1

Choose from the

list below digital
modalities
2
1. Plain film.
2. Computed axial
Tomography.
3. Ultrasonography. 5

4. Magnetic Resonance 2
Imaging.
5. Scintigraphy.

2_3_4_5
4
1
 Is this conventional or
computer tomogramm?

1
2

3
1
1 conventional lateral head tomogramm
2 computer head tomogramm
4
2
Is this conventional or computer
tomogramm?

1
2

2
1. Conventional chest tomogramm
2. Computed axial tomogramm of the chest
4
3
 Which of images is made
after IV contrast
administration?

1 2
2 4
Which of images is made after IV
and per oral contrast
administration?

1 2
1 5
 Computed Axial Tomography

• Also called CAT scanning or “CT”

• Image formed using a rotating thin
beams of ionizing radiation
• Image “slices” reconstructed by
computation
• The image formed is related to the
subjects density
• Image display on computer or multiple
films
 Computed Axial
Tomography
• Advantages
☺ Can image calcium More useful than MRI for investigating cortical
bone fractures and calcification of organs.
☺ Rapid imaging Modern machines can produce images in a matter
of a few seconds, depending on the type of scan.
☺ Good for obese patients Fat separates the abdominal organs and
good CT images can be generated. Ultrasound is not possible in
obese patients.
☺ Good contrast between different tissues Good contrast is seen
between tissues which are mainly bone, fat, water, and air. Use of
a narrow X-ray beam and windowing can produce detailed images.
However CT cannot differentiate well between different parts of
the same organ.
☺ Cancer Treatment CT is particularly useful for staging and treating
tumours.
☺ Three-dimensional Imaging Computers can use CT data to
produce two- and three-dimensional images. Overlying tissues are
not superimposed as they are on radiographs.
 Computed Axial
Tomography
• Disadvantages
☹ High ionizing dose A thoracic CT scan may expose the patient to as
much radiation as 40 chest X-rays.
☹ Bony artefacts Brain scans may be distorted by bony artefacts
☹ Imaging in the transverse (axial) plane only Sagittal and coronal
images are generally difficult, although possible if the patient
can be positioned appropriately within the scanner.
☹ High cost of equipment and procedure CT scanners are fairly
expensive to purchase and the number of personnel involved means
that each scan is considerably more expensive than an X-ray.
☹ Very small lesions may be missed The wavelength of the X-ray beam
means that lesions under 1cm may be missed
☹ Limited contrast CT cannot differentiate between tissues of very similar
density or between areas of inconsistancy within an organ.
 Magnetic Resonance
•Also called “MRI” Imaging
(used to be NMRI)
• Image formed by transmitting and receiving radio
waves inside a high magnetic field
• Image “slices” reconstructed by computation
• The image formed is related to:
– Scanner settings
– Patient hydrogen density
– Patient hydrogen chemical/physical environment
• Image display on computer or multiple films
• The concept of magnetic resonance was first
discovered by Felix Bloch and Edward Purcell,
who won the Nobel Prize for Physics in 1952
•
Magnetic Resonance Imaging
Magnetic Resonance Imaging, as the name suggests,
is an imaging technique which relies on the inherent
magnetic properties of molecules within the body.
• When a strong magnetic field is applied to the body,
water molecules shift their orientation so that they
line up along the axis of the magnetic field.
• A measured pulse of energy, in the form of radio
waves, is directed into the body and knocks some of
these molecules out of alignment.
• When the radio transmitter is turned off more radio
waves are released by the water molecules as they
shift back into their aligned position.

10
 Magnetic Resonance
Imaging

• These are detected and tell a computer

how much water there is in each individual
tissue.
• Because, the body is composed of more
than 60 per cent water MRI provides
information about almost all tissue types
and can be used to differentiate between
tissues of very similar density.
• The computer uses several different
"slices" through the body to generate a
three-dimensional image.

