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CT scan

Practical Part of Diagnostic images Total marks: 5+5

Pass mark : 6
Compartment (for details, please see the course contents) Topic Allotted Actual
marks marks
obtained
Radiological 5. Normal X-ray - Identify modality 1+1+2+1
& Imaging image: - Mention
Anatomy type/plane/view
6. Normal CT/MRI/ - Identify 2 structures 1+1+2+1
Ultrasonographic - Mention relevant
image clinical implication
of modality

CT scan: for 1st Professional MBBS Exam:

• CT scan of chest at the level of 4th thoracic vertebra (corrected)

• HR-CT of chest
• CT scan of abdomen at the level of 2nd lumbar vertebra
• CT scan of brain at different levels (at the level of ventricles and at sagittal plane)
Check list

Roll Modality of Type/plane/view Identification Relevant Total

no. the image: of the image: 1 2 clinical marks
(1) (1) (1) (1) implication of (5)
modality
(1)
01
02

Computed tomography (CT scan or CAT scan) is a noninvasive diagnostic imaging procedure
that uses a combination of X-rays and computer technology to produce horizontal, or axial,
images (often called slices) of the body.

Like traditional x-rays, it produces multiple images or pictures of the inside of the body.

A CT scan shows detailed images of any part of the body, including the bones, muscles, fat,
organs, and blood vessels. CT scans are more detailed than standard X-rays.

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[Computed Tomography (CT or CAT) Scan of the Abdomen,

https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/computed-tomography-ct-
or-cat-scan-of-the-abdomen ]

Views/planes Terminology Side determination

of CT scan
images

sagittal, The shade of tissues or fluid or *When interpreting axial views, the image is
coronal and air is referred with the word viewed from the feet upwards – and so the
axial plane density: left-hand side of the image refers to the
Hyperdense patient’s right.
Isodense
Hypodense

HU or Hounsfield units are used in CT imaging to quantify radiodensity.

It reflects the level of absorption of x ray beams by certain structures in the body, which
ranges from
+1000 (hyperdense), 0 (isodense) to -1000 (hypodense).
The structures having more density, appear lighter on CT scans.
Pure water is isodense.
Hyperdense: brighter or more dense (gray to white)
Hypodense: darker or less dense (gray to black)

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Advantage of CT scan: (https://www.radiologyinfo.org/en/info/chestct)

• There is more detail about bony structures

• CT scanning is painless, noninvasive, and accurate.
• It’s a more powerful and sophisticated x-ray that takes a 360-degree image of the body.
• Unlike conventional x-rays, CT scanning provides very detailed images of many types of
tissue as well as the lungs, bones, and blood vessels.
• In emergency cases, CT scan can reveal internal injuries and bleeding quickly enough to
help save lives e.g. CT scan of head/brain is usually done in RTA to exclude any
hemorrhage
• Use of a contrast dye injected into the blood helps to see the body structures more clearly
on the CT scan.
• CT imaging provides real-time imaging, making it a good tool for guiding needle
biopsies and needle aspirations, particularly for the procedures involving the lungs,
abdomen, pelvis, and bones.
• Cost effective than MRI
• Unlike MRI, an implanted medical device of any kind will not prevent the patient from
having a CT scan.

Disadvantage of CT scan
• There is moderate amount of exposure to radiation in CT scan
• There may be risks of cancer
• It is not ideal for soft tissue details

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• There may be allergic reactions due to use of contrast media

• Nausea, dizziness
• Because children are more sensitive to radiation, they should have a CT exam only if it is
essential for making a diagnosis. They should not have repeated CT exams unless
necessary.

CT scan of chest at the level of 4th thoracic vertebra:

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CT scan of chest at the level of 4th thoracic vertebra

(https://radiologykey.com/wp-content/uploads/2019/05/f18-01-05-9780323394192.jpg)

Check list for CT scan of Chest at The level of 4th Thoracic vertebra

Modality Type/plane Identification: (any TWO features) Relevant clinical

of the /view of the implication of modality
image image

Given Modality features Structural

features
Hyperdense: Hypodense: darker
brighter or more or less dense (gray
dense (gray to to black)
white)

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Non Anatomy of Skin ▪ Subcutaneous Lung window ▪ To examine abnormalities

contrast CT lung, tissue containing found on x- ray chest
Muscles: Mediastinal
scan of mediastinu fat
window ▪ To see any distortion e.g.
chest m and erector spinae,
▪ Trachea mediastinal shifting or
bones at the pectoralis major, Bony window
lesions, tumor, inflammation,
level of T4, intercostal ▪ Right and left
infection etc.
muscles lung
axial scan
▪ To detect and evaluate the
or view Muscular tube:
extent of tumor
▪ esophagus
▪ To see any disruption -
Bones injury to chest, hemorrhage

