Transcript
SPINE IMAGING
ODLM
BTP
OD SP
AAC1AAC2
SP
B
TP
AP
TF
PA
TF
AAOD
SP
BPM
ZJ
IVS
B
SP
MPR
Pathologies
Ankylosing spondylitis is a type of arthritis that affects the spine. Spondylitis may cause pain and stiffness from the neck down to the lower back. The bones of the spine, called vertebrae, may grow or fuse together, resulting in a rigid spine. These changes may be mild or severe, and may lead to a stooped-over posture.
Spondylolisthesis
Description The most common X-ray identified cause of low back pain in adolescent athletes is a stress fracture in one of the bones (vertebrae) that make up the spinal column. Technically, this condition is called spondylolysis (spon-dee-low-lye-sis). It usually affects the fifth lumbar vertebra in the lower back, and much less commonly, the fourth lumbar vertebra. If the stress fracture weakens the bone so much that it is unable to maintain its proper position, the vertebra can start to shift out of place. This condition is called spondylolisthesis (spon-dee-low-lis-thee-sis). If too much slippage occurs, the bones may begin to press on nerves and surgery may be necessary to correct the condition
HNP-herniated nucleus pulposus
Many types of tumors start in the central nervous system (CNS) (brain and spinal cord). If you have one of these tumors, your symptoms, outlook for survival (prognosis), and treatment depend on your age, the tumor type, and the precise location of the tumor within the CNS
Astrocytoma: Most tumors that arise within the brain itself start in brain cells called astrocytes. These tumors are called astrocytomas. About 35% of brain tumors are astrocytomas. Most astrocytomas cannot be cured because they spread widely throughout the surrounding normal brain tissue. Sometimes astrocytomas spread along the cerebrospinal fluid pathways. With only rare exceptions, astrocytomas, however, do not spread outside of the brain or spinal cord
Astrocytoma
DefinitionLumbar Spinal Stenosis is derived from the word stenosis meaning narrowing. Imagine the spinal canal is a circle. The circle can be average, big or small. Since the spinal nerves travel in the circle at this level of the spine, any narrowing of the circle could put pressure on the spinal nerves. Unless the individual is born with a small spinal canal (congenital stenosis), spinal narrowing occurs most commonly from progressive degenerative changes (acquired spinal stenosis).
Fractures- Jefferson’s
A Jefferson fracture consists of a fracture of the C1 ring. This results from an axial loading injury to the head with compression force to C1 (typically from diving).
Hangman’s fracture- C2-C3
Unstable hangman's type fracture of the C2 body and posterior elements extending into the left foramen transversarium.
COMPRESSION FRACTURE
BURST FRACTURE
Burst fractures are comminuted fractures of the vertebral bodies often associated with bone fragments in the canal
VACUUM “GAS” PHENOMENON
Vacuum" phenomena relate to the accumulation of gas, principally nitrogen, in crevices within the intervertebral disk or vertebra.
Protocols
C-SPINE
SCOUT: LAT
LANDMARK: XIPHOID
SLICE PLANE: OML
I.V. CONTRAST: FOR EVALUATION OF DEGENERATIVE DISK DISEASE, DIFFERENTIATION OF THE DISK FROM THE SURGICAL SCAR TISSUE
BREATH HOLD: QUIET RESPIRATION
SLICE THICKNESS: 2-4 MM ( IF ONE DISK TO SCAN- 2MM)
INDEX: CONTIGUOUS SLICES
START LOCATION: PEDICLE OF C3
END LOCATION: THROUGH C7
FILMING: SOFT TISSUE AND BONE + MPR RECONSTRUCTION (IF SPIRAL)
T-SPINE
SCOUT: LAT
LANDMARK: STERNAL NOTCH
SLICE PLANE: SPIRAL
I.V. CONTRAST: FOR EVALUATION OF DEGENERATIVE DISK DISEASE, DIFFERENTIATION OF THE DISK FROM THE SURGICAL SCAR TISSUE
BREATH HOLD: QUIET RESPIRATION
SLICE THICKNESS: 3-5 MM
INDEX: CONTIGUOUS SLICES
IF ONE VERTEBRAE
START PEDICLE ABOVE
END LOCATION: PEDICLE BELOW
FILMING: SOFT TISSUE AND BONE + MPR RECONSTRUCTION (IF SPIRAL)
SCOUT: LAT
LANDMARK: XIPHOID
SLICE PLANE: Angle the gantry so the slices will be parallel to the intervertebral disk spaces.
I.V. CONTRAST: FOR EVALUATION OF DEGENERATIVE DISK DISEASE, DIFFERENTIATION OF THE DISK FROM THE SURGICAL SCAR TISSUE
BREATH HOLD: QUIET RESPIRATION
SLICE THICKNESS: 3-5 MM
INDEX: CONTIGUOUS
START LOCATION: PEDICLE OF L3
END LOCATION: S1
FILMING: SOFT TISSUE AND BONE
SCOUT: LAT
LANDMARK: XIPHOID
SLICE PLANE: AXIAL OR SPIRAL
I.V. CONTRAST: FOR EVALUATION OF DEGENERATIVE DISK DISEASE, DIFFERENTIATION OF THE DISK FROM THE SURGICAL SCAR TISSUE
BREATH HOLD: QUIET RESPIRATION
SLICE THICKNESS: 3-5 MM
INDEX: 3-5 MM
START LOCATION: PEDICLE OF L3
END LOCATION: S1
FILMING: SOFT TISSUE AND BONE + MPR RECONSTRUCTION
3-D RECON: 50% OVERLAP
MYELOGRAPHY
CT MYELOGRAM
PURPOSE OF CT MYELOGRAM TO DETECT:
• HNP
• TUMOR INVADING CANAL
• BONY FRAGMENTS IN THE CANAL
• CYSTS
IV CONTRAST USED IN CT MYELOGRAM
• TO DIAGNOSE DEGENERATIVE DISK DISEASE (EPIDURAL SPACE WILL ENHANCE)
• DIFFERENTIATION OF THE DISKS FROM THE SURGICAL SCAR TISSUE
CONTRAST – INTRATHECAL INJECTION
SCANNING
• 1-4 HOURS AFTER THE CONTRAST INSTILLED
• THE DELAY ALLOWS FOR CONTRAST DILUTION SO THE INTRADURAL SPACES ARE CLEARLY VISUALIZED
• ROLLING OF THE PATIENT BEFORE THE SCAN PREVENTS LAYERING OF THE CONTRAST
• PRONE POSITION TO PREVENT POOLING OF THE CONTRAST
CERVICAL MYELOGRAM
LUMBAR MYELOGRAM
IMAGES
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