Computed tomography. Dr. Csébi Péter SZIE, ÁOTK, Surgery. Development of the CT scanners 1. Fourth generation CT. Third generation CT.

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1 Computed tomography Dr. Csébi Péter SZIE, ÁOTK, Surgery The main parts of the CT GE 9000 Controll panel Gantry and table High voltage generator Multiformat kamera Shimadzu 4500 TE GE Development of the CT scanners 1. Third generation CT Fourth generation CT 1

Digital imaging CT window Hounsfield scale: The CT windows Different

CT Reconstructions 3D CT Postprocessing Anaesthesia!

Contrast procedures Postprocessing Hard copy The CT examination Contrast

: iohexol Intrathecal contrast material - f.i.:.: iohexol Per os c.

2 Digital imaging CT window Hounsfield scale: The CT windows Different windows Density measuring Distance, size Magnification High resolution CT Reconstructions 3D CT Postprocessing Anaesthesia! Symmetrical positioning Scout view DV Scout view LL Transversal slices Contrast procedures Postprocessing Hard copy The CT examination Contrast materials Iv. contrast -f.i.:.: iohexol Intrathecal contrast material - f.i.:.: iohexol Per os c.: -positiv contrast m. (f.i( f.i.:.: Gastrografin) -water Possible complications with iv. contrast materials: - allergy-anaphylaxy anaphylaxy! 2

CT in veterinarian medicine CT MRI Brain and skull Bulla

Temporomandibular joint Spine Orthopedy (elbow, tarsus,

) Thorax, endocrin glands, abdomen Neoplastic diseases

dogs, and meingeoma in cats More than 50 % in

3 CT in veterinarian medicine CT MRI Brain and skull Bulla tympani Orbita Nasal cavity and sinuses Temporomandibular joint Spine Orthopedy (elbow, tarsus, hip, pelvis etc.) Thorax, endocrin glands, abdomen Neoplastic diseases Etc. Brain tumors - Incidentia: Stünzi et al 5300 dogs / 61 brain tumor (1.2 %) Generally over 6 years of age Most often glioma in dogs, and meingeoma in cats More than 50 % in brachycephal dogs Diagnostic imaging in brain tumors CT and MRI Iv. contrast material! Thick bones, thick muscles, small brain Generally severe progrediating cases CT is effective in most of the cases, but not allways! Imaging is not equal with a histopat. result- brain biopsy! 3

4 Plexus chorioideus papilloma Chorioid plexus papilloma Nationale: 9 y, mastiff, male dog Anamnesis: chronic, progrediating vestibular signs Neurology: apathy, head tilt, inbalance, anorexy Lokalisation: brainstem, central vestibular syndrome Nativ Postcontast Morphology dilatatio ventriculi 4

$fracture, epidural,$ haemorrhage, contusion,

$fracture of the skull CT:$ $fracture, intracranial$

5 Morphology Brain tumor Brain tumors Hydrocephalus CT is very sensitive and specific in case of ventriculomegalia The clinical signs are not linearly connected to the ventriculomegalia The result of the neuro. exam is very important! Hydrocephalus Traumatic injuries of the skull and brain Consequences: fracture, epidural, subdural, subarachnoideal haemorrhage, contusion, diffuse axonal injuries, cerebral edema Rtg: fracture of the skull CT: fracture, intracranial bleeding, cerebral edema, planning of surgical treatment 5

6 Traumatic injuries of the skull and brain Car accident Bulla tympani CT and conv. radiology Remedios: the result of the x-ray exam. was neg. In 25% of the surgically treated otitis media cases. Griffiths: by experimental examinations the radiographs show 80% sensitivity and 65% specificity in fluid accumulation in the bulla cavity Love: : CT is more sensitive than radiographs Horner-syndrome Bulla tympani Bulla tympani 6

7 Eye and orbital region Exophtalmus and 3rd eyelid protrusion in most of the cases retrobulbar mass! Tumor, abscess, cyst, haematoma Diag. imaging: : UH, CT and MR (generally( radiograph is not helpful) UH: eyeglobe and retrobulbar soft tissues. CT, (MR): retrobulbar soft tisues + bones Osteosarcoma of the eyeglobe Retrobulbar abscess Retrobulbar foreign body 7

8 Retrobulbar masses Neoplasma Neoplasma Nasal cavity and paranasal sinuses Tumor or chronic rhinitis? CT is more sensitive and specific than conv. rad. Easier planning of the radio and surdgical therapy Nasal cavity and sinuses Coronal view Transversal view 8

9 Nasal cavity and sinuses Adenocarcinoma adenocarcinoma Nationale: 9 y, female, shephard dog History: chronic nasal discharge, epistaxis on the left side, later epileptic seizures and lethargy Neurology: semicoma,, no menace reflex, epistaxis, exophtalmus Lokalisation: forebrain, nasal cavity, retrobulbar region CT CT Natív Postcontrast 9

10 Macromorphology Macromorphology Diabolo bullet osteoma osteoma 10

11 2 months control Spine Trauma CT, MRI, (RTG) compression MRI, (myelography (myelography,, CT, CTCT-myelo) myelo) Myelon Preop CT 2 months control 11

12 Spine compressive lesions Intramedullar compression neoplasma Spine Extramedullar compression - neoplasma osteosarcoma osteosarcoma 12

13 osteosarcoma osteosarcoma Discus hernia 13

14 Discus hernia Discus protrusio subarachnoideal cyst 14

$fracture$ Tumor 15

15 Fracture of the atlas Post op. C5 fracture Post op. Tumor 15

16 fibrosarcoma nativ postcontrast Orthopedy Thyroid gland follicular adenocarcinoma FCP j.o. 16

17 Thorax acropachia neoplasma Development of CT scanners Helical CT (volumen CT) Hernia diaphragmatica 17

18 Multislice CT Thanks for your attention! 18

HEAD AND NECK IMAGING. James Chen (MS IV)

HEAD AND NECK IMAGING. James Chen (MS IV) HEAD AND NECK IMAGING James Chen (MS IV) Anatomy Course Johns Hopkins School of Medicine Sept. 27, 2011 OBJECTIVES Introduce cross sectional imaging of head and neck Computed tomography (CT) Review head