LOM Radiology Notes
CHAPTER 18 -RADIOLOGY
Introduction
Radiology is the medical specialty concerned with the study
and application of x-rays and other technologies (such as ultrasound and magnetic
resonance) to produce and interpret images of the human body for the diagnosis of
disease.
A radiologist is a physician who specializes in the practice of diagnostic radiology.
X ray
X-rays are invisible waves of energy that are produced by an energy source (such as an x-
ray machine or cathode ray tube) and are useful in the diagnosis and treatment of disease.
CHARACTERISTICS OF X-RAYS
Several characteristics of x-rays are useful to physicians in the
diagnosis and treatment of disease. Some of these characteristics are the following:
Ability to cause exposure of a photographic plate
If a photographic plate is placed in front of a beam of x-rays, the x-rays,
traveling unimpeded through the air, will expose the silver coating of the plate and cause it
to blacken.
Ability to penetrate different substances to varying degrees
X-rays pass through the different types of substances in the human body with
varying ease.
Invisibility
X-rays cannot be detected by sight, hearing, or touch.
Travel in straight lines
LOM Radiology Notes
This property allows the formation of precise shadow images on the x-ray plate
Scattering of x-rays
Scattering occurs when x-rays come into contact with any material. Greater
scatter occurs with dense objects and less scatter with those substances that are
radiolucent.
Ionization
X-rays have the ability to ionize substances through which they pass.
X-RAY POSITIONING
In order to take the best possible view of the part of the body being radiographed,
the patient, film, and x-ray tube must be positioned in the most favorable alignment
possible.
Some of the x-ray terms describing the position of the x-ray terms describing the
position of the x-ray beams are;
AP view (anteroposterior): in this view, the patient is usually supine (lying on the back),
and the x-ray tube is aimed from above at the anterior of the body with the beam passing
from anterior to posterior.
PA view (posteroanterior): In this view, the patient is upright with his or her back to
the x- ray machine and the film to the chest. The x-ray machine is aimed horizontally at a
distance of about 6feet from the film.
Lateral view: In this view, the x-ray beam passes from one side of the body toward the
opposite side. In taking a right lateral view, the right side of the body is held closely
against the x-ray film and the x-ray beam passes from the left to the right through the
body
Oblique view: In this view, the x-ray tube is positioned at an angle from the perpendicular
plane. Oblique views are used to show regions that would be hidden and superimposed in
routine AP&PA views
LOM Radiology Notes
8
LOM Radiology Notes
The following terms are used to describe the position of the patient or part of the body in
the x-ray examination:
abduction Movement away from the midline of the body.
adduction Movement toward the midline of the body.
eversion Turning outward.
extension Lengthening or straightening a flexed limb.
flexion Bending a part of the body.
inversion Turning inward.
lateral decubitus Lying down on the side (with the x-ray beam horizontally positioned).
prone Lying on the belly (face down).
recumbent Lying down (may be prone or supine).
supine Lying on the back (face up).
LOM Radiology Notes
Computed Tomography (CT)
The CT scan, sometimes called “CAT scan” (computerized axial tomography) is
made by beaming x-rays at multiple angles through a section of the patient’s body. The
absorption of all of these x-rays, after they pass through the body, is detected and used
by a computer to create multiple views, especially cross-sectional images. The ability of a
CT scanner to detect abnormalities is increased with the use of iodine-containing contrast
agents, which outline blood vessels and confer additional density to soft tissues.
CT scanners are highly sensitive in detecting disease in bones and can actually provide
images of internal organs that are impossible to visualize with ordinary x-ray technique.
Magnetic Resonance Imaging
Magnetic resonance imaging (MRI) uses magnetic fields and radiowaves rather than x-
rays. This technique produces sagittal, coronal (frontal), and axial (cross-sectional) images,
the latter being similar to CT scanning. MRI, however, uses no x- rays and does not require
a contrast medium. The technique is based on the fact that the nuclei of some atoms
behave like little magnets when a large magnetic field is applied. The nuclei spin and emit
radio waves that create an image as the nuclei move back to an equilibrium position.
Hydrogen nuclei, present in water and abundant in living tissue, are the nuclei used to
create an image.MRI is useful in detecting edema in the brain, projecting a direct image of
the spinal cord, detecting tumors in the chest and abdomen, and visualizing the
cardiovascular system.
Ultrasound Imaging
Ultrasound imaging, or ultrasonography, uses high-frequency inaudible sound waves
that bounce off body tissues and are then recorded to give information about the anatomy
of an internal organ. An instrument called a transducer or probe is placed near or on the
skin, which is covered with a thin coating of gel to ensure good transmission of sound
waves. The transducer emits sound waves in short, repetitive pulses. The ultrasound waves
LOM Radiology Notes
move through body tissues and detect interfaces between tissues of different densities.
An echo reflection of the sound waves is formed as the waves hit the various body tissues
and bounce back to the transducer. These ultrasonic echoes are then recorded as a
composite picture of the area of the body over which the instrument has passed. The
record produced by ultrasound is called a sonogram.
