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Pocket Atlas of Radiographic Positioning (eBook)

Including Positioning for Conventional Angiography, CT, and MRI
eBook Download: EPUB
2008 | 2. Auflage
577 Seiten
Thieme (Verlag)
9783132579699 (ISBN)

Lese- und Medienproben

Pocket Atlas of Radiographic Positioning - Torsten Bert Moeller, Emil Reif
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<p><strong><em>Radiographic positioning - comprehensive and concise</em></strong></p><p>Now in its second edition, <strong><em>Pocket Atlas of Radiographic Positioning</em></strong> is a practical how-to guide that provides the detailed information you need to reproducibly obtain high-quality radiographic images for optimal evaluation and interpretation of normal, abnormal, and pathological anatomic findings. It shows positioning techniques for all standard examinations in conventional radiology, with and without contrast, as well as basic positioning for CT and MRI. For each type of study a double-page spread features an exemplary radiograph, positioning sketches, and helpful information on imaging technique and parameters, criteria for the best radiographic view, and patient preparation. Clearly organized to be used in day-to-day practice, the atlas serves as an ideal companion to Moeller and Reif's <em>Pocket Atlas of Radiographic Anatomy</em> and their three-volume <em>Pocket Atlas of Cross-Sectional Anatomy</em>. </p><p><strong>Highlights of the second edition:</strong></p><UL><LI>New chapters on positioning in MRI and CT, including multislice CT <LI>A greatly expanded section on mammography <LI>Special features, including information on the advantages of a specific view, variations of positions, and practical tips and tricks <LI>Nearly 500 excellent radiographs and drawings demonstrating the relationship between correct patient positioning and effective diagnostic images </LI></UL><p><strong><em>Pocket Atlas of Radiographic Positioning, Second Edition</em></strong> is an excellent desk or pocket reference for radiologists, radiology residents, and for radiologic technologists.</p>

1 Skull


Lines of Projection


a Vertical auricular line (connects the two external auditory meatus, divides skull into two halves)

b Eye–ear line (orbitomeatal line, extends from the outer canthus of the orbit to the external auditory meatus)

c Horizontal infraorbitomeatal line (from the bony inferior orbital rim to the external auditory meatus)

A = Median line

Skull: PA


Criteria for a Good Radiographic View

............................................................................................

– Skull symmetrical and completely visualized

– Skull PA: superior petrous ridge (1) projects into mid-orbit (2)

– Skull AP: superior petrous ridge projects into the lower third of the orbit

– Outer table of the skull visible

Imaging Technique

............................................................................................

Image receiver (e. g., film): size 24 × 30 cm (10 × 12″), portrait

Image receiver dosage (sensitivity class): ≤ 5 μGy (SC 400)

SID: 115 cm (40″)

Bucky: yes (under the table, r 8 [12])

Focal spot size: large (focal spot nominal value: 0.6 [≤ 1.3])

Exposure: 70–85 kV, automatic, center cell

Patient Preparation

............................................................................................

– Remove dentures, glasses; open braids

– Remove jewelry (necklace, earrings, hairpins, glasses, hearing aid)

– Open clothes (buttons, zipper)

Positioning

............................................................................................

– Prone, arms along sides of the body

– Forehead supported on a sponge wedge, tip of the nose rests on the table, chin is flexed (horizontal infraorbitomeatal line is vertical)

– Supine position, head flexed so that the horizontal infraorbitomeatal line is vertical, support the head if necessary

– Tilt tube to align the central ray parallel to the horizontal infraorbitomeatal line, median plane in middle of the film, skull straight

– Head immobilized with weighted band

– Skull filter, “keyhole,” long portion over the region of the cervical spine

– Gonads shielded (large lead apron)

Alignment

............................................................................................

– Projection: (1) PA, or (2) AP, perpendicular to the film at the middle of the skull

– Central ray directed to occipital protuberance at the center of the film

– Centering and collimation, side identification

– No breathing or swallowing during the exposure

Tips & Tricks

............................................................................................

– The skull is straight when both auditory meatus are projected at the same level

Skull: Lateral Projection


Criteria for a Good Radiographic View

............................................................................................

– Complete visualization of the entire skull

– Both temporomandibular joints superimposed

– Lesser and greater sphenoid wings of the two sides superimposed (1)

– Sella linear (2) (no double line)

– Clinoid processes superimposed (3)

Imaging Technique

............................................................................................

