2020


What is MRI ?PDF download

X-ray 
What is MRI ?PDF download X-ray


Similar to the case with most other intracranial pathology, MRI is the examination of decision for the determination and portrayal of meningiomas. At the point when appearance and area are run of the mill, the determination can be made with a high level of sureness. In certain cases, in any case, the appearances are atypical and cautious understanding is expected to make a right preoperative determination.

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Meningiomas ordinarily show up as extra-hub masses with a wide dural base. They are typically homogeneous and all around surrounded, albeit numerous variations are experienced. It appears that the sign power of meningiomas on T2-weighted pictures corresponds with the histological subtypes 29.

Signal attributes ( in MRI )


Signal attributes of regular meningiomas include:


T1 (in MRI )


normally isointense to dark issue (60-90%) 3,8,13

hypointense to dark issue (10-40%): especially stringy, psammomatous variations

T1 C+ (Gd): generally extraordinary and homogeneous upgrade

T2 (in MRI )


generally isointense to dim issue (~50%) 3,8,13

hyperintense to dim issue (35-40%)

generally corresponds with a delicate surface and hypervascular tumors 13

seen in microcystic, secretory, cartilaginous (metaplastic) choroid and angiomatous variations 12

hypointense to dark issue (10-15%): contrasted with dim issue and typically connects with harder surface and progressively sinewy and calcified substance

DWI/ADC: (in MRI )

atypical and dangerous subtypes may show more prominent than anticipated confined dispersion albeit late work proposes this isn't helpful in tentatively foreseeing histological evaluation 15,16 


MR spectroscopy: (in MRI )

for the most part it doesn't assume a noteworthy job in finding yet can help recognize meningiomas from impersonates. Highlights include: 


increment in alanine (1.3-1.5 ppm)

expanded glutamine/glutamate

expanded choline (Cho): cell tumor

missing or fundamentally decreased N-acetylaspartate (NAA): non-neuronal beginning

missing or fundamentally decreased creatine (Cr)

MR perfusion: (in MRI )

great relationship between's volume move consistent (k-trans) and histological evaluation 28

CT scan : (radiation) 
Ct scan (radiation) information PDF download


CT is frequently the principal methodology utilized to explore neurological signs or side effects, and regularly is the methodology which distinguishes a coincidental injury:


non-differentiate CT (radiation) :-


60% marginally hyperdense to typical cerebrum, the rest are more isodense

20-30% have some calcification 8

post-differentiate CT (radiation) :-


72% splendidly and homogeneously differentiate improve 8

dangerous or cystic variations exhibit greater heterogeneity/less extreme improvement

hyperostosis (5%) 23

run of the mill for meningiomas that adjoin the base of the skull

need to recognize receptive hyperostosis from:

direct skull vault intrusion by adjoining meningioma

essential intraosseous meningioma

growth of the paranasal sinuses (pneumosinus dilatans) has likewise been proposed to be related with front cranial fossa meningiomas 20

lytic/dangerous areas are seen especially in higher evaluation tumors however should make one speculate elective pathology (for example hemangiopericytoma or metastasis) ref








Meningiomas


Meningiomas are extra-hub tumors and speak to the most widely recognized tumor of the meninges. They are a non-glial neoplasm that begins from the meningocytes or arachnoid top cells of the meninges and are found anyplace that meninges are found, and in certain spots where just rest cells are dared to be found. Despite the fact that they are generally effectively determined and are ordinarily favorable to have a low pace of repeat following medical procedure, there are countless histological variations with variable imaging highlights and, in certain occurrences, increasingly forceful natural conduct.

An expansive division of meningiomas is into essential intradural (which might possibly have an optional extradural augmentation) and essential extradural (uncommon) 18. They can likewise be arranged by the area (for example spinal, intraosseous, intraventricular, and so on.), by histological variations (for example clear cell, rhabdoid, and so on.), and by etiology (for example radiation-initiated, and so on.).

Normal meningiomas show up as dural-based masses isointense to dim issue on both T1 and T2 weighted imaging improving clearly on both MRI and CT. A portion of the variations as referenced before can, be that as it may, differ drastically in their imaging appearance.

This article is a general conversation of meningioma concentrating on run of the mill essential intradural meningiomas and the imaging discoveries of intracranial malady. For spinal and essential extradural tumors allude to spinal meningioma and essential extradural meningioma articles separately. A considerable lot of the histological variations are likewise talked about independently.