11
 How do molecules behave as
magnets?
The ability of some atoms to behave like tiny
magnets when exposed to a magnetic field
is central to MRI physics.
Within a human body the main atom that we
are interested in is hydrogen although any
atom with an odd number of protons can
behave in this way.
The reason the hydrogen atom is so
informative is that it is present in such
huge quantities in the body.
There are more than one thousand billion
billion hydrogen atoms in an adult, mostly
in the form of water.

H2O

12
• The single proton that makes up
the nucleus of the hydrogen atom
spins around its axis and the
spinning creates a magnetic field.
• This is a property known as spin.
• The protons are all acting as little
magnets each aligned in a
different direction.
• When a large magnetic field is
applied they all try and line up with
the external magnetic field.

13
 What happens to protons (Hydrogen
atoms) within a magnetic field?They
precess.
• However, instead of physically
moving to line up with the magnet
they precess.
• Precession is similar to what
happens to a spinning top just
before it falls over.
• The top wobbles towards the
ground due to the force applied by
gravity.
• In MRI it is the magnetic field that
causes the wobble.
spinning top
• In this case the wobble is towards
the magnetic field, rather than
towards the ground.

14
 Precession
• Precession slow movement of the axis
of a spinning body around another
axis due to a torque (such as
gravitational influence) acting to
change the direction of the first axis.
• It is seen in the circle slowly traced
out by the pole of a spinning
gyroscope.

15
 What happens to a person within a
magnetic field? Within an MRI scanner, a
person becomes slightly magnetized.
•The protons exposed to a magnetic field do not all
line up in the same direction.
•About half line up in the direction of the magnetic
field and about half are aligned in the opposite
direction.
•Therefore the magnetic effect of most of the
atoms is cancelled out.
•However, because it is slightly easier to be
aligned with the magnetic field (the aligned
position is at a lower energy state), about 10
additional hydrogen atoms are aligned with the BO
field for every one million that cancel each other
out.
•Thus there is a slight net magnetization in line
with the magnetic field.
•It is these unmatched atoms that are essential to
produce the image.

16
MRI scanner is
• The MRI scanner is primarily a
large magnet with a hole in the
middle.
• The magnetic field required to
produce MR images is huge.
• The strength of the main MRI
magnetic field is known as B0
(B-zero).
• UK guidelines allow a maximal
B0 of 4.0 Tesla (40 000 Gauss)
compared to the Earth's
magnetic field of 0.5 Gauss
• most MRI scnners have a B0 of
between 0.5T and 1.5T.

17
What happens next?
Resonance!
• All objects vibrate at a certain speed,
known as the natural or resonant
frequency.
• When the object is forced to vibrate at its
resonant frequency there is a large
increase in the amplitude of vibration.
• The energy causing the object to resonate
is absorbed and is subsequently released.
• When a glass is forced to resonate by
musical note, sung by an opera singer for
example of the same frequency as the
glass natural frequency the release of
energy causes the glass to shatter.

18
• The resonant frequency of the protons is
known as the Larmor frequency and is
dependent upon the tissue being imaged
and the strength of the magnetic field.
• A radio frequency (rf) pulse at the
Larmor frequency causes the protons to
precess in a different direction .
• SO resonant absorption of energy by the
protons due to an external oscillating
magnetic field will occur at the Larmor
frequency of external signal.
• The hydrogen atoms, which have the
same frequency as the radio wave, will
become 'excited' (that is, they will be
raised to a higher state of energy) and
start to resonate with the exciting wave.

19
 Allowing this field to return to
its original orientation
(relaxation)
When the radio signal is
turned off, the hydrogen
atoms will, after a period of
time, return to their original
energy state.
The excitation energy, which
they had gained, will be
released in the form of radio
waves, which are detected by
the MRI machine.
This emitted energy is called
an echo!
Detecting and measuring the
field after relaxation

Signal detection is based on

electromagnetic induction
(Faraday's law), which
states that if a magnetic
field through a coil of wire
changes for any reason a
voltage will be produced in
the coil that opposes that
change.
• RF COILS receive a radio signal
back from each point of the body
being imaged.
• The frequency of this signal
depends on the type of tissue and
its position within the body (as
well as factors kept constant
during the scan such as magnetic
field strength).
• The radio signal received by the
coils generates an electric current,
which is subsequently digitized by
an Analogue-Digital converter.
• This digital signal provides a
computer with the required data
to construct an image.

