what are the indications for mri & ct:
DESCRIPTION
What are the indications for MRI & CT:. Disc lesions Post-operative spine(after surgery) Tumors Any degenerative disease Trauma Congenital abnormalities of the spine. Preparations for CT & MRI: 1-Fasting for 4-6 hours 2-Contrast material Urographin ,telebrix 1-2 mg/kg - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/1.jpg)
What are the indications for MRI & CT:
Disc lesionsPost-operative spine(after surgery)
TumorsAny degenerative disease
TraumaCongenital abnormalities of the spine
![Page 2: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/2.jpg)
• Preparations for CT & MRI:1-Fasting for 4-6 hours2-Contrast material Urographin ,telebrix 1-2 mg/kg
• Administration of contrast:Yes: In post-operative lumbar spine,
inflammatory disorders& neoplastic lesions.No: disc lesions, trauma.AnesthesiaUsed with children & uncooperative patients.
![Page 3: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/3.jpg)
Patient position: Is usually supine, sometimes side lying, &
rarely prone. How to see: Scanogram: primitive picture to detect the
site of lumbar spine
![Page 4: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/4.jpg)
Computed tomography (CT): . Usual scanning. . Axial slides 2-4 mm.
2 mm in cervical spine / 4 mm in lumbar spine Has bone & soft tissue window. CT screening:. Whole segment of the spine 5 mm in cervical spine, 8 mm in lumbar spine.. Selective Scanning Every 3 mm especially in trauma, also in cervical
disc lesions. N.B:If I want to see one vertebra e.g. L3 I have to take 1
vertebra above (L2 )& 1 below (L4).
![Page 5: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/5.jpg)
![Page 6: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/6.jpg)
![Page 7: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/7.jpg)
CT Myelography:o Is considered as intrathecal contrast injection with
L- puncture needle.o We have 2 windows o Soft tissue & bone window.What are the structures I should evaluate in CT of
lumbar spine:• Lumbar spinal canal diameter normally 13 mm.• Disc lesions.• Others.
• facet, sacroiliac joints & paravertebral soft tissue.
![Page 8: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/8.jpg)
Soft &bone window (CT) LumbarSoft &bone window (CT) Lumbar
![Page 9: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/9.jpg)
![Page 10: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/10.jpg)
1. Lumbar spinal canal diameter:Spinal canal is bony structure, so we see it in
bone window.The spinal canal must be closed (at the level of
pedicles).We measure the AP diameter. Types of canal stenosis:1-Relative:11-12 mm & this doesn’t need operation but it
needs operation if there’s disc. 2- Absolute: 8 -10 mm & it must be operated.
![Page 11: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/11.jpg)
• Disc lesions:We detect it in soft tissue window.
Posterior border of the disc is more important as it has relation to the disc.
The normal posterior border of the disc is CONCAVE.
The abnormal is STRAIGHT OR CONVEX.
![Page 12: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/12.jpg)
N.B:. Normally due to overload ,the disc of L5-
S1 is CONVEX & the abnormal is also convex, so to judge if it’s normal or no look at the next slide if: the posterior border of the disc is convex so it is ABNORMAL.
. The angle of inclination in L5-S1 is more than 30 & the device accept up till 30 only so part of the slide will contain bone & part will contain disc.
![Page 13: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/13.jpg)
![Page 14: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/14.jpg)
![Page 15: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/15.jpg)
Normal CT Lumbar
![Page 16: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/16.jpg)
Disc bulge(CT axial)
![Page 17: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/17.jpg)
NERVE ROOTS
MRI – LUMBAR SPINEM
AXIAL VIEW
FORAMEN
![Page 18: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/18.jpg)
Manifestations of arthritis in any joint: (Spondylosis in spine and osteoarthritis of
other joints)1.Osteophytic lipping.2.Narrow joint space.3.Subarticular bone sclerosis4.Sub cortical pseudo cystic changes.5.Intra articular air.(vaccum phenomena)
![Page 19: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/19.jpg)
Vacuum phenomenaVacuum phenomena
![Page 20: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/20.jpg)
CT of cervical spine
![Page 21: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/21.jpg)
We have 2 types of joints:• Neurocentral joint:Is the articulation between one vertebra above &
one vertebra below which makes the shape of the body of the vertebral end plate .
• Facet joint:Is the articulation between the inferior lip of the
transverse process of one vertebra above with the superior lip of the transverse process of the vertebra below, it’s called Hamburger’s Sandwich.
