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Conventional Tomography
Tomo = cut, section or layer slice Image which provides just a slice of the whole structure Focused image without superimposition of structures with thick image layer
Conventional Tomography
Film based tomography Blurring of structures outside plane of interest X-ray tube moves about a fulcrum Tube and film opposite sides of fulcrum Tube and film move in opposite directions Angle determines thickness of the slice
Tomography Movements
Linear Tomography
Spiral Tomography
Hypocycloidal Tomography
Computed Tomography
Introduced in 70s Principle: Internal structures of an object can be reconstructed from multiple projections of the object
CT Scanner
CT Movement/Geometry
CT Geometry
Early scanners involved few detectors with the tube and the detectors moving Newer scanners use spiral or helical movement to create overlapping images
Mechanism of CT
Detectors
X-ray tube is rotated around the patient Radiation transmitted through the patient is absorbed by a ring of detectors Absorbed radiation is converted to an image
Image construction
X-ray hits detector which consists of an ionization chamber or scintillation crystals Scintillation crystals
Cadmium tungstate most common Crystals convert x-rays to light Photodiode converts light to electric current
Ionization chamber detector w/ Xe gas creates current Analog information digitized and sent to the computer for reconstruction
Ionization Chamber
X-ray ionizes xenon gas Electrons move towards anode Generates small current Converted to electrical signal
Image Construction
CT Image Construction
Pixel - Voxel
Pixel - picture element Voxel - volume element
Image construction CT
The image consists of a matrix of individual pixels representing the face of a volume called a voxel A single-plane image is constructed and displayed as differences in optical density
Range is from 1000 to +1000 Hounsfield units
Windowing
Usual CRT can display ~256 gray levels Approx. 60 shades are visually discernible 2000 CT numbers Assign 8 CT numbers to one shade Or, select the CT number of the tissue of interest, then range of 128 shades
Windowing
Center CT number is the window level Range of CT number above and below the window level is window width Window level determines brightness Window width determines contrast
Windowing
Manipulation allows customization of visibility
soft tissues
brain
dense structures
bone
200
WL = 0 WW = 400
400
-200
CT Number
Tissues Air Lung Fat Water Muscle Bone Typical CT values Range (Hounsfield unit) -1000 -200 to 500 -50 to 200 0 +25 to +45 +200 to +1000
CT
1. 2. 3. 4. 5.
1. 2. 3. 4. 5.
Superior rectus m. Optic nerve Inferior rectus m. Lateral rectus m. Zygomatic bone
spin They spin around their axes similar to earth spinning around its axis Elements with nuclear spin has odd number of protons, neutrons
and
23Na
has nuclear
Magnetic Moment
When a nucleus spins, it has angular momentum When the spinning nucleus has a charge, it has magnetic dipole moment Moving charges produce magnetic fields
Hydrogen Nucleus
Most abundant Yields strongest MR signal
N Spin
Precession of a Top
Radiofrequency Pulse
RF pulse is an electromagnetic wave Caused by a brief application of an alternating electric current
Receiver Coils
Send or broadcast the RF pulse Receive or pick up the MR signals Types: Body coils, head coils, and a variety of surface coils
Relaxation
This is the process that occurs after terminating the RF pulse The physical changes caused by the RF pulse revert back to original state
Advantages of MRI
Higher resolution of tissues No ionizing radiation Multiplanar imaging
Disadvantages of MRI
Long imaging time Hazards with ferromagnetic metals (pacemakers, vascular clips, etc) Claustrophobia Higher cost
Gray
Black
1.
2. 3. 4.
1. 2. 3. 4. 5. 6.
Infratemporal sp. Masticator space Parotid space Parapharyngeal sp Int. carotid Carotid space
Nuclear Medicine
radioactive compounds target tissues radioactive agents pools in the target tissues detected and imaged by external detectors
Nuclear Medicine
Shows structure and function of the target tissues Static and dynamic conditions Scintigraphy scans or RN (radionuclide) scans Bone scans or salivary gland scans
Technetium
99mTcO - - thyroid and salivary 4 99Tc phosphate - bone scan 99mTc
gland scan
scan
Case 1
Is this an active disease?
Use Modality Conventional TMJ, Implant, Bony Tomography Pathology CT TMJ, Implant, Bony Pathology, Some soft tissue Cone Beam TMJ, Implant, Bony CT Pathology MRI TMJ, Soft tissues, Pathology, Sinus
Advantage Simple Technique, Low radiation Great resolution, images many structures Low Radiation, resolution,images many structures Soft tissue visualization, Nonionizing radiation Detecting Metastases, Active infection