22
 Signal intensity
• The correct descriptive terminology
for the grayscale seen on MRI is
signal intensity. 5
• High signal is appear white.
• Low signal is black. 3 4

2
T1 and T2 imaging
• There are two main forms of MRI, known as
T1 weighted and T2 weighted.
• The two image types are also known as T1
contrast and T2 contrast.
• As these names imply, the reason that more
than one image type is required is that
some tissues are contrasted better, and
thus are easier to see, with one technique
rather than the other.
• T1 contrast shows better anatomical detail
and better distinction between solid and
cystic structures. T2 contrast shows
pathological changes better.

24
 • A 90-degree pulse is used to displace the
T1 Weighted protons.
• The protons are rotated around into the
Imaging X-Y plane where they precess in phase
(in time with each other).
• After the RF pulse is switched off the
protons come out of phase (dephase).
• The decaying signal sent out as the
protons return to the Z-plane is
measured over a time known as TR.
• The faster protons realign the stronger
the signal that is emitted.
• Early measurement of this signal is
required to differentiate between various
tissues.
• To maximize T1 contrast a short TR
sampling time must be used.
• In T1 imaging you are measuring
how the protons realign relative to
the external magnetic field.

25
T2 Weighted • However, as the protons dephase a
180-degree pulse is fired which puts
Imaging them back in phase.
• After this second pulse is switched
off the protons again dephase.
• In a T2 image we are looking to
emphasise tissues which remain in
phase for a long time and therefore
maintain a strong signal.
• This can be achieved by delaying
the sampling time after the 180-
degree pulse (a time known as TE).
• To maximize T2 contrast a long TE
sampling time must be used.
• In T2 imaging you are measuring
how the protons realign relative
to each other.

26
T1 and T2 imaging

• T1 contrast shows better

anatomical detail and better
distinction between solid and
cystic structures.
• T2 contrast shows pathological
changes better.

27
 T1
T2

• Obviously it is a lot easier to identify a structure if you know what type of tissue it is.
• The colours of the structure in the image provide this information.
• The colours are not the same on T1 and T2 weighted images.

28
 Substance T1 weighted T2 weighted
Water Dark grey Light grey or white
Fat White Light grey
Muscle Grey Grey
Air Black Black
Cortical bone Black Black
Fatty bone marrow White Light Grey
Liver Grey Grey
Spleen Grey Grey
Flowing blood Black Black
Brain: White matter Light Grey Grey
Brain: Grey matter Grey Very light grey
CSF in ventricle Dark grey Light grey or white
CSF fast flowing Dark grey or black Dark grey or black

29
 Low signal is black

• Air (1)
• Cortical bone (2) 5
• Flowing blood (3)
• Fibrous tissue (4)
4
3
• Water (5)|edema (on
T1)
6
2
 High signal intensity (white)
• Fat (and other
lipids - 1) 2
• Hemorrahage
• High protein
• Melanin
• Microcalcifications 1
• Water (2)|edema
(on T2)
 Special terms
used on MRI
reports:
•T 1 images (with
low signal from
water structures)
•T2 images (with the
high signal from
water)
•Highsignal intensity
•Low signal intensity
• MR images are most commonly T1,
they are the best for visualizing
anatomy.
• T2 weighted is better for visualizing
the disease.
• MR images can also be a mixture of
both called proton density weighting.
• FLAIR sequences produce heavily T2
weighted images they are good to
determine the edema and ischemia of
tissues.
33
 The basic phenomena involved in
magnetic resonance experiments may
be classified into the following four
groups:
1. Inducing a magnetic field in the sample
2.Reorienting this magnetic field by a
known amount (the"spin flip")
3.Allowing this field to return to its original
orientation (relaxation)
4. Detecting and measuring the field after
relaxation is underway
MRI T1-weighted Images

