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CT Scans: and Their Application
CT Scans: and Their Application
THAT HAND
INTERESTINGLY!
Development of CT is thought by some to be the Greatest Legacy of the BEATLES
Records sales allowed EMI to fund scientific research Path of flight 600 times over 100 years CT technology 1200 times over 25 years
Why CT?
3-D image as compared to Only 2-D image possible on X Ray Superimposed structures made out seperately
COMPUTED TOMOGRAPHY
Tomos is the Greek word for cut or section, and tomography is a technique for digitally cutting a specimen open using X-rays to reveal its interior details.
A CT image is typically called a slice, as it corresponds to a slice from a loaf of bread. -
DEVELOPMENT
Ist Commercial CT Godfrey Newbold Hounsfield Hayes, England Thorn EMI Research Laboratories Idea conceived in 197 Made public 1972 Received Nobel along with Allan McLeod Cormack in 1979
CT EQUIPMENT
X RAY TUBE DETECTORS
AND TODAY
A bit of history
In the U.S., the first installation was at the Mayo Clinic
As a tribute to the impact of this system on medical imaging the Mayo Clinic has an EMI scanner on display in the Radiology Department.
SPIRAL CT
Speed - a large volume can be covered in 20-60 seconds the patient can hold their breath for the entire study, reducing motion artifacts Optimal use of intravenous contrast enhancement, The study is quicker than the equivalent conventional CT permitting the use of higher resolution acquisitions in the same study time Well-suited for 3D imaging
Multislice CT
Similar in concept to the helical or spiral CT - but more than one detector ring Initially 2 rings in mid nineties, with a 2 solid state ring model designed and built by Elscint (Haifa) called CT TWIN, with one second rotation (1993) Now 4, 8, 16, 32, 40 and 64 detector rings, with increasing rotation speeds. Current models (2007) have up to 3 rotations per second, and isotropic resolution of 0.35mm voxels with z-axis scan speed of up to 18 cm/s.
Major benefit - increased speed of volume coverage. This allows large volumes to be scanned at the optimal time following intravenous contrast administration; this has particularly benefitted CT angiography techniques - which rely heavily on precise timing to ensure good demonstration of arteries.
Dual Source CT
Siemens introduced a CT model with dual X-ray tube and dual array of 64 slice detectors, at the 2005 RSNA medical meeting. Only half the rotation needed for image as compared to other CT macines Dual sources increase the temporal resolution by reducing the rotation angle required to acquire a complete image, thus permitting cardiac studies without the use of heart rate lowering medication, as well as permitting imaging of the heart in systole.
CT BRAIN
CT THORAX
CT ABDOMEN
FROM THIS
BONE RECONSTRUCTION
CIRCLE OF WILLIS
BENEFITS
CT scanning is painless, noninvasive and accurate. Unlike conventional x-rays, CT scanning provides very detailed images of many types of tissue as well as the lungs, bones, and blood vessels. CT examinations are fast and simple; in emergency cases, they can reveal internal injuries and bleeding quickly enough to help save lives. CT has been shown to be a cost-effective imaging tool for a wide range of clinical problems. CT may be less expensive than MRI. In addition, it is less sensitive to patient movement. CT can be performed if you have an implanted medical device of any kind, unlike MRI. No radiation remains in a patient's body after a CT examination.
DRAWBACKS
Main - radiation. However, the benefit of an accurate diagnosis far outweighs the risk. The effective radiation dose from this procedure is about 10 mSv, which is about the same as the average person receives from background radiation in three years. Contra indicated if pregnant. CT scanning is, in general, not recommended for pregnant women because of potential risk to the baby. Nursing mothers should wait for 24 hours after contrast material injection before resuming breast-feeding. The risk of serious allergic reaction to contrast materials that contain iodine is rare, and radiology departments are well-equipped to deal with them.
LIMITATIONS
Very fine soft-tissue details in areas such as the knee or shoulder can be more readily and clearly seen with MRI
Very obese may not fit into the opening of a conventional CT unit.
Radiation exposure
Recent comprehensive survey in the UK - CT scans constituted 7% of all radiologic examinations Contributed 47% of the total collective dose from medical X-ray examinations in 2000/2001. Increased CT usage has led to an overall rise in the total amount of medical radiation used, despite reductions in other areas.
CT colonoscopy / bronchoscopy
RECENT APPLICATIONS
Newer CT scan has the ability to both predict stone composition and delineate structural features necessary to predict stone fragility to lithotripter shock waves.
Cardiac CT
Reconstructing mummies!
SDH
EDH
PARENCHYMAL HEMORRHAGE
HEMORRHAGIC CONTUSION
TRAUMA - pneumocephalus
INFARCT
SOMETHING TODAY!