MSU CHM radiology 2

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MSU CHM radiology 2

Ionizing radiation

CTo Meningitis: Ceftazidime is the antibiotic of choice because of its high penetration into the subarachnoid space and the high susceptibility of Pseudomonas to this drug.
o Eye Infection: Ophthalmic aminoglycoside solution.
o Ear Infection: Local antibiotics
o UTI: Parenteral aminoglycoside OR quinolones.
o Skin: Double antibiotic therapy should be instituted in accordance with the local susceptibility patterns because burn centers may harbor Pseudomonas strains that are resistant to multiple drugs.
o General list for treatment: newer aminoglycosides, carbenicillin, ticarcillin, 3rd and newer cephalosporins (ceftazidime, cefepime, cefoperazone), carbapenems, monobactams, ciprofloxacin. Combination therapy is useful, especially -lactam + aminoglycoside.
• Prevention - Vaccines incorporating somatic antigens from multiple P. aeruginosa serotypes have been developed, though they are still experimental.
• Complications -
o Pseudomonal endocarditis may cause brain abscess, cerebritis, and mycotic aneurysms. Septic emboli to the lungs and spleen are not uncommon, and cardiac complications may include conduction blocks and congestive heart failure.
o Pseudomonal bacteremia can cause septic shock and death.
o Pseudomonal pneumonia may be severe enough to require respiratory support.
o Ear infections can cause perichondritis; sinusitis; mastoiditis; osteomyelitis of the temporal bones; cranial nerve involvement of seventh, ninth, eleventh, and twelfth nerves; and thrombosis of the lateral and sigmoid sinuses. Meningitis and brain abscesses are relatively rare.
o Eye infections can result in corneal perforations, endophthalmitis, and orbital cellulitis.
o GI involvement by Pseudomonas can cause typhlitis, cecal perforation, and peritonitis.
o A severe bout of diarrhea can result in vascular collapse and death.
o Pseudomonas skin and soft tissue infections can be destructive and can cause massive necrosis and gangrene.

o Meningitis: Ceftazidime is the antibiotic of choice because of its high penetration into the subarachnoid space and the high susceptibility of Pseudomonas to this drug.
o Eye Infection: Ophthalmic aminoglycoside solution.
o Ear Infection: Local antibiotics
o UTI: Parenteral aminoglycoside OR quinolones.
o Skin: Double antibiotic therapy should be instituted in accordance with the local susceptibility patterns because burn centers may harbor Pseudomonas strains that are resistant to multiple drugs.
o General list for treatment: newer aminoglycosides, carbenicillin, ticarcillin, 3rd and newer cephalosporins (ceftazidime, cefepime, cefoperazone), carbapenems, monobactams, ciprofloxacin. Combination therapy is useful, especially -lactam + aminoglycoside.
• Prevention - Vaccines incorporating somatic antigens from multiple P. aeruginosa serotypes have been developed, though they are still experimental.
• Complications -
o Pseudomonal endocarditis may cause brain abscess, cerebritis, and mycotic aneurysms. Septic emboli to the lungs and spleen are not uncommon, and cardiac complications may include conduction blocks and congestive heart failure.
o Pseudomonal bacteremia can cause septic shock and death.
o Pseudomonal pneumonia may be severe enough to require respiratory support.
o Ear infections can cause perichondritis; sinusitis; mastoiditis; osteomyelitis of the temporal bones; cranial nerve involvement of seventh, ninth, eleventh, and twelfth nerves; and thrombosis of the lateral and sigmoid sinuses. Meningitis and brain abscesses are relatively rare.
o Eye infections can result in corneal perforations, endophthalmitis, and orbital cellulitis.
o GI involvement by Pseudomonas can cause typhlitis, cecal perforation, and peritonitis.
o A severe bout of diarrhea can result in vascular collapse and death.
o Pseudomonas skin and soft tissue infections can be destructive and can cause massive necrosis and gangrene.

Excellent discrimination between subtle tissue density differences

CT

First line evaluation in suspected cerebral vascular events (hemorrhagic vs. ischemic)

CT

First line evaluation in soft-tissue and skeletal trauma

CT

First line evaluation in suspected pulmonary embolism

CT

First line evaluation in suspected urinary calculi

CT

CVA evaluation

CT

Primary applications of CT (head/neck)

* CVA evaluation
* Carotid and intra-cerebral vascular evaluation
* Head/neck trauma - evaluation for subdural and epidural hematoma - evaluation for cervical fracture
* Neoplasm staging

Carotid and intra-cerebral vascular evaluation

CT

Head/neck trauma - evaluation for subdural and epidural hematoma - evaluation for cervical fracture

CT

Neoplasm staging

CT

Primary applications of CT (thorax)

* Lung - mediastinum nodule/mass evaluation
* Cardiac, coronary, pulmonary and great vessel vascular evaluation
* airway evaluation
* neoplasm staging

Lung - mediastinum nodule/mass evaluation

CT

Cardiac, coronary, pulmonary and great vessel vascular evaluation

CT

airway evaluation

CT

Primary applications of CT (abdomen/pelvis)

* solid organ evaluation
* urinary tract evaluation for calcification
* CT angiogram
* CT colonography
* CT urography
* Lumbar spine evaluation (pacemakers, stimulators)
* Neoplasm staging

solid organ evaluation

CT

urinary tract evaluation for calcification

CT

angiogram

CT, MRI

colonogram

CT, MRI

Urogram

CT, MRI

Lumbar spine evaluation (pacemakers, stimulators)

CT

Primary applications for CT (bones/joints)

* 3D joint reconstructed images
* Evaluation of fracture union
* Evaluation of neoplasm/extent

3D joint reconstructed images

CT

Evaluation of fracture union

CT

Secondary applications of CT

- Evaluation of patients with a contraindication to MRI imaging
- Bone mineral density analysis

Primary applications of MRI

- first line evaluation of suspected neurologic abnormality
- first line evaluation of soft tissue mass/neoplasm
- first line evaluation of joint disarrangements
- first line evaluation of bone neoplasm

first line evaluation of suspected neurologic abnormality

MRI

first line evaluation of soft tissue mass/neoplasm

MRI

first line evaluation of joint disarrangements

MRI

first line evaluation of bone neoplasm

MRI

Developmental anomalies of the head

MRI

Effect of arthritis and degenerative changes of the neck

MRI

Infection of the head

MRI

Spine - cord, roots, body, farming, stenosis, arthritis

MRI

Heart - function, perfusion

MRI

Liver - mass, iron content, biliary tree

MRI

Retroperitoneum

MRI

Prostate hypertrophy

MRI

Uterus/Ovary Masses

MRI

Uterus/ovaries leiomyoma

MRI

tendon/ligament injury

MRI

articular cartilage evaluation

MRI

Muscle abnormality

MRI

RLL Pneumonia (front view)

Density at the right lateral diaphragm, obliteration of lateral diaphragm border.

RLL Pneumonia (side view)

Density at the mid diaphragm, sharp margination at the major fissure.

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