35
MRI T2-weighted Images

36
 Magnetic resonance angiography
• Resonance Angiography (MRA)
are a group of techniques based
on MR to image blood vessels.
• Magnetic Resonance Angiography
is used to generate images of the
arteries in order to evaluate them
for stenosis, occlusion, aneurism
• MRA is often used to evaluate the
arteries of the neck and brain, the
thoracic and abdominal aorta, the
renal arteries, and the legs (called
a "run-off").

37
 A variety of techniques can be used to
generate the pictures, based on flow
effects or on contrast (inherent or
•
pharmacologically generated).
The contrast medium is injected into a
vein, and images are acquired during
the first pass of the agent through the
arteries. Provided that the timing is
correct, this may result in images of
very high quality.
• An alternative is to use a contrast
agent that does not, as most agents,
leave the vascular system within a
few minutes, but remains in the
circulation up to an hour (a "'blood-
pool agent'"). Since longer time is
available for image acquisition, higher
resolution imaging is possible. A
problem, however, is the fact that
both arteries and veins are enhanced
at the same time.

38
 A variety of techniques can be used to
generate the pictures, based on flow
effects or on contrast (inherent or
•
pharmacologically generated).
Time-of-flight (TOF) or Inflow
angiography, uses a short echo time
and flow compensation to make
flowing blood much brighter than
stationary tissue.
• As flowing blood enters the area
being imaged it has seen a limited
number of excitation pulses so it is
not saturated, this gives it a much
higher signal than the saturated
stationary tissue.
• As this method is dependent on
flowing blood, areas with slow flow
(such as large aneurysms) may not
be well visualized.
• This is most commonly used in the
head and neck and gives detailed
high resolution images

39
 A variety of techniques can be used to
generate the pictures, based on flow
effects or on contrast (inherent or
•
pharmacologically generated).
Phase-contrast (PC-MRA) the
phase of the MRI signal is
manipulated by special gradients
(varying magnetic fields) in such
a way that it is directly
proportional to velocity. Thus,
quantitative measurements of
blood flow are possible, in
addition to imaging the flowing
blood.

40
 A variety of techniques can be used to
generate the pictures, based on flow
effects or on contrast (inherent or
pharmacologically generated).
• Fresh blood imaging (FBI):
An imaging technique
using fast or super fast
spin echo sequences
(FSE/SFSE). Takes
advantage of the longer T2
relaxation of blood
compared to surrounding
tissue. The images are
acquired by fast spin echo
sequences that can be
synchronized with heart
beats

41
 A variety of techniques can be used to
generate the pictures, based on flow
effects or on contrast (inherent or
pharmacologically generated).
• 4D Dynamic MR
Angiography (4D-MRA):
• The first images, before
enhancement, serve as a
subtraction mask to
extract the vascular tree in
the succeeding images.
Allows to divide arterial
and venous phases of a
blood-groove with
visualisation of its
dynamics.

42
 Magnetic resonance
cholangiopancreatography replaced
ERCP

43
 Endoscopic retrograde
cholangiopancreatography (ERCP)
ERCP is used primarily to diagnose
and treat conditions of the bile
ducts, including gallstones,
inflammatory strictures (scars),
leaks (from trauma and surgery),
and cancer.

Through the endoscope, the

physician can see the inside
of the stomach and
duodenum, and inject dyes
into the ducts in the biliary
tree and pancreas.
44
 Magnetic resonance
cholangiopancreatography
• MRCP is a less invasive
alternative to ERCP in the
diagnosis of biliary and
pancreatic duct disorders.
• However, while ERCP can
be both images can be
obtained, displaying not
only the ductal system but
also surrounding
parenchyma; this allows
direct visualisation of
pancreatic neoplasm.