Infrequently (for example 1-2% of cases 27) meningiomas may likewise emerge at ectopic locales (ectopic essential meningioma, for example, in head and neck, circle, nose, paranasal sinus, oropharynx and even places, for example, the lung

What is ultrasound in ultrasonography? It's risks ,side effects, strengths and weaknesses?


Definition of ultrasonography :-


  • Ultrasonography (usg) is application of medical with ultrasound based imagine diagnostic technique used to visualize internal oragans, structure and their pathological sessions.
  • Ultrasonography is widely utilized in medicine primarily in gastroentrology, cardiology, gynecology and obstetrics, urology and diagnosis or therapeutic procedure with the guidance of ultrasonography (for instance biopsies or drainage fluid collection).

Ultrasound in ultrasonography :-


  • In physics the term "ultrasound" applies the all acoustic energy. (Longitudinal mechanical wave)with a frequency above the audiable range of human hearing.
  • The audiable range of sound is 20hertz - 20 kilohertz .
  • Ultrasound frequency is greater than 20 kilohertz.

Strengths and weaknesses :-


  • The images muscles and soft tissue very well and particularly useful for delineating the interfaces between solid and fluid filled spaces.
  • It renders "live "images where are the operator can dynamically select the most useful section for the diagnosing and documenting changes often enbiling repid diagnosis.
  •  It show the structure as well as some aspects of the function or organs.
  • It has known long-term side effects and competitively flexible ; examination can be performed bedside.

Weakness of ultrasound imaging :-


  • Ultrasound can not penetrate bone And performs poorly when there is air between the scanner and oragan of interest.
  • For ex :- overlying gas in the gastrointestinal tract often makes ultrasound scanning of the pancreas difficult.
  • Even in the absence of bone or air , the depth penetration of ultrasound is limited, making it difficult to image structures that are far removed from the body surface, especially in obsess patient.
  • The method is operator dependent.
  • A high level of skill and experience is need to acquire good quality images and make accurate diagnoses.

Risks and side effects :-


  • Ultrasound is generally considered a "safe"imagine modality .
  • However slight detrimental effects have been accasionally observed.
  • Diagnostic ultrasound studies of the fetus are generally considered to be safe during pregnancy.
  • This diagnostic procedure should be performed only when there is valid medication indication and the lowest possible ultrasonic exposure settings should be used to gain the necessary diagnostic information under the "as low as reasonably achievable" or alarm principle.
  • World health organization technical report series 875 (1998)  support that ultrasound is harmless.
  • "Diagnostic ultrasound is recognized as a safe effective and highly flexible imagine modality capable of providing clinically relevant information about most part of the body in a rapid and cast effective fashion"
  • Although there is no evidence ultrasound could be harmful for the fetus , as food and drug administration views promotion, selling or leasing of ultrasound equipment for making "keepsake fetal videos" to be an unproved us of a medical device .
  • Studies in the safety of ultrasound a study at the Yale school of medicine found a correlation between prolonged and frequent use of ultrasound and abnormal neuronal migration in mice.
  • A meta analysis of several ultrasonography studies no drastically significant harmful effects  from ultrasonography.
  • Studies found no statically significant harmful effect ultrasonography but mentioned that there was a lack of data on long term substantive outcomes such as neurodevelopment.

How many part of the x-ray machine?


  1. X-ray tube
  1. Operating console
  1. High voltage transformer
  1. Tube head & protective housing
  1. Bucky
  1. Colimeter
  1. Gride
  1. Patient table
  1. Radiographic film


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X-RAY TUBE :-
             The part of the x-ray tube have two major component :-

How many  parts of the x-ray machine and x-ray  tube PDF download


  1. Cathode 
  1. Anode 
  1. Glass envelop




  1. The cathode  :-

  • Cathode has a negative electrical charge
  • Contain two major components
  1. Filament
  2. Focusing cup

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1. Filament :-

  • This is a negative because it is a source of electron
  •            
  • Note that the diaphragm show a magnified view of face and it's show dual filament.
  • Only one filament at time will work.
  • The small filament designed to be used with relatively small part while the larger filament is used when the larger body part being X-RAYs.
  • The structure which support the filament is. Known as the "focusing cup".
  • It is designed and shaped so that when the X-RAY machine powered up, electron will literally "boil"of the filament.
  • It glows White hot and the elecrtons however the filament Ina space" charge" until the moment of the exposure and they accelerate very rapidly towards the anode which is not very far away .
This process is known as a "thermionic emmision".
  • The thermionic emission occur when the technologist being make an exposure by pressing the "ready" button on the machine.
  • This action initiates the "boost phase" or that part of the exposure process, where the X-RAY tube is being prepared for he exposure to take the place.
  • While can not the see the actual Shep of the focusing cup, it is designed such that it help"concentrate "the electron stream in a predetermined area of the anode target area known as the" focal spot".
  • The filament has its own circuit powered by a reletevly low voltage and 4-6amps.

