ADVANCED IMAGING NYCC MIDTERM EXAM: A+ GRADED
GUIDE WITH THE LATEST KEY QUESTIONS AND ANSWERS.
These type of tests go as follows:
•Not performed as screening tools
•Increased risk to patients health
•May require patient to be deceased
•Expensive
Gold Standard Tests
•Autopsy
•Biopsy
•Surgery
Probability that a patient who actually has a pathology will be diagnosed as
having that pathology that the test is intended to reveal
Sensitivity
•X-Ray not sensitive to bone turnover, but bone scintigraphy is
Represents the probability that a patient without a pathology will be diagnosed as
such
Specificity
MRI, CT, SPECT and Angiography are considered what type of test?
Intermediate
•done after screening test
•more specific
•more expensive
•more invasive
Women of child bearing age should be radiographed when?
During the 1st 10 days following their onset of the menstrual cycle
•Obtain a signed release from patients to confirm they aren't pregnant
,True or false
The only films that can be taken on a pregnant person is extremity films
False: no radiographs should be taken if possible
If absolutely needed send patient to special facility that monitors fetal dose
What is scintigraphy also known as?
Bone Scan
What photo shows a PA chest film?
Top: Lung apices
Bottom: Costophrenic Angles
On full inspiration with a PA chest, where should the diaphragms sit?
10th Posterior Rib
Should a high mAs or kVp be used for soft tissue visualization?
kVp
What photo shows an Apical Lordotic Film?
•Taken AP
•15-30° cephalad tube tilt OR patient walks feet out from bucky to increase lordosis
•Used to see lung apices free of clavicle superimposition
What photo shows a Lateral Decubitis film?
•Used to asses for pleural effusion of a minimum of 10-15mL (Lat req 50 and PA req
300)
What photo shows an Expiratory film
•Taken PA
•Good for evaluating trapped air in the lungs - COPD, inhaled objects
•Used to evaluate a pneumothorax
The following describes what:
•Used to show body planes free of superimposition
,•Achieved by simultaneous motion of the x-ray tube and cassette around a
fulcrum of interest
•Only objects seen in the plane of interest are visualized sharply
Tomography
What is the best way to anatomically assess the thorax?
Notes:
•Utilizes a narrow pencil or fan beam
•X-Ray tube and detectors rotate around the patient
•Generates axial slices
•Contrast may be used to differentiate mediastinal and lung structures
•Greyscale may be adjusted
CT
(computed Tomography)
What shows a list of indications for CT?
•Staging of 1° pulmonary neoplasm
•DDx of pulmonary metastasis from a 1° tumor
•Characterize solitary pulmonary nodules
•Characterization of focal and diffuse lung disease
•Evaluate the chest wall
Radionuclide Scanning looks for a "VQ Mismatch"
Regional Blood Supply Documentation: Particle Perfusion
Regional Ventilation: Particle Ventilation
What photo shows a Radionuclide Scan?
What photo shows Pulmonary Angiography?
Notes:
•Radio-opaque contrast injected into pulmonary artery (or femoral art, IVC or R.
, atrium)
•Used to evaluate vascular nature of a lesion: AV Malformation, Infarctions,
Tumor (neovascularity)
This imaging modality offers advantages in imaging the heart, great vessels, and
chest wall.
It offers no clinically relevant additional information in the thorax compared to the
best modality
Patient must be still during exam
MRI
(as opposed to CT)
What photo shows Bronchography?
Notes:
•Usually performed to clarify bronchoscopic findings - bronchiectasis is main
indication
•Rarely performed anymore
•Patient forced to inhale contrast material
This is used under the guidance of CT for exact diagnosis of pulmonary lesions
with a sample of tissue being taken then a sample of the fluid being drawn up.
Used only after all other appropriate imaging has been done
Fine Needle Biopsy
What photo shows a Companion Shadow (normal)?
-a smooth, homogenous, radiodensity with a well-defined margin that runs
parallel with a bony landmark. Companion shadows represent soft tissue that
overlies the respective bony landmark in profile
What is the DDx for unilateral Hyperlucent Hemithorax?