45
 Functional MRI
• measures signal changes in the brain hat are
due to changing neural activity.
• The brain is scanned at low resolution but at a
rapid rate (typically once every 2–3 seconds).
• Increases in neural activity cause changes in
the MR signal via T2* changes.
• this mechanism is referred to as the BOLD
(blood oxygen level dependent effect).
• Increased neural activity causes an increased
demand for oxygen, and the vascular system
actually overcompensates for this increasing
the amount of oxygenated hemoglobin relative
to deoxygenated hemoglobin. Because
deoxygenated hemoglobin attenuates the MR
signal, the vascular response leads to a signal
increase that is related to the neural activity.

46
Differentiating between MRI and
CT

47
 Where is MRI?
1 2

48
 Patient Safety

Contraindications do exist for

some patients.
Some objects, particularly
metal objects, are incompatible
with a strong magnetic field
and can have potentially
harmful effects. Patients are
advised to notify their physician
or MRI technologist if they have
had brain, ear, eye, or other
surgeries prior to their MR
examination.
 Contrindication for MRI

•Pacemaker
•Metal implants
•Neurostimulator (TENS-unit)
•Intrauterine device (IUD),etc.
•Aneurysm clips
•Surgical staples
•Implanted drug infusion device
•Foreign metal objects in the eye
•Shrapnel or bullet wounds
•Permanent eyeliner
•MRI is not generally recommended for pregnant
patients, especially during the first trimester.
In 2006, a new classification system for implants and ancillary clinical devices has
been developed by ASTM International and is now the standard supported by the US
Food and Drug Administration: MR Safe signMR-Safe — The device or implant is 
completely non-magnetic, non-electrically conductive, and non-RF reactive, 
eliminating all of the primary potential threats during an MRI procedure. MR
Conditional signMR-Conditional — A device or implant that may contain magnetic, 
electrically conductive or RF-reactive components that is safe for operations in 
proximity to the MRI, provided the conditions for safe operation are defined and 
observed (such as 'tested safe to 1.5 teslas' or 'safe in magnetic fields below 500 
gauss in strength'). MR Unsafe signMR-Unsafe — Nearly self-explanatory, this 
category is reserved for objects that are significantly ferromagnetic and pose a clear 
and direct threat to persons and equipment within the magnet room.

51
 Magnetic Resonance
• Imaging
Advantages
☺ Non-ionizing radiation. Because MRI does not ionize tissue it is considered
amongst the safest of radiological techniques. There are no known physiological
side effects of being exposed to a magnetic field.
☺ High soft-tissue contrast. MRI images provided very detailed information about
soft tissues. They can differentiate between normal and abnormal tissues and
may show damage missed on CT
☺ Images can be produced in any plane. This is great value in studies of the Central
Nervous System.
☺ Visualisation of areas deep within bony structures. MRI is thus invaluable for the
diagnosis and treatment of brainstem tumours.
☺ Shows vasculature without contrast. Because the patient is not subject to any
invasive procedure (i.e. the injection of contrast media) the technique is less
unpleasant.
☺ Good for angiography. MRI is excellent for imaging blood flow and studying heart
function. Functional MRI maps changes in blood flow in the brain during specific
tasks. This provides valuable information about how the brain works.
☺ 3D imaging. Computer manipulation of the digital data can be used to produce
exact three-dimensional images of organs. A further development is the
production of perfect-replica models of organs using the digital information.
 Magnetic Resonance
Imaging
• Disadvantages
☹ High cost of equipment. An MRI scanner can cost over GB£ 1 500 000 (US$ 2 400 00) to
purchase.
☹ Claustrophobia. Up to 10% of patients experience claustrophobia during an MRI scan
and 1% of scans have to be aborted because of it.
☹ Long imaging time. A complete image may take up to 30mins and movement at the
wrong time can cause artefacts in the image. However, new techniques have reduced
imaging time.
☹ Strong magnetic field. MRI imaging is unsuitable for many patients with metal implants
(e.g. artificial joints) and is especially dangerous for patients with pacemakers, neural
stimulators, or cochleal implants. Loose metal objects must be removed before coming
near to the scanner otherwise they may be attracted so strongly by the magnet that they
fly through the air like tiny missiles!
☹ Unable to image calcium. Because MRI detects water rather than molecular density,
calcium is not well visualized. This means that tissue calcification, a feature of a number
of disease processes, can not be detected. Bone is also less obvious than on a CT scan.
☹ Acoustic noise. Switching on and off of the gradient coils causes repeated loud bangs.
Noise levels may reach 95 dB for much of the scan. Ear plugs are advisable to reduce the
risk of temporary or even permanent hearing loss.
☹ Various minor biological effects. At high field strengths direct stimulation of muscles or
nerves are may be experienced. Some patients experience visual flashes
(magnetophosphenes) produced by stimulation of the optic nerve. Although there are no
known harmful effects on the foetus scanning is avoided during pregnancy, especially
during the first trimester, unless the alternatives are more dangerous (e.g. ionizing
radiation)
 Indication for MRI
• White matter diseases • Pathology of liver
(Leukoencephalopathy),
and ducts,
• Acute Brain Infarction,
• Spinal Cord Problems, • Pelvic pathology,
• Posterior fossa diseases, • Pediatric patients,
• Head trauma,
• Vessels and Heart
• Joint pathology and trauma,
pathology.
55
56
57
 Pelvic pathology

