Radiology is a science that uses medical imaging to diagnose and sometimes also treat diseases in the body.
Imaging techniques such as X-ray radiography, ultrasound, computed tomography (CT), nuclear medicine including positron emission tomography (PET), and magnetic resonance imaging (MRI) are used to diagnose and/or treat diseases. Interventional radiology is the performance of medical procedures (usually minimally invasive) with imaging technology guidance.
The acquisition of medical images is usually performed by radiographers, often known as Radiologic Technologist. The Diagnostic Radiologist, a specially trained physician, then interprets or "reads" the image and generates reports of findings and impressions or their diagnosis. In some places, a Reporting Radiographer, a radiographer with additional training, will take on a diagnostic reporting role. In some countries, a radiographist will attach a short comment which is then forwarded to the Clinic requiring imaging. Comments known as "radiographic comments" or "early imagery evaluations" provide a rapid initial response to clinical questions, followed later by major radiologist diagnostic reports. Medical images are stored digitally in image archiving and communication systems (PACs) where they are visible to all members of the health team in the same health system and then compared to future imagery.
Video Radiology
Diagnostic imaging modalities
Radiographic projection (plain)
Radiography (originally called roentgenographs, named after the inventor of the X-ray, Wilhelm Conrad RÃÆ'¶ntgen) is produced by sending X-rays through the patient. X-rays are projected through the body to the detector; images are formed based on the rays passed (and detected) compared to those absorbed or dispersed in the patient (and thus undetectable). RÃÆ'¶ntgen discovered X rays on November 8, 1895 and received the first Nobel Prize in Physics for their discovery in 1901.
In screen-film radiography, X-ray tubes produce X-ray light, intended for patients. X-rays passing through the patient are filtered through a device called a grid or X-ray filter, to reduce scattering, and attack undeveloped films, held tightly on the light-phosphor screen in a tight light. tapes. The film was then developed chemically and the image appeared in the film. Screen movie radiography is being replaced by radiography of phosphor plates but recently with digital radiography (DR) and EOS imaging. In the two latest systems, the X-ray sensor strikes that convert the resulting signal into digital information, which is transmitted and converted into images displayed on a computer screen. In digital radiography, the sensor forms a plate, but in the EOS system, which is a slot-scanning system, the linear sensor vertically scans the patient.
Plain radiography is the only imaging modality available during the first 50 years of radiology. Because of its availability, speed, and lower cost compared to other modalities, radiography is often the first choice test in a radiological diagnosis. Also despite the large amount of data in CT scans, MR scans and other digital-based imaging, there are many disease entities in which classical diagnosis is obtained by plain radiography. Examples include various types of arthritis and pneumonia, bone tumors (especially benign bone tumors), fractures, congenital skeletal anomalies, etc.
Mammography and DXA are two applications of low energy projection radiography, used for evaluation for breast cancer and osteoporosis, respectively.
Fluoroscopy
Fluoroscopy and angiography are special applications of X-ray imaging, where fluorescent screens and image intensifier tubes connect to closed-circuit television systems. This allows real-time imaging of structures in motion or coupled with radiocontrast agents. The radiocontrast agent is usually given by swallowing or injecting into the patient's body to describe the anatomy and function of the blood vessels, genitourinary system, or gastrointestinal tract (gastrointestinal tract). Two radiocontrast agents are currently commonly used. Barium sulfate (BaSO 4 ) is given orally or rectally for gastrointestinal evaluation. Iodine, in various forms of ownership, is given by the oral, rectal, vaginal, intra-arterial or intravenous route. This radiocontrast agent greatly absorbs or disperses X-rays, and along with real-time imaging, enables demonstration of dynamic processes, such as peristalsis in the gastrointestinal tract or blood flow in the arteries and veins. Contrast of iodine can also be concentrated in abnormal areas more or less than in normal tissues and make abnormalities (tumors, cysts, inflammation) more striking. In addition, under certain circumstances, air may be used as a contrast agent for the gastrointestinal system and carbon dioxide may be used as a contrast agent in the venous system; in this case, the contrast agent weakens less X-ray radiation from the surrounding tissue.
