in aneurysm, embolization agent. Commonly used
pneu-thorax, cystic structures motion artefact multiple planes (axial, in acute GI bleed radioisotope – Technitium
- Barium studies: (thyroid nodule liver ✓ Excellent in assessing coronal, oblique) without 99m, which decay the
peritoneum) Swallow = Oesophagus mets, collection in abdominal / pelvic / repositioning the patient. production of gamma rays
Meal = Stomach abdomen) thoracic collection and ✓ Some angiographic images (ionizing radiation).
Follow-through = Small bowel masses might not need contrast Source of radiation is
Enema (double-contrast if air is ✓ Less likely causing material patient. Done ds – sodium
also used) = Large bowel claustrophobia ✓ Advanced technique allow floride 18.
precise ts charactrztn
(diffusion, spectroscopy, - radiopharmaceutical
perfusion) Diffusion agents injected into the
weighted image → acute body (IV) and radioactivity
ischemic stroke. captured gamma camera
✓ Functional MRI – visualize in static / dynamic fashion
active part of brain during
certain activities,
understanding e/l networks

Disadvg  Involving  High radiation exposure  Operator dependent  Utilizing collimated X-ray  Time consuming (pt  Invasive procedure  Poor anatomical
ionizing  Require different  Limited to body part beam with multi array and evaluation, medical  High radiation dose resolution
radiation contrast media (GI, HSG, imaging (x for high computer processing apparatus, scanning time)  Radiation
 Limited in MCU) acoustical impedance  Very high radiation  MRI image acquisition is
values structures, structures  Require IV contrast media, noisy
encased in bone) possibility of contrast  Expensive, only in tertiary
 Body habitus induced nephropathy, hosp
 Poor image in hollow allergy rx  Claustrophobia
structures (air) eg  Expensive mostly in tertiary  Not safe for patient with
bowels hospital (not easily metal implant and foregin
 high freq → potential available) bodies
risk of thermal  Can cause nephrogenic
heating /mechanical systemic fibrosis
injury to tissue at a
microscopic level
*fetal imaging.

Term Opacity vs Filling defect Echogenicity Density Signal intensity Uptake

Lucency
CM Iodine (eg IV Barium/Air/Gastrografin/LOCM Air (microbubbles) Iodine Gadolinium Iodine based Radioactive labelled
pyelogram) “tracer”
CI/ Pregnancy Poor mobility Body habitus, operator skill Renal impairment, fasting, Metals, electronics, RP, fasting, allergies Pregnancy, breastfeeding
problems (relative) allergy, pregnancy (relative) claustrophobia
Prep NBM, bowel prep HPB need fasting RP, Hydration (low eGFR) RP, Remove ferrous metal object. Renal insufficiency,
Full bladder (gynae Oral prednisolone 40mg 12 and 4 hypersensitivity to iodinated
transabd), Empty bladder hr before scan / IV contrast media (relative)
(transvaginal us) hydrocortisone

Franklin’s
 Common ▪ Chest: lung ▪ Barium studies: Barium ▪ Abdominal ▪ Brain (with/without ▪ Brain MRI with ▪ Diagnosis of obstructive ▪ Evaluation of kidney
clinical pathology swallow, barium meal ultrasound: To contrast and perfusion diffusion/perfusion studies vascular diseases function
app ▪ Skeletal: and follow-through, visualize the anatomy study)/Cranial/Head/Neck ▪ Spinal MRI ▪ Diagnosis of aneurisms
bone barium enema for and pathology of the CT ▪ Abdominal MRI to assess particularly intracranial
structure, dx evaluation of the gastro- liver, GB, spleen, ▪ CT myelography liver, spleen, kidneys, MR aneurism
fractures, intestinal tract. kidneys, ▪ Chest/mediastinum/high cholangiography, etc ▪ Diagnosis of arterio-
dislocation ▪ Hysterosalphingography retroperitonium, resolution CT ▪ Neck MRI venous malformations
abdominal vascular
/other bone (HSG): for evaluation of ▪ Abdominal CT ▪ Magnetic resonance ▪ Diagnosis of bleeding
pathology the uterine cavity and the structures, LN
▪ Pelvic CT angiography vessels
▪ Abdomen: fallopian tubes. ▪ Pelvic ultrasound: To ▪
▪ CT urography ▪ Cardiac MRI Assessment of the
can assess ▪ Retrograde urethrogram, assess the prostate,
abdominal micturating cysto- urinary bladder, ▪ CT Colonography ▪ Extremities for joints, vascularity of malignant
tumours
obstruction, urethrogram: for the reproductive organs, ▪ Cardiac CT muscles, bone disorders
adnexial masses, ▪ CT angiography ▪ Chest/mediastinal MRI ▪ Image guided
free air or evaluation of the interventional procedures
free fluid abnormalities of the vascular structures, ▪ Quantitative Computed ▪ Image-guided interventional
within the urinary system. lymph nodes. Tomography, QCT procedures
Indication: endovascular
abdominal ▪ Fistulography: for the ▪ CVS Densitometry
aneurysm repair, arterial
cavity evaluation of fistulae. echocardiography: To ▪ Extremities balloon angioplasty, arterial
▪ Dental: ▪ Reduction of fractures assess the heart and stenting, endovascular
cavities or under image guidance peripheral vascular embolization, thrombetomy
abscesses structures.
▪ Intraluminal
Ultrasound: To assess
GIT, blood vessels.
▪ Obstetric ultrasound:
To assess the fetus
and related
structures in
pregnant women.
▪ Small parts
ultrasound: Thyroid,
scrotum, breast
ultrasound
▪ Transfontanelle
ultrasound: To
visualize the
intracranial
structures before the
closure of the
fontanelles in
paediatric patients or
through boreholes.

CT scan : Hounsfield chose a scale that affects the four basic densities, with the following values: air = -1000, fat = -60 to -120, water = 0, compact bone = +1000
Myelography is a form of imaging intended to evaluate the subarachnoid spaces within the spinal canal. It is now usually performed with either CT or MR imaging of the spine after injection of an intrathecal
iodinated or gadolinium-based contrast agent. MR myelography may also provide evaluation without the need for intrathecal gadolinium by utilizing specific fluid-sensitive acquisition techniques.

Franklin’s