▪ vertebral body ▪ In some patients with

& laminae reduced kidney function, CT
▪ manubrium contrast material may worsen
▪ ribs kidney function.
▪ scapula
▪ Image guided procedure
Blood vessels
▪ Superior vena
cava
▪ ascending and
descending aorta
▪ descending
thoracic aorta
▪ azygous vein

HRCT chest (High Resolution CT scan)

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Checklist
Modality Type/plane/vi Identification: (any TWO features) Relevant
of the ew clinical implication
image of the image
Modality features Structural ▪ It is done for diagnosis
Hyperdense: Hypodense: darker features and monitoring of
brighter or more or less dense (gray diseases of the lung tissue
dense (gray to to black) and the airways.
white) ▪ To detect small lesion of
chest where other in
HRCT Coronal Features: Features: Lungs conventional chest
chest reconstruction ▪ Aorta ▪ Right and left lung Vessels images, it is difficult to
Pulmonary ▪ shadow of fields Trachea detect the lesion.
blood vessels ▪ Trachea Bronchi
window ▪ As there is no use of
in lung field ▪ Right and left Muscles
▪ The diaphragm contrast medium, there is
principal bronchi Bones
▪ Ribs no risks of allergic
Vertebra reactions.

CT scan of abdomen at L2 level

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Check-list

Modality Type/pla Identification: (any TWO features) Relevant

of the ne/view . clinical implication
image of the
image
Hyperdense: (gray to Hypodense: darker or
white) brighter or less dense (gray to
more dense black)
Non Soft Organs: ▪ Transverse colon 1. For detailed information about
contrast tissue ▪ Liver ▪ fat around the kidneys abdominal organs
CT scan and bony ▪ Gall bladder, ▪ Subcutaneous tissue 2. To see any distortions:
of window, ▪ Duodenum, containing fat inflammation, unexplained abdominal
▪ Pancreas pain, obstructions and/or diseases of the
abdomen at 2nd
▪ Small intestine, abdominal organs.
lumbar ▪ Right & left kidneys 3. To see any disruptions e.g. injuries,
vertebral with intra-abdominal bleeding
level their hila 4. Diagnosis and treatment: used to
Axial Blood vessels visualize placement of needles during
view / ▪ Abdominal aorta, biopsies of abdominal organs or tumors
section ▪ Inferior vena cava or during aspiration (withdrawal) of
▪ Superior mesenteric fluid from the abdomen.
artery 5. For monitoring tumors and other
& superior mesenteric conditions of the abdomen before and
vein after treatment.
Bones
▪ L6 Vertebral body &
spine
▪ Ribs
Muscles:
erector spinae,
intercostal, anterior
abdominal
Skin

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CT scan of brain at different levels

At the level of the ventricles
( https://radiopaedia.org/cases/normal-ct-brain )

https://prod-images-
static.radiopaedia.org/images/4170261/c5d7c3ed6c7fe53e59c2dd902e44b9_big_ga
llery.jpg

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CT scan of brain Anatomical Society of Bangladesh
Modality Type/plane Identification: (any TWO features) Relevant clinical
of the /view of the implication of the
image image Hypodense: Isodense: gray Hyperdense: brighter or modality
darker or less structures such as more dense (gray to
dense (gray to water white)
black)
CT scan of Non Features: Features: Features: To see disruptions:
brain at contrast ▪ Frontal air sinus ▪ lateral ventricles ▪ Bones ▪ Vascular abnormalities
the level Axial ▪ subcutaneous fat containing CSF ▪ Cerebral cortex - Ischemic stroke (> 2
of the section ▪ 3rd ventricle ▪ Choroid plexus days old)
ventricles ▪ Sulci containing ▪ White matter: - Hemorrhagic stroke
CSF internal capsule (acutely)
▪ Sub-arachnoid ▪ Caudate nucleus ▪ Trauma (fracture of
space ▪ Genu and splenium of skull bones)
corpus callosum
▪ Thalamus To see any distortions:
▪ Skin ▪ Hydrocephalus
▪ Tumor (both primary
for CNS and metastatic)
▪ Inflammations
▪ Abscess
(the use of contrast, it is
more helpful to diagnose
these conditions)

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CT scan of brain at sagittal plane

Checklist

Modality Type/plane/view Identification: (any TWO features) Relevant clinical

of the of the image implication of the
image: Hypodense Isodense Hyperdense modality

CT scan of Non contrast Subcutaneous Sulci gyri of cerebral cortex ▪ To see any
brain Sagittal reform tissue containing thalamus disruptions e.g.
containing fat CSF brain stem Inflammation,
Frontal air Ventricles cerebellum vascular
sinus filled with white matter corpus abnormalities:
Sphenoidal air CSF callosum hemorrhage
sinus Sub- hypophyseal fossa
Nasal cavity arachnoid bones of cranial vault ▪ To see any
space scalp distortions e.g. space
occupying lesions,
tumors, edema.
Hydrocephalus

▪ Stroke –
differentiate between
fresh and old ischemia
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