• Low signal intensity right posterior mass in prostate gland (arrow)

 Ultrasound
• Also called “sono” or “echo” or
“US”
• Image formed by transmitting
and receiving high frequency
sound waves
• Image “slices” reconstructed by
computation
• The image formed is related to
interfaces between tissue areas
of differing sound transmission
characteristics
• Image display on computer or
multiple films
The basic phenomena involved
in ultrasound
• utilises high-frequency
sound waves, which screen
are reflected in
specific ways by
different tissues in the
body;
• the reflected sound
(echo) is processed by
a computer to produce
a real-time image
which is displayed on a Ultrasound transducer
screen instantly.
 A -mode of ultrasound
Schematic drawing of transducer(1)
transmitting a narrow beam of
ultrasound into the glass with
water and a object (2 and 3).
Four reflecting structures along the
beam are indicated: the surface
of the glass (1), the anterior wall
of the object (2), the posterior
wall of the object (3), and the
posterior glass wall (4).
A-mode gives a 1D trace that
depicts the depth of four
reflecting structures and the
strength of reflecting signal .
 M -mode of ultrasound
M (movement)-mode display of the
same four structures. But if the
object moves, movement may be
seen as periodic changes in the
distance between the anterior and
posterior glass wall echoes.
 M-mode of ultrasound
M mode displays the trace of
the movement of structures
within the line of sound
beam.
It is used to imaging movement
of heart and vessels

Dilated cardiomyopathy, M-
Mode
B (brightness)-mode

• Gives 2 D slices
that map the
different
magnitudes of echo
in gray scale
 B (brightness)-mode.

Normal hepar and ren.

The real time dynamic B-mode
image displayed on a monitor.
The image is made from numerous
bright dots, the vertical position of
each dot being determined by the
time delay of the echo, and the
horizontal position being
determined by the position of the
receiving transducer element. The
echo amplitudes determine the
brightness of the dots.
 Doppler sonography (D mode
of ultrasound)
• Measurement of
blood flow velocity
using ultrasound, is
usually based upon
the general
phenomenon that the
frequency of a wave
form is dependent
upon the relative
velocity between the
emitter and receptor
of the wave
 Different doppler modalities.
Waveform regime.