  • 2. Focusing cup :-   How the focusing cup works 
  • Shape of focusing cup works 
  • Projectile electron stream  
       


  • We have to examples of how  electron can function given two difference conditions.
  • In the model of top you will see that because of electron repulse each other , as soon as they leave the structure the electron tend spread out.
  • The is would not conducive to good x-ray production.
  • The spread out the occur because the focusing cup is not negatively charged.
  • In the second model , you will notice that cathode structure is negatively charged.
  • This changed then forces the electron together as they exit the cathode structure thereby ensuring that the electron stream does not strike the focal spot in relatively small parts.
  • Focusing cup use:-
           - support the filaments
           - controls trajectory of projectile                       electrons.
           - made of molybdenum nickel alloy.

  • In summary, cathode structure contains the filament and the focusing cup.
  • The purpose is filament cut is to guide the electron stream to the target area on the anode.
  • Because of tremendous amount of the heat the is generated cathode.
  • The structure is made of molybdenum nickel alloy which has excellent thermal qualifies.

2. THE ANODE. :-



  • Anode has a positive electron charge
  • Attracts electrons
  • Has a specific area where the projectile electrons impact focal spot, large vs small
  • The second major part of x-ray is the anode 
  • The anode has a positive electrical charge and attracts electrons when the exposure machine is pressed.
  • The anode is actually a disc made of tungsten because of its thermal qualities also.
  • The disc is designed to rotate during operation.
  • Recall how the cathode is positioned in relation to the anode and you can that the electron stream will strike at the electrons stream will strike the lower part of the disc along an area called the focal track .
  • It is called a track because the anode rotates very fast an the idea is for the electron not concentrate on any given spot for any length of time.
  • Rotation "spreads" the build up of heat along the entire disc rather than just given spot.
  • The specific spot along the track where the electrons stream strikes is called the "focal spot " or tube focus.
  • Rotates at high speed  :- 3200 rpm or 10,000


Two type of anode :-
  1. Stationary anode 
  1. Rotating anode



1. Rotating anode :-


  • The anode is a attached to a cylindrical part known as the" rotor".
  • The rotor is actually part of motor that is made of rotate very high speed.
  • The most x-ray tube revolution per minute is usually 3200 for standard technologist setting, however if the technologist select exposure factors that are considerably larger and therefore very hot, than the rotor can rotate at much greater speed extending 5000rpm.
  • The rotation of the anode ensure that into any one spot will receive successive pulses of the electrons.
  • If there was a rotation then it is very likely that he anode face would be damaged to high heat.

The anode disc :- composed of
      Disc:- molybdenum
      Target focal track*rhenium & tungsten
      Backed by graphite go improve heat
The part of the rotating anode :-

  •  The tungsten disc, The tungsten have a belelloed edge by 6°-20° to utilise the line focus principle, typical size of the disc are 75 mm, 100mm,and 125mm.
  • The rotating assembly with silvery as lubricant and ball bearings.ball bearing of the both edge improve the machine of the anode.
  • A molybdenum stem,poor heat conductor,to minimize,the the role of conduction and increase heat lost by radiation.

Why the copper block ?

     It is improve the thermal capacity of the       anode even further allowing it to handle       higher temperature than the tungsten           plate alone.

Why the tungsten ?


  • Characteristics of the tungsten alloy.
  • It has high atomic number (74).
  • Characteristics interaction.
  • High melting point.
  • Heat conduction.

Focal spot angle :-


  • Focal spot characteristics, large and small focal spot superposed, anode angle facilities X-RAYs directed downward.
  • The focal spot which are imbedded in the rotating anode disc are angled in such a way that when the electrons strike the focal track , the angle makes it easier for X-RAY to be emited in a downward direction.
  • While the projectile electron do not "bounce " away from the target the at which is  positioned allows more X-ray to be directed toward the image receptor or film.

Stationary anode tube :-


  • Low powered systems.
  • Anode does not rotate.
  • Poor heat loading.

Glass envelope :-


  • High evacuated.
  • Tolerates high heat.
  • Made of pyrex.
  • Window or port is thinner.
  • Coating of glass 10y vaporized w.
  • Immersed in oil.
  • The contents of the tube are sealed by in vacuum inside a glass chamber.
  • If gas is present in the enclosure, ionisation would occur producing a widely variable and unwanted tube current (which depend on the number of flowing electron) and variable x-ray energy (which depends on the speed of electrons).
  • Vacuum allows the number of electrons(mA) and the speed of electron (kV) to be controlled independently.

