AP side downPA side up
21
Caldwell Sinus Projection Film
• This view will provide a clear view of the frontal and ethmoid sinuses.
• The super orbital rims can be evaluated for fracture when facial bone are of interest.
• To project the petrous ridges farther down, increase angle to 30 degrees
Sinus Lateral
• Lateral – External auditory meatus externally and mandible inferiorly with supracillary arch superiorly in view.
• CR centered to zygoma, midway between outer canthus and EAM
• Midsagittal plane is parallel to IR• IPL is perpendicular to IR
Lateral Sinus Anatomy
Positioning: Waters
• Prone or seated upright
• Chin on bucky -OML 37 angle with plane of cassette
• Mentomeatal line should be perpendicular to film with mouth closed.
• Nose 3/4 inch from IR
• Suspend respiration
• CR perpendicular to exit acanthion
Waters Radiograph
• Distance from lateral border of skull and orbit equal on each side
• Petrous ridges projected immediately below maxillary sinuses
Modified Parietoacanthial (Modified Waters)
• OML 55 degrees to the IR• Chin and nose on table• Petrous pyramids are seen mid-maxillary sinus• CR exits acanthion• Blowout Fractures
• See pg. 355 (Merrill’s 12th Edition)
Modified Waters Radiograph
• Petrous ridges projected immediately below the inferior border of the orbits
• Equal distance from lateral orbit to lateral skull on both sides
Reverse Waters
• Supine
• Extend neck so OML is 37 degree with plane of IR
• MML perp
• Suspend respiration
• CR perpendicular and enters acanthion
Lateral Nasal Bones
• Semiprone
• IPL perpendicular
• CR perpendicular to the bridge of nose at a point ½ inch distal to the nasion
Bilateral Arches - SMV
• IOML parallel to IR and perpendicular to CR
• CR midsaggital and collimate to outer edges of zygoma
Oblique Tangential
• Same position as SMV except head tilt 15 degrees toward side of interest
(Merrill’s p. 362 12 ed)
Esophagus
• RAO• Left side elevated
35-40 degrees• Center at T-5 or T-6
Stomach• PA
– Center at pylorus L2 (midway between xiphoid and umbilicus)
– Expiration• RAO
– L side elevated 40-70 degrees– Between vertebrae and elevated
surface– Center at duodenal bulb– Expiration
• Lateral– Recumbant (R lateral), Erect (L
lateral)– Between axilla and anterior
surface – Center at pylorus
Small Bowel
• Central ray at iliac crest (or slightly above for early exposures)
Colon
• PA or AP– Center at iliac crest
• PA Axial (may be done AP)– Prone– Center @ iliac crest– CR 30-40 degrees caudad– Sigmoid Colon– Smaller IR; CR enters @ ASIS
• Bilat Obliques• Lateral Decubitus• Lateral Rectum
– Enter at ASIS
Intravenous Urography
• KUB• Obliques– Rotated 30 degrees –
kidney farthest from IR is parallel; kiney closest is perpendicular to film
• AP Bladder– CR at ASIS
Cystography
• AP Axial– 10-15 degrees caudal– CR 2-3 in above pubic
syphysis• Oblique
– 40-60 degrees• PA Bladder
– CR 1 in distal to tip of coccyx– 10-15 degree cephalad
angle• Lateral