What are the indications for MRI & CT презентация

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1. What are the indications for MRI & CT
2. Preparations for CT & MRI: 1-Fasting for
3. Patient position: Is usually
4. Computed tomography (CT): . Usual scanning.
7. CT Myelography: Is considered as intrathecal contrast
8. Soft &bone window (CT) Lumbar
10. 1. Lumbar spinal canal diameter: Spinal canal
11. Disc lesions: We detect it in soft
12. N.B: . Normally due to overload ,the
15. Normal CT Lumbar
16. Disc bulge(CT axial)
17. NERVE ROOTS MRI – LUMBAR SPINEM AXIAL VIEW FORAMEN
18. Manifestations of arthritis in any joint: (Spondylosis
19. Vacuum phenomena
20. CT of cervical spine
21. We have 2 types of joints: Neurocentral
22. Cervical disc in CT: We see it
23. Difference between cervical & lumbar spine in CT
27. Stages of disc pathology (4 stages)
28. CT of the spine
29. CT axial bone& soft tissue widow
31. CT machine
38. MRI
39. CT– CERVICAL SPINE AXIAL SAGITTAL C2-3 INTERVERTEBRAL
40. AXIAL SAGITTAL CT- CERVICAL SPINE C-1 SECTION
41. DISC SPINOUS PROCESS CT- LUMBAR SPINE POST MYELOGRAM
42. CT– CERVICAL SPINE C- 3 SECTION AXIAL SAGITTAL PEDICLE PEDICLE LAMINA
43. AXIAL SAGITTAL CT-- CERVICAL SPINE C-2 SECTION
44. CT axial
45. PEDICLE PEDICLE NERVE ROOTS CT- LUMBAR SPINE POST MYELOGRAM Axial
46. Posterior arch #(CT)
47. Burst # (CT) axial
48. sagittal CT
49. CT axial section (base of the skull)
50. FORAMEN CT- LUMBAR SPINE POST MYELOGRAM FORAMEN
51. CT of cervical spine(sagittal)
52. CT axial
53. CT of cervical spine (axial)
54. CT sagittal
55. CT sagittal tear drop # dislocation Tear drop # dislocation(plain)
56. THECAL SAC LAMINA LAMINA CT-LUMBAR SPINE POST MYELOGRAM
57. FACET JOINTS CT- LUMBAR SPINE POST MYELOGRAM
58. PEDICLE PEDICLE NERVE ROOTS CT- LUMBAR SPINE POST MYELOGRAM

Preparations for CT & MRI: 1-Fasting for 4-6 hours 2-Contrast material Urographin ,telebrix 1-2 mg/kg Administration of contrast: Yes: In post-operative lumbar spine, inflammatory disorders& neoplastic lesions. No: disc lesions, trauma.

Слайд 1 What are the indications for MRI & CT:
Disc lesions
Post-operative spine(after surgery)
Tumors
Any

degenerative disease
Trauma
Congenital abnormalities of the spine

Слайд 2Preparations for CT & MRI: 1-Fasting for 4-6 hours 2-Contrast material Urographin ,telebrix

1-2 mg/kg
Administration of contrast:
Yes: In post-operative lumbar spine, inflammatory disorders& neoplastic lesions.
No: disc lesions, trauma.
Anesthesia
Used with children & uncooperative patients.

Слайд 3Patient position:
Is usually supine, sometimes side lying, &

rarely prone.
How to see:
Scanogram: primitive picture to detect the site of lumbar spine

Слайд 4Computed tomography (CT):
. Usual scanning.
. Axial slides 2-4 mm.
2

mm in cervical spine / 4 mm in lumbar spine
Has bone & soft tissue window.
CT screening:
. Whole segment of the spine
5 mm in cervical spine, 8 mm in lumbar spine.
. Selective Scanning
Every 3 mm especially in trauma, also in cervical disc lesions.
N.B:
If I want to see one vertebra e.g. L3 I have to take 1 vertebra above (L2 )& 1 below (L4).

Слайд 5

Слайд 6

Слайд 7CT Myelography:
Is considered as intrathecal contrast injection with L- puncture needle.
We

have 2 windows
Soft tissue & bone window.
What are the structures I should evaluate in CT of lumbar spine:
Lumbar spinal canal diameter normally 13 mm.
Disc lesions.
Others.
facet, sacroiliac joints & paravertebral soft tissue.

Слайд 8Soft &bone window (CT) Lumbar

Слайд 9

Слайд 101. Lumbar spinal canal diameter:
Spinal canal is bony structure, so we

see it in bone window.
The spinal canal must be closed (at the level of pedicles).
We measure the AP diameter.
Types of canal stenosis:
1-Relative:
11-12 mm & this doesn’t need operation but it needs operation if there’s disc.
2- Absolute:
8 -10 mm & it must be operated.

Слайд 11Disc lesions:
We detect it in soft tissue window.
Posterior border of the

disc is more important as it has relation to the disc.
The normal posterior border of the disc is CONCAVE.
The abnormal is STRAIGHT OR CONVEX.

Слайд 12N.B:
. Normally due to overload ,the disc of L5-S1 is CONVEX

& the abnormal is also convex, so to judge if it’s normal or no? look at the next slide if: the posterior border of the disc is convex so it is ABNORMAL.
. The angle of inclination in L5-S1 is more than 30 & the device accept up till 30 only so part of the slide will contain bone & part will contain disc.

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Слайд 15Normal CT Lumbar

Слайд 16Disc bulge(CT axial)

Слайд 17NERVE ROOTS
MRI – LUMBAR SPINEM
AXIAL VIEW
FORAMEN

Слайд 18Manifestations of arthritis in any joint:
(Spondylosis in spine and osteoarthritis of

other joints)
Osteophytic lipping.
Narrow joint space.
Subarticular bone sclerosis
Sub cortical pseudo cystic changes.
Intra articular air.(vaccum phenomena)

Слайд 19Vacuum phenomena

Слайд 20CT of cervical spine

Слайд 21We have 2 types of joints:
Neurocentral joint:
Is the articulation between one

vertebra above & one vertebra below which makes the shape of the body of the vertebral end plate .
Facet joint:
Is the articulation between the inferior lip of the transverse process of one vertebra above with the superior lip of the transverse process of the vertebra below, it’s called Hamburger’s Sandwich.
Arthritis of the neurocentral or facet joint gives the same manifestations of nerve compression due to disc lesion.

Слайд 22Cervical disc in CT:
We see it in soft tissue window
.The

disc in cervical spine is very narrow so every slide will contain both disc & bone, therefore there isn’t a slide of pure disc, So we choose the slide which contain more disc for assessment.
. All posterior edges of cervical spine are normally convex.
. See if there’s disc substance protruded than the bone.
. Normal spinal cord picture is kidney shaped.