10/20/2011

Introduction to
Radiographic Imaging
Image Interpretation

Objectives
The student will be able to:
Correctly

review a radiographic study

conventional anatomic terminology
Correctly name a radiographic view
Correctly hang a radiographic image
List and explain the roentgen signs
Know and identify the five radiographic
opacities
Use

Review
Radiograph is picture of x-rays able to

penetrate object literal shadow of object

Differential absorption of x-rays passing

through tissues is basis of radiography

Radiograph is a two-dimensional depiction
of a three-dimensional object

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Principles of interpretation
Review radiographs in appropriate environment

(low lighting, quiet)

Be sure to have appropriate views and complete

study
Hang or display radiographs in a standard

manner
Make sure patient positioning and preparation

are adequate
Make sure radiographic technique is appropriate
Evaluate entire radiograph systematically

Principles of interpretation
Radiographic interpretation

need not be mysterious

Knowledge of normal radiographic
anatomy and possible variants is
required!
Be systematic
Use basic radiographic signs
Formulate a differential diagnosis
list

Conventional Terminology
Use same terminology as in anatomy class
Trunk: cranial, caudal, dorsal, ventral
Head: rostral, caudal, dorsal ventral
Extremity
Above carpus and tarsus: cranial, caudal, proximal,
distal
At and below carpus and tarsus:

Front limb: dorsal, palmar, proximal, distal

Rear limb: dorsal, plantar, proximal, distal

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Conventional Terminology

Application Question
Collimation refers to restricting the x-ray

beam to the confines of the imaging plate.

What is one important reason to do this?

Radiographic Views
Named according to the direction of the

x-ray beam as it penetrates the body part

from point-of-entrance to point-of-exit

For example, during a ventrodorsal

projection of the thorax, the beam enters the
ventral aspect of the thorax and leaves the
dorsal aspect of the thorax while the patient
is in dorsal recumbency

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Ventrodorsal (VD) view of thorax

X-ray beam

Ventrum

Dorsum

Radiographic Views
Technically, lateral views of abdomen/thorax

should be described as right to left lateral or

left to right lateral

Convention shortens name:

Left lateral patient in left lateral recumbency

Right lateral patient in right lateral recumbency

Technically, lateral views of extremities should

be described as lateromedial or mediolateral

Convention shortens name:

Lateral

Right lateral view of the abdomen

X-ray beam

Left lateral aspect

Right lateral aspect

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Dorsopalmar (DP) view of carpus

From Tech of Vet Rad, 5th

ed, Morgan JP, 1993

Radiographic Views
Oblique views are views that are made off

angle from the standard lateral and

DP/CrCd views

Still named by the path of the x-ray beam

Technically should include angle of obliquity
(dorsal 60 lateral-palmaromedial oblique)
Not

needed for standardized views

However, degree of obliquity does change

appearance

Dorsolateral-plantaromedial
(DLPM) oblique view of tarsus

From Tech of Vet Rad, 5th

ed, Morgan JP, 1993

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Why oblique views?

Generally, abnormalities (fractures, bony

reactions, etc) are easier to see if the x-ray

beam strikes them tangentially
Abnormalities are much more difficult to
see if the x-ray beam strikes them head-on
(en face)
Nearly obligatory for complex structures
(equine carpus and tarsus, skull)

En face versus tangential

En face

Tangential

Application Question
What is wrong with this radiograph?

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Radiographic Image
Through and through concept
For a given view (for example, craniocaudal
versus caudocranial) it generally does not
matter which way the beam enters and leaves
the object image will appear the same
Some

exception for organ sag and gas distribution

seen in thorax and abdomen

Radiographic image

Displaying or hanging
radiographs for interpretation
By convention, images are always hung

on the view box or displayed on a monitor

in the same manner

Assists in developing picture of normal

anatomy

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Displaying or hanging
radiographs for interpretation
Ventrodorsal (VD)/Dorsoventral (DV) view of

trunk

Cranial portion of image at top of viewing screen

Patients left positioned on viewers right

Ventrodorsal (VD)/
Dorsoventral (DV) View
Patients head (cranial)

Patients
left

Patients
right

Patients rear (caudal)

Displaying or hanging
radiographs for interpretation
Lateral view of trunk
Dorsal portion of image at top of viewing
screen
Cranial portion of image positioned on
viewers left

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Lateral View

Patients dorsum

Patients
Head
(cranial)

Displaying or hanging
radiographs for interpretation
Craniocaudal (CrCd)/Caudocranial (CdCr),

Dorsopalmar (DP)/Palmarodorsal (PD),

Dorsoplantar (DP)/Plantarodorsal (PD) of
extremities

Proximal portion of image at top of viewing screen

Viewers discretion how to place medial and lateral
aspects of image

Consider hanging as if looking at the patient

OR place lateral aspect of the limb on the viewers left

Dorsopalmar View
Proximal

L
A
T
E
R
A
L

L
A
T
E
R
A
L

Medial

Left

Right
Distal

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Dorsopalmar View
Proximal

L
A
T
E
R
A
L

L
A
T
E
R
A
L

Left

Right
Distal

Displaying or hanging
radiographs for interpretation
Lateromedial (lateral)/mediolateral (lateral)

view of extremities
Proximal portion of image at top of viewing
screen
Cranial (or dorsal) portion of image positioned
on viewers left

Lateromedial View
Proximal

Caudal

Cranial

Plantar

Dorsal

Distal

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Lateromedial View
Proximal
R

Cranial

Caudal

Distal

Application Question
Why cant we tell where the lumen of the

heart chambers are on a radiograph?

Displaying or hanging
radiographs for interpretation
Important concept:
You cannot determine right from left without
anatomic or artificial markers
Must

incorporate positioning markers with images

convention, the positioning markers should be
placed at the lateral aspect or the cranial/dorsal
aspect of an extremity

By

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Which Limb?

Radiographic Image
REMEMBER:
Two-dimensional shadow of a threedimensional object

Need at least two orthogonal views to portray

object faithfully

Necessity of two views

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Necessity of two views

Roentgen Signs
Identify radiographic abnormalities

(Roentgen signs)
Opacity
Size
Shape
Number
Location/position/alignment
Margination
Function

Radiographic Opacities
Five basic radiographic opacities
Air (gas) opacity black
Fat opacity dark gray
Fluid/Soft tissue opacity light gray

Bone

Fluid:

water, blood, urine, etc

Soft tissue: muscle, organ

Bone opacity gray white

Metal opacity white
Air

Fat

Fluid

Metal

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Radiographic Opacities
Bone

Air

Metal

Fat

Fluid/Soft tissue

Roentgen Signs
example

Roentgen Signs
example
Opacity soft tissue

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Roentgen Signs
example
Size 13 cm long x 8 cm high

Roentgen Signs
example
Shape ovoid

Roentgen Signs
example
Number one

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Roentgen Signs
example
Location cranioventral abdomen near tail of
spleen

Roentgen Signs
example
Margination irregular or lobulated

Roentgen Signs
example
One ovoid, lobulated, 13 x 8 cm, soft

tissue mass in the cranioventral abdomen

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Goal of Imaging
Create an image that will faithfully

represent what is going on in the area of

the patient being imaged while limiting
exposure to the patient and those handling
the patient

Application Question
Which view of the tarsus is being made?

A. Craniocaudal
B. Caudocranial
C. Dorsoplantar
D. Plantarodorsal

Summary
Radiographic views named by path of x-rays

using conventional terminology

Always display or hang radiographs in a

standard manner
Evaluate radiographs using Roentgen signs to

describe findings
There are five basic radiographic opacities

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