Image receiver (e. g., film): size 24 × 30 cm (10 × 12″), landscape

Image receiver dosage (sensitivity class): ≤ 5 μGy (SC 400)

SID: 115 cm (40″)

Bucky: yes (under the table, r 8 [12])

Focal spot size: small (focal spot nominal value: 0.6 [≤ 1.3])

Exposure: 70–80 kV, automatic, center cell

Patient Preparation

............................................................................................

– Remove dentures, glasses, hearing aids, etc.

– Remove jewelry (necklace, earrings, hairpins)

– Open clothes (buttons, zipper)

Positioning

............................................................................................

– Prone (or seated), side of the skull to be examined adjacent to the film

– Upper arm along the side of the body, forearm rests on the table

– Anterior shoulder and chin supported with sponge wedge so that the median plane of the skull is parallel to the film

– Upper border of the cassette 2 FB above the skin line (or simply: middle of the cassette = middle of the skull)

– Skull immobilized with weighted band

– Skull filter

– Gonads shielded (long lead apron)

Alignment

............................................................................................

– Projection: lateral, perpendicular to the film

– Central ray directed to the middle of the skull (about 1 cm above and in front of the external auditory meatus, center of the film)

– Centering and collimation, side identification

– No breathing or swallowing during the exposure

Tips & Tricks

............................................................................................

– Put a pillow wedge under the chest of thin patients and children so that the median sagittal plane of the skull is parallel to the table

Paranasal Sinuses: Occipitomental Projection


Criteria for a Good Radiographic View

............................................................................................

– Both orbits symmetrical (1)

– Superior petrous ridges (3) below antral floors (2)

– Sphenoid sinus (4) projected through the open mouth

Imaging Technique

............................................................................................

Image receiver (e. g., film): size 13 × 18 cm (5 × 7″) or 18 × 24 cm (8 × 10″), portrait

Image receiver dosage (sensitivity class): ≤ 5 μGy (SC 400)

SID: 115 cm (40″)

Bucky: yes (under the table, r 8 [12])

Focal spot size: small/large (focal spot nominal value: 0.6 [≤ 1.3])

Exposure: 70–85 kV, automatic, center cell

Patient Preparation

............................................................................................

– Remove dentures, glasses; open braids

– Remove jewelry (necklace, earrings, hairpins)

– Open clothes (buttons, zipper)

Positioning

............................................................................................

– Facing the film (seated erect)

– Head straight (median sagittal plane perpendicular to the table)

– Head extended backwards so that the chin touches and the tip of the nose is about 1 FB from the vertical cassette

– Mouth wide open

– Extension cone may be used

– Gonads shielded (large lead apron)

Alignment

............................................................................................

– Projection: occipitonasal

– Central ray enters 2 FB above occipital protuberance, emerges at the level of the upper lip (directed at maxillary antrum or inferior orbital rim) in the center of the film

– Centering and collimation, side identification

– No breathing or swallowing during the exposure

Tips & Tricks

............................................................................................

– Before taking the exposure, tape a paper towel to the cassette holder to put chin and mouth against (hygiene)

– If the patient cannot extend the head far enough, have him or her rest it on the chin and nose, move the tube cephalad and angle the central ray correspondingly, craniocaudad (mostly 12°, but possibly up to 30°)

– The cross in the center of the upright Bucky may be used as a centering aid: center of the cross directly below the nose

Paranasal Sinuses: Occipitofrontal (PA) Projection


Criteria for a Good Radiographic View

............................................................................................

– Frontal sinuses completely visualized (1)

– Both superior petrous ridges (2) projected over the upper third of the orbit

Imaging Technique

............................................................................................

Image receiver (e. g., film): size 13 × 18 cm (5 × 7″) or 18 × 24 cm (8 × 10″), portrait

Image receiver dosage (sensitivity class): ≤ 5 μGy (SC 400)

SID: 115 cm (40″)

Bucky: yes (under the table, r 8 [12])

Focal spot size: large (focal spot nominal value: 0.6 [≤ 1.3])

Exposure: 77 kV, automatic, center cell

Patient...

Erscheint lt. Verlag 19.11.2008
Sprache englisch
Themenwelt Medizinische Fachgebiete Radiologie / Bildgebende Verfahren Radiologie
Studium 2. Studienabschnitt (Klinik) Anamnese / Körperliche Untersuchung
Schlagworte anatomy • Angiography • Computed tomography • CT • imaging procedures • Magnetic Resonance Imaging • Mammography • MRI • nuclear spin tomography • Positioning • Radiograph • radiograph positioning • X-Ray
ISBN-13 9783132579699 / 9783132579699
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