GUIDE WITH THE LATEST KEY QUESTIONS AND ANSWERS.
These type of tests go as follows:
•Not performed as screening tools
•Increased risk to patients health
•May require patient to be deceased
•Expensive
Gold Standard Tests
•Autopsy
•Biopsy
•Surgery
Probability that a patient who actually has a pathology will be diagnosed as
having that pathology that the test is intended to reveal
Sensitivity
•X-Ray not sensitive to bone turnover, but bone scintigraphy is
Represents the probability that a patient without a pathology will be diagnosed as
such
Specificity
MRI, CT, SPECT and Angiography are considered what type of test?
Intermediate
•done after screening test
•more specific
•more expensive
•more invasive
Women of child bearing age should be radiographed when?
During the 1st 10 days following their onset of the menstrual cycle
•Obtain a signed release from patients to confirm they aren't pregnant
,True or false
The only films that can be taken on a pregnant person is extremity films
False: no radiographs should be taken if possible
If absolutely needed send patient to special facility that monitors fetal dose
What is scintigraphy also known as?
Bone Scan
What photo shows a PA chest film?
Top: Lung apices
Bottom: Costophrenic Angles
On full inspiration with a PA chest, where should the diaphragms sit?
10th Posterior Rib
Should a high mAs or kVp be used for soft tissue visualization?
kVp
What photo shows an Apical Lordotic Film?
•Taken AP
•15-30° cephalad tube tilt OR patient walks feet out from bucky to increase lordosis
•Used to see lung apices free of clavicle superimposition
What photo shows a Lateral Decubitis film?
•Used to asses for pleural effusion of a minimum of 10-15mL (Lat req 50 and PA req
300)
What photo shows an Expiratory film
•Taken PA
•Good for evaluating trapped air in the lungs - COPD, inhaled objects
•Used to evaluate a pneumothorax
The following describes what:
•Used to show body planes free of superimposition
,•Achieved by simultaneous motion of the x-ray tube and cassette around a
fulcrum of interest
•Only objects seen in the plane of interest are visualized sharply
Tomography
What is the best way to anatomically assess the thorax?
Notes:
•Utilizes a narrow pencil or fan beam
•X-Ray tube and detectors rotate around the patient
•Generates axial slices
•Contrast may be used to differentiate mediastinal and lung structures
•Greyscale may be adjusted
CT
(computed Tomography)
What shows a list of indications for CT?
•Staging of 1° pulmonary neoplasm
•DDx of pulmonary metastasis from a 1° tumor
•Characterize solitary pulmonary nodules
•Characterization of focal and diffuse lung disease
•Evaluate the chest wall
Radionuclide Scanning looks for a "VQ Mismatch"
Regional Blood Supply Documentation: Particle Perfusion
Regional Ventilation: Particle Ventilation
What photo shows a Radionuclide Scan?
What photo shows Pulmonary Angiography?
Notes:
•Radio-opaque contrast injected into pulmonary artery (or femoral art, IVC or R.
, atrium)
•Used to evaluate vascular nature of a lesion: AV Malformation, Infarctions,
Tumor (neovascularity)
This imaging modality offers advantages in imaging the heart, great vessels, and
chest wall.
It offers no clinically relevant additional information in the thorax compared to the
best modality
Patient must be still during exam
MRI
(as opposed to CT)
What photo shows Bronchography?
Notes:
•Usually performed to clarify bronchoscopic findings - bronchiectasis is main
indication
•Rarely performed anymore
•Patient forced to inhale contrast material
This is used under the guidance of CT for exact diagnosis of pulmonary lesions
with a sample of tissue being taken then a sample of the fluid being drawn up.
Used only after all other appropriate imaging has been done
Fine Needle Biopsy
What photo shows a Companion Shadow (normal)?
-a smooth, homogenous, radiodensity with a well-defined margin that runs
parallel with a bony landmark. Companion shadows represent soft tissue that
overlies the respective bony landmark in profile
What is the DDx for unilateral Hyperlucent Hemithorax?
