ORL RadiologyORL Radiology

BANDAR AL-QAHTANI, MD

KSMC

Roles we should knowRoles we should knowDon't read X-ray without clinical information Always keep in closed contact with the radiologist Remember that radiology is an objective

examinationAlways correlate radiology films with clinical

informationStart systemic :patients name ,sex,age,date of

examination ,axial vs coronal vs sagital, T1 vs T2 ,+/- contrast

In medico legal problem –should be ordered

Simple X-ray.CT scan.MRI scan

X-ray X-ray

Less radiation of CT scan .Quick Usefull in trauma and ??FBLess accurate than the other modalityGood in sinus diseases /trauma (air vs bone )To assess nasal # and possible opaque FBIn chest and vertebral spinesRisky in pregnancy-especially 1st trimaster

Lateral x-ray noseLateral x-ray nose

Waters view of sinusWaters view of sinus

CT scan CT scan

-more radiation than simple X-ray

-excellent visualization of the bones and (for certain extent) the soft tissues like sinus and middle ear diseases .

-very informative in neck problems -with iIVcontrast-

-in issues of medico legal judgement

-replaced by MRI scan in soft tissues -brain ,orbit

-faster than MRI

-risky in pregnancy -especially the 1st trimaster

-terminology

-axial vs coronal vs sagital

-related to a solid bony landmark –hard palat

-sagital parallel to sagital sinus in the brain

-radio opaque contrast

Sagital view Sagital view

Coronal view -best for sinus Coronal view -best for sinus diseases/traumadiseases/trauma

Axial view of the sinusAxial view of the sinus

Axial temporal bone scan Axial temporal bone scan

Axial temporal boneAxial temporal bone

Axial neck CT scan with Axial neck CT scan with contrastcontrast

Coronal vs sagital CT scan Coronal vs sagital CT scan neckneck

MRI scan MRI scan

-no radiation

-magnetic field applied for the tissues then measure the holding capacity of the tissues to that field – tissues are resonating

-longer examination time than CT scan-anxiety/phobia

-relatively safer than CT scan in pregnancy

-T1 vs T2 (early scan vs late )

-needs experienced radiologist to read the films

MRI cont”MRI cont”

-air appear black

-vascular structures -black

-bones appear – black

-excellent soft tissues visualization (brain ,orbit,muscle ..etc

-fat is variable in TI and T2 mostly hyper intense in T1 and hypo intense in T2

-fluid is hypo intense in T1 and hyper intense

In T2 (CSF ..etc ) and variable in case of thick protein content

MRI scan MRI scan

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