Crozer-Keystone Residency Manual - Special Studies
Terms in this set (21)
What are the phases of bone scan? When is each phase done?
Phase 1 - Immediate, early, blood flow, or angiogram (it goes by all these names)
Phase 2 - Blood pool
Phase 3 - Delayed
Phase 4 - Fourth phase
What do each of the phases of the bone scan test for?
Immediate - Blood flow
Pool - Soft tissue
Delayed - Bone activity
Fourth phase - Bone uptake for patient with PVD
What normally lights up on a bone scan?
Epiphysis of a growing child
Tips of scapula
What is the half-life of Technetium-99?
What does it mean if the bone scan lights up in Phases 1-2 but not in 3?
Cellulitis most likely
Name a way to test between Charcot disease and osteomyelitis
Ceretec scan or Indium-111
What does Indium-111 tag?
What does Indium-111 test for?
WBC's (as does the Ceretec scan)
Highly sensitive and specific for acute soft tissue and osseous infections
What does Gallium-67 test for?
Acute inflammation and infection
How long does it take for a Gallium-67 test to work?
Note: it's expensive
What causes increased signal intensity on a T1 image?
What causes increased signal intensity on a T2 image?
Fluid, Infection, Inflammation, Tumor (F.I.I.T.)
For MRI, what are the main indications for STIR imaging?
It is useful for evaluation of edema in high lipid regions, such as bone marrow. It is also useful for evaluating cartilage.
What is fat saturation used for?
Evaluation of fat...c'mon, that's obvious
What is Gradient Echo also known as?
What is Gradient Echo used for?
Steady State Magnetization
What are 2 uses for Gadolinium?
It will be distributed to places with increased vascularity, such as neoplasms and inflammation
Cellulitis and walls of abscesses will enhance, but the pus will not.
Tests cartilage integrity
What will a stress fracture show up as on MRI?
T1 - Linear zone of decreased signal intensity surrounded by a less defined area of signal
T2 - Linear zone of decreased signal intensity surrounded by an increased signal intensity due to edema
STIR: Increased signal intensity because fatty bone marrow is suppressed
How will osteomyelitis show up on MRI?
T1- Break in cortex, decreased signal in the bone marrow
T2- Break in cortex, increased signal in the bone marrow
How will AVN show up on MRI?
T1 and T2
Decreased signal intensities
STIR and Long T2
Double rim sign: Inner margin will show an increased signal intensity (this represents granulation tissue). Outer margin will show decreased signal intensity (this shows mineralization).
What does MRA stand for?
What is MRA used for in the LE?
Magnetic Resonance Angiography
PVD, DVT, neoplasm and anatomic studies
Most commonly ordered by a vascular surgeon for further description of occlusions/stenosis
What are the 3 planes of a CT Scan?
a. Which of these planes is computer reconstructed?
b. What does the coronal plane of a CT scan represent?
c. What does the axial plane of a CT scan represent?
b. Frontal plane (Memorization tip! 1st vowel in coronal and frontal is "O")
c. Transverse plane
(Memorization tip! 1st vowel in transverse and axial is "A")
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