OVERVIEW OF CT

1
OVERVIEW OF CT MRI
2
CT MRI

• Principles.
• Indications.
• Strengths.
• Weaknesses.
• The future now!

3
CT

• X ray based.
• Beam of Xrays.
• Detected by a row of detectors.
• Image created.

4
Faster,newer applications cardiac CT and
angiography, 3D CT
5
CT

• QUICK
• CHEAP
• EASILY AVAILABLE
• EASY PATIENT MONITORING

6
MRI

• Powerful magnets
• Pulse sent into body
• Signal is collected
• No radiation

7
ADVANTAGES OF MRI

• MULTIPLANAR CAPABILITIES
• BETTER INTRINSIC SOFT TISSUE CONTRAST
• NO RADIATION
• NO IODINATED CONTRAST

8
Contrast
MRI
CT

• Iodinated.
• May cause anaphylactic reaction
• Not in allergy, renal failure.

• Gadolinium
• Safe
• No absolute contraindications except pregnancy

9
Caution
No MR in
No CT in

• Cardiac pacemakers.
• Aneurysm clips.
• Cochlear implants.

• Pregnancy

10
Indications

• Head
• Chest
• Abdomen
• Spine
• Musculoskeletal
• Vascular

11
Stroke

• Bleed vs infarct
• Cause

12
Hematoma

• CT gt MR

13
Infarct

• MR gtgtgt CT
• Diffusion in 3 hrs

• RELEVANCE IN PTA THERAPY
• Golden window period

14
MCA INFARCT
15
TUMORS

• Location
• size
• Extent
• Mass effect

16
GLIOMA
17
PILOCYTIC ASTROCYTOMA
POST CONTRAST
18
meningioma
19
MR gtgt CT

• Multiplanar capability exact extent and
  relationship
• Posterior fossa beam hardening artifact
  in CT
• Better delineation of the lesion

20
Head injury

• Bleed
• Contusions
• Hematoma-subdural/epidural
• Diffuse axonal injury

21
SDH
EDH
CT is modality of choice
22
TRAUMA-DIFFUSE AXONAL INJURY
MRI can detect these lesions
23
Mastoiditis/Sinusitis

• Incidental
• CT/MR
• Need to look at nasopharynx

24
Sinus thrombosis
MRV
25
Subarachnoid haemorrhage
26
Meningitis

• Imaging to look for complications
• Contrast to look for exudates
• Imaging may be normal

27
EncephalitisHerpes

• MR gt CT

28
Tuberculomas Vs
Neurocysticercosis
Hypointense on T2WI
Hyperintense on T2WI
29
Abscess
30
TORCHCMV
31
OPTIC NEURITIS
32

• Optic nerve glioma

33
TRAUMA
34
ACOUSTIC SHWANNOMA
CEMR
35
Chest
36

• SOLITARY PULMONARY NODULE

benign
malignant
37
BRONCHIECTASIS
CT -DETECTS OCCULT DISEASE -HELPS IN SURGICAL
PLANNING
38
MEDIASTINAL LYMPHADENOPATHY
39
Bronchogenic Ca

• Diagnosis
• Detection of metastasis
• Staging
• Biopsy
• FU

40
BRONCHOGENIC CARCINOMA STAGING
HILAR NODES
PLEURAL METS
41
CT GUIDED BIOPSY
42
DISSECTION
43
RECENT ADVANCES

• 3D RECONSTRUCTION
• CT ANGIOGRAPHY
• VIRTUAL BRONCHOSCOPY
• LUNG VOLUMETRY

44
Abdomen and pelvis
CT is modality of choice Developments in MRI are
making it useful
45
Pancreatitis

• Cause
• Confirm
• Complications
• Prognosis

46
Pancreatitis
acute
cchronic

• Necrosis
• Fluid collections

• Calcification
• Parenchymal atrophy
• Vessel thrombosis

47
Renal colic

• Low dose Spiral CT is Investigation of choice

48
Mass

• Origin
• Nature
• Extent
• Biopsy

49
RETROPERITONEAL SARCOMA
50
HEPATOCELLULAR CARCINOMA
51
ERCP MRCP

• Invasive
• Complications
• Not beyond a block
• Only luminal pathology

• Non Invasive
• Less Complications
• Beyond block
• Extra luminal pathology

52
Large Distal CBD Stone

• MRCP is useful in identifying the cause and
  level of biliary obst. in the setting of a
  nondiagnostic USG

53
GYNAECOLOGY
BICORNUATE
SEPTATE
54
CA CERVIX
55
JANICEPS TWINS
Midline fusion of face, neck, chest and abdomen
56
Low backache-degenerative changes

• Disc bulges
• Facetal arthropathy
• Level
• Cause
• Surgical or medical

57
HERNIATION
58
Potts spine

• Diagnoses early
• Localizes
• Cord compression
• Drainable collections

59
INTRAMEDULLARY TUMORS
Ependymoma
Astrocytoma
60
TRAUMA
3D CT
61
TRAUMA
CORD CONTUSION
62

• ROLE OF MRI IN MSK
• EXQUISITE DETAILS OF CARTILAGE, LIGAMENTS,
  TENDONS, MUSCLES

63
KKNEE
MM POST. HORN TEAR
64

• SUPRASPINATUS TEAR

65
tumors

• Extent
• staging
• no need for contrast

66
OGS FEMUR
3D
67
VASCULAR
CTA and MRA - non invasive
68
CTA MRA

• Calcification seen better
• quick
• large amt of contrast injection

• No radiation
• safe contrast
• can be done in impaired renal function

69
(No Transcript)
70
Head CTA
71

• Cerebral CTA
• 2 x 1.0 mm
• Pitch 1.5
• 130 kV
• 70 mAs
• 1.25 mm slice width
• 0.5 mm increment

VESSELS IN SKULL BASE
72
CctccCTarotid CTA
CTA
73
Aortic aneurysm
CTA
74
MRA
75
Renal
CTA
76
Normal renal arteries - MRA
77
PERIPHERAL MRA
Focal Aortic Stenosis
78
CTA
CALCIFICATION, STENOSIS IN THE LEFT FEMORAL
ARTERY
79
The road ahead

• Coronary angiography
• Bronchoscopy,Colonoscopy
• Perfusion

• MRS
• Diffusion
• Functional MR

80
CT CORONARY ANGIOGRAPHY CTA - 3 Vessels Disease
120kV, 350mAs, 4x 1mm, P1.5
VIRTUAL ANGIOSCOPY
81
POST-CABG EVALUATION
82
CT COLONOGRAPHY
83
CT PERFUSION
CBF
CBV
PEAK ENHANCEMENT
TTP
84
MR PERFUSION IMAGING
85
MR SPECTROSCOPY
86

Functional MRI
87
THANK YOU