Color flow imaging CFI: The color

image shows the arteries and vein
clearly
Color Power Angio regime (PD)
 Ultrasound

Advantages Disadvantages
☺It does not use ☹ Is highly dependent on
ionizing radiation, the operator, not least
☺Real-time imaging, due to his/her ability to
☺Multy planar imaging, interprete the images
correctly and evaluate in
☺Non invasive vascular a proper clinical setting,
imaging (vessels),
☹ Poor quality in obese
☺Portable, quick, subjects
cheap.
☹ Interference from bone,
bowel gas, calculi and
other superimposed
structures.
Contrindication for Ultrasound

•NO

This is a normal fetal ultrasound

Indications for ultrasound examination of
the abdomen and/or retroperitoneum
include, but are not limited to:
• Abdominal, flank, and/or back pain.
• Signs or symptoms that may be referred from the abdominal and/or
retroperitoneal regions such as jaundice or hematuria.
• Palpable abnormalities such as an abdominal mass or
organomegaly.
• Abnormal laboratory values or abnormal findings on other imaging
examinations suggestive of abdominal and/or retroperitoneal
pathology.
• Follow-up of known or suspected abnormalities in the abdomen
and/or retroperitoneum.
• Search for metastatic disease or occult primary neoplasm.
• Evaluation of suspected congenital abnormalities.
• Abdominal trauma.
• Pretransplantation and post-transplantation evaluation.
• Planning and guidance for an invasive procedure.
• Search for the presence of free or loculated peritoneal and/or
retroperitoneal fluid.
 Liver diseases.
Hepatocellular carcinoma.
Transverse view shows a large, Nodularity (arrows) of the anterior
hypoechoic solid mass (arrows) surface of the liver, surrounded by
within the right lobe. ascites

•
Pancreas and gall bladder diseases.
The appears swollen, edematous and
hypoechoic. These findings suggest
acute pancreatitis.

Ultrasound image shows the

distended gall bladder with a
linear, echogenic lesion without
an acoustic shadow - the worm.
 Kidney and urinary bladder
diseases

Lipoma - echogenic, rounded, small, This is a polypoid mass seen in the

mass lesion within the kidney.
It is a benign lesion and is usually, of urinary bladder. 
little clinical significance.
 Indications for ultrasound
examination include, but are not
limited to:
• Heart and vessels diseases.
• Diseases of soft tissues.
• Diseases of thyroid gland.
• Diseases of joints.
• Diseases of brain of neonates.
• Normal and pathological pregnancy.
 Prostate and testicular diseases.

Scan shows a hypoechoic collection Ultrasound images of a case of

of 2.5 cms within the right lobe intratesticular varicocele associated
of the prostate. The walls of the with extratesticular varicocele
lesion are shaggy s/o an abscess.
DIAGNOSIS: PROSTATIC ABSCESS.
 Soft tissues diseases

The defect in the linea alba with hernia projecting anteriorly.

 Heart diseases

The above ultrasound image of the heart in a neonate shows a

small hypoechoic collection (pericardial fluid), between the two
layers of the pericardium.
 Interventional Radiology
• Also called angiography or “angio” or “IR”
• Image formed using broad beam ionizing radiation
(fluoroscopy)
• Images acquired using digital detector and
processed by computer
• The image formed is related to the subjects density
• Usually involves the use of iodinated contrast
agents and long catheters
• Many varied techniques including the use of CT or
MRI
• Image display on computer or multiple films
 Interventional angiography

A sirolimus-eluting stent was Severe stenosis of the saphenous vein

implanted graft is shown on coronary angiography

79
Carotid angioplasty and stenting.
Angiography before and after.

80
 Interventional Endoscopic retrograde
cholangiopancreatography
ERCP, CBD Stones ERCP after endoscopic operation

81
Biopsy of lung tumor
General suggested
readings
• Essentials of radiology by Fred A. Mettler Jr.
Publisher: Saunders. 2004.
• Radiology by Amit Mehta, Douglas P. Beall,
Publisher: Humana Press. 2007.
• Clinical Radiology Made Ridiculously Simple
(Paperback) by Hugue Ouellette, Patrice
Tetreault, 1999.
• Learning Radiology: Recognizing the Basics: On
Timeby William Herring Textbook.
Publisher: Elsevier Science. 2007.

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