Induction motor :-

    -  Causes rotor to rotate

Protective housing :-


  • Support the tube. 
  • Cools the tube.
  • Insulates from high voltage.
  • Controls leakage radiation.



                     Biography of  

                               Wilhelm rontgen



                                Early life 



Wilhelm Conrad rontgen born on March 27,1845,at kennel in the lower Rhine province of Germany, as the only child of  a merchant in, an manufacturer of,cloth.


When he was three years old his family moved to Apeldoorn in the Netherlands, where went to the institute of martinus Harman van Doorn ,  a boarding school.

 He did not show any special aptitude, but showed a love of nature and was fond of roaming in the open country and forest.
  

                          Education


In 1862, he entered a technical school at ultecht , where he was how ever unfairly explolled accused of having produced a caricature of one of the teacher, which was in fact done by someone else.

In the 1865 , he was unfairly explolled from high  school when one of his teachers intercepted a caricature of one of the teacher which was down by someone else .

Without high school diploma , rontgen could only attend university in the Netherlands as a visitor . Upon hearing he could enter the federal polytechnic institute in zurichhe passed the entrance examination and began studies there as a student of mechanical engineering . 

In 1869 , he graduated with a PhD  from the university of Zurich 

                          Career



Rontgen first work was published in 1870, dealing with the specific heats of gases followed a few years later by a paper on the thermal conductivity of crystals .

Among other problems he studied were the electrical and other characteristics of quartz the influence of presser on the reflective induces of various fluids ; the modification of planes polarised light by electromagnetic influences ; the variations in the function of the temperature and compressibility of water.

                              X-ray


In 1895 , he was studying the phenomena accompanying the passage of  an electric current through a gas of extremely low pressure.

Rontgen on cathode rays led him , however ,to the discovery of a new and different kind of rays . 

On the evening of Nov 8 ,1895, he found that ,if the discharge tube is enclosed in sealed , thick black carton to exclude in all light ,and if he worked in a dark room, a paper plate covered on one side with barium platinocynide placed in the path of the rays become fluorescent .

This was the first "rongenogram " ever taken.in further experiments rontgen showed that the new rays are produced by the impact of cathode rays on a material obje
  
Because their nature was then unknown  ,he gave them the name rays.later, max Laue and his pupils showed that they are of the same electromagnetic nature as light , but differ from it only in the higher frequency of their vibration.

 Numerous honours were showered upon him . In several list of prizes medals , honorary  doctorates etc.

                              Nobel prize


In 1901, rontgen was awarded the first Nobel prize in physics. Rontgen donated the money reward from his Nobel prizes to his university.

Rotten refused to take out patents related to his discovery of x -rays, as he wanted society as  whole to benefit from practical application of the phenomenon.

 Rontgen died at Munich on February 10, 1923 from carcinoma of the intestine.


                          
                 

             Layout of 500mA X-RAY machine

  • 1. x-rays examination table
  •  2. Spot film device
     3. column stand
     4. X-ray tube head
     5. &6. Unit electronics
     7. Chest stand 
     8. Control unit 
     9. MPB with lead glass viewing of 1.7mm lead equivalence. 

                 PROPERTY  OF X-RAY
  
Definition :-
   
       X-ray are defined as weightless package of pure energy that are without electrical charge and that are travel in waves along a straight line with a specific frequency and speed 

   The properties of x-rays maybe classified as :-

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  1. Physical
  2. Biological
  3. Chemical
  4. Physiochemical
           

  1. Physical properties of x-ray :-
  • X-ray belong to a family of electromagnetic radiation . Having a wevlegth between 10A and 0.01A
  • They travel with the same speed as that of visible light (1,86,000 miles/sec)
  • They are invisible to the eye and can not be seen , heard or smelt
  • They remain undetected by the human senses
  • They cannot be reflected, refracted or deflected by a magnetic or electric field as they do not posses any charge
  • X-rays are pure energy ,no mass and they transfer energy from place to place in the form of quanta (photons)
  • X-ray are produced by the collision of electron with tungsten atom. 
  • The Collisions which occur are of two types,thus giving rise to two type of spectra:
  1. Continuous spectra ( general radiation, Bremsstrahlung radiation,or braking radiation)
  2. Characteristic spectrum or line spectrum   



  • X-rays can penetrate various objects and the degree of penetration depend upon the quality of x-rays beam and also on the intensity and wavelength of the x-ray beam.