Arthritis of the neurocentral or facet joint gives the same manifestations of nerve compression due to disc lesion.
![Page 22: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/22.jpg)
Cervical disc in CT:• We see it in soft tissue window .The disc in cervical spine is very narrow so every
slide will contain both disc & bone, therefore there isn’t a slide of pure disc, So we choose the slide which contain more disc for assessment.
. All posterior edges of cervical spine are normally convex.
. See if there’s disc substance protruded than the bone.
. Normal spinal cord picture is kidney shaped.
![Page 23: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/23.jpg)
Item Cervical Lumbar
Slide Width 2 mm 4mm
Neurocentral joint Present Absent
Spinal canal diameter
No diameters, but assessed by vision the spinal cord is kidney shaped & surrounded by C.S.F.
13 mm
Posterior edge of disc
Is usually convex All lumbar discs are concave except L5-S1 is normally convex or flat.
Difference between cervical & lumbar spine in CT
![Page 24: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/24.jpg)
![Page 25: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/25.jpg)
![Page 26: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/26.jpg)
![Page 27: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/27.jpg)
Stages of disc pathology (4 stages)
![Page 28: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/28.jpg)
CT of the spine
![Page 29: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/29.jpg)
CT axial bone& soft tissue widow
![Page 30: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/30.jpg)
![Page 31: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/31.jpg)
CT machine
![Page 32: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/32.jpg)
![Page 33: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/33.jpg)
![Page 34: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/34.jpg)
![Page 35: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/35.jpg)
![Page 36: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/36.jpg)
![Page 37: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/37.jpg)
![Page 38: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/38.jpg)
MRI CT plain x-Ray
![Page 39: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/39.jpg)
CT– CERVICAL SPINE
AXIAL SAGITTAL
C2-3 INTERVERTEBRAL DISC
DISC
FACET JOINTFACET JOINT
SPINOUS PROCESS
FORAMEN
FORAMEN
![Page 40: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/40.jpg)
AXIAL SAGITTAL
CT- CERVICAL SPINEC-1 SECTION
ARCH OF C-1
DENS
BASE OF SKULL
MASTOID
![Page 41: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/41.jpg)
DISC
SPINOUS PROCESS
CT- LUMBAR SPINEPOST MYELOGRAM
![Page 42: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/42.jpg)
CT– CERVICAL SPINEC- 3 SECTION
AXIAL SAGITTAL
PEDICLE
PEDICLE
LAMINA
![Page 43: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/43.jpg)
AXIAL SAGITTAL
CT-- CERVICAL SPINEC-2 SECTION
CT-- CERVICAL SPINEC-2 SECTION
C-2 SPINOUS PROCESS
C-2 BODY
DEGENERATED
C6-7
![Page 44: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/44.jpg)
CT axial CT sagittal
![Page 45: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/45.jpg)
PEDICLE PEDICLE
NERVE ROOTS
CT- LUMBAR SPINEPOST MYELOGRAM
Axial
![Page 46: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/46.jpg)
Posterior arch #(CT)
![Page 47: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/47.jpg)
Burst # (CT) axial
![Page 48: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/48.jpg)
sagittal CT
![Page 49: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/49.jpg)
CT axial section (base of the skull)
![Page 50: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/50.jpg)
FORAMEN
CT- LUMBAR SPINEPOST MYELOGRAM
FORAMEN
![Page 51: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/51.jpg)
CT of cervical spine(sagittal)
![Page 52: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/52.jpg)
CT axial
![Page 53: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/53.jpg)
CT of cervical spine (axial)
![Page 54: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/54.jpg)
CT sagittal
![Page 55: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/55.jpg)
CT sagittal tear drop # dislocation
Tear drop # dislocation(plain)
![Page 56: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/56.jpg)
THECAL SAC
LAMINALAMINA
CT-LUMBAR SPINEPOST MYELOGRAM
![Page 57: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/57.jpg)
FACET JOINTS
CT- LUMBAR SPINEPOST MYELOGRAM
![Page 58: What are the indications for MRI & CT:](https://reader034.vdocuments.site/reader034/viewer/2022051821/56814efd550346895dbc8c4b/html5/thumbnails/58.jpg)
PEDICLE PEDICLE
NERVE ROOTS
CT- LUMBAR SPINEPOST MYELOGRAM