  • Effect of interaction of x-rays with matter
  1. Coherent scattering.  
  2. Photoelectric scattering. 
  3. Compton scattering. 

Barium Swallow
A Gastrointestinal Series (G.I.) is an x-ray examination of your esophagus (the passage from the
mouth to the stomach), the stomach and the duodenum (the first part of your intestine).
A Barium Swallow is an x-ray that takes pictures of the passage from the mouth to the stomach
(pharynx and the esophagus).
Preparation
• Preparation begins on the day prior to the exam.
• Patients with diabetes and allergies should consult their Physician for changes in preparation.
Inform the office staff and technologist immediately on arrival.
• You may have a normal supper the evening prior to the examination.
• You are not to eat or drink anything from 8 p.m. on the evening prior to the examination until it
has been completed.
• No medications are to be taken the morning of the examination.
• Do not swallow water when brushing your teeth in the morning.
• Do not wear jewelry to your appointment.
• Children may not be left unattended in the Waiting Room.
• Please let the Technologist know if you have any allergies or if there is any chance of
pregnancy.
Children Under 12
• May eat and drink in the evening.
• Not to eat or drink in the morning.
Newborn - 2 Years
• Nothing to eat or drink 3 hrs. prior to exam time.
• Children with diabetes should fast 2 hrs. prior to the exam.
Procedure
• You will be instructed to change into a hospital gown. You may leave underwear on except an
underwire bra. Remove neck chains and earrings.
• You will be instructed to take some carbon dioxide crystals to produce gas and asked not to
burp. Immediately after this, you will be asked to drink a flavored barium suspension.
• The X-Ray Technologist will ask you to swallow a white chalk-tasting mixture (barium sulphate
and water) several times during the test.
• The Technologist will ask you to move in different positions. The table is motorized and will
also move.
• You may be asked to hold your breath during image capture. Your Technologist will tell you if
delayed pictures are required.
• If a small bowel follow-through is also ordered you will be asked to drink another cup of
barium. This will require images to be taken after extended periods of time to evaluate your
small bowel. Please ensure that you have this time available to complete the exam (up to 6
hours, average 1.5 hours). You may be allowed to leave and return to the department.
After the Test
• The Technologist will tell you when your examination is complete. It is recommended that you
increase your water/clear fluid intake over the next few days as barium can be constipating.
• The barium is excreted through your stools. Your stool will be lighter in colour. Y
• Your Physician may want you to take a laxative if you should become constipated after the
test.

EARLY LIFE
• Wilhelm Conrad Röntgen was born on March 27,
1845, at Lennep in the Lower Rhine Province of
Germany, as the only child of a merchant in, and
manufacturer of, cloth.
• When he was three years old, his family moved to
Apeldoorn in The Netherlands, where he went to the
Institute of Martinus Herman van Doorn, a boarding
school.
• He did not show any special aptitude, but showed a love
of nature and was fond of roaming in the open country
and forests.


EDUCATION
• In 1862 he entered a technical school at Utrecht, where
he was however unfairly expelled, accused of having
produced a caricature of one of the teachers, which was
in fact done by someone else.
• In 1865, he was unfairly expelled from high school when
one of his teachers intercepted a caricature of one of the
teachers, which was drawn by someone else.
• Without a high school diploma, Röntgen could only
attend university in the Netherlands as a visitor. Upon
hearing that he could enter the Federal Polytechnic
Institute in Zurichhe passed the entrance examination
and began studies there as a student of mechanical
engineering. In 1869, he graduated with a PhD from the
University of Zurich.


CAREER
• In 1874, Röntgen became a lecturer at the University of
Strasbourg. In 1875, he became a professor at the
Academy of Agriculture at Hohenheim, Württemberg.
• He returned to Strasbourg as a professor of physics in
1876, and in 1879, he was appointed to the chair of
physics at the University of Giessen.
• In 1888, he obtained the physics chair at the University
of Würzburg, and in 1900 at the University of Munich, by
special request of the Bavarian government. He
remained in Munich for the rest of his career.

 Röntgen’s first work was published in 1870, dealing with
the specific heats of gases, followed a few years later by
a paper on the thermal conductivity of crystals.
• Among other problems he studied were the electrical
and other characteristics of quartz; the influence of
pressure on the refractive indices of various fluids; the
modification of the planes of polarised light by
electromagnetic influences; the variations in the
functions of the temperature and the compressibility of
water.

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