Computed tomography
CT imaging uses X-rays in conjunction with computational algorithms for body images. In CT, an X-ray tube in contrast to an X-ray detector (or detector) in a ring-shaped device rotates around the patient, producing a computer-generated cross-sectional image (tomogram). CT is obtained in axial plane, with the coronal and sagittal images produced by computer reconstruction. Radiocontrast agents are often used with CT for better anatomical imaging. Although radiography provides higher spatial resolution, CT can detect subtle variations in X-ray damping (higher contrast resolution). CT exposes patients to ionizing radiation more significantly than radiography.
Spiral multidetector CT uses 16, 64, 254 or more detectors during continuous movement of the patient through radiation to obtain fine detail images in a short test time. By providing rapid intravenous contrast during CT scan, these fine detail images can be reconstructed into 3D (3D) images of the carotid, cerebral, coronary or other arteries.
The introduction of computed tomography in the early 1970s revolutionized diagnostic radiology by providing a clinical picture of a real three-dimensional anatomical structure. CT scans have become a test of choice in diagnosing several urgent and emerging conditions, such as cerebral hemorrhage, pulmonary embolism (lumps in the pulmonary artery), aortic dissection (rupture of the aortic wall), appendicitis, diverticulitis, and kidney stone obstruction. Continuous improvement in CT technology, including faster scan times and increased resolution, has dramatically improved the accuracy and usefulness of CT scans, which in part leads to increased use in medical diagnoses.
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Medical ultrasonography uses ultrasound (high frequency sound waves) to visualize the soft tissue structure in the body in real time. No ionizing radiation is involved, but the quality of images obtained using ultrasound is highly dependent on the skill of the person (ultrasonographer) performing the examination and the size of the patient's body. Larger examination, overweight patients may have image degradation because their subcutaneous fat absorbs more sound waves. This results in fewer sound waves penetrating into the organ and reflecting back to the transducer, resulting in a loss of information and a worse quality image. Ultrasound is also limited by its inability to image through an air bag (lung, gut loop) or bone. Its use in medical imaging has grown substantially in the last 30 years. The first ultrasound image is static and two-dimensional (2D), but with modern ultrasonography, 3D reconstruction can be observed in real time, effectively being "4D".
Because ultrasound imaging techniques do not use ionizing radiation to produce images (unlike radiographs, and CT scans), they are generally considered to be safer and therefore more common in midwifery imaging. The development of pregnancy can be thoroughly evaluated with less attention to the breakdown of the techniques used, allowing early detection and diagnosis of many fetal anomalies. Growth can be assessed over time, important in patients with chronic illness or pregnancy-induced disease, and in multiple pregnancies (twins, triplets, etc.). Doppler color-flow ultrasound measures the severity of peripheral vascular disease and is used by cardiologists for the dynamic evaluation of the heart, heart valves and major vessels. Stenosis, for example, of the carotid artery may be a warning sign for an impending stroke. A clot, embedded deep inside one of the inner leg veins, can be found through ultrasound before dislodges and runs into the lungs, producing a potentially fatal pulmonary embolus. Ultrasound is useful as a guide for performing biopsies to minimize damage to surrounding tissues and in drainage such as thoracentesis. Small and portable ultrasound devices are now replacing the peritoneal rinses in the trauma ward with a non-invasive assessment for internal bleeding and internal organ damage. Extensive internal bleeding or injury to major organs may require surgery and repair.
Magnetic resonance imaging
MRI uses a strong magnetic field to align the atomic nucleus (usually proton hydrogen) inside the body tissues, then use radio signals to interfere with the axis of rotation of this core and observe the radio frequency signals generated when the nuclei return to their baseline state. Radio signals are collected by a small antenna, called a coil, placed near the area of ​​interest. The advantage of MRI is its ability to produce images in inclined, coronal, sagittal and some inclined plane with the same ease. MRI scans provide the best soft tissue contrast of all imaging modalities. With advances in scanning speed and spatial resolution, as well as improvements in computer 3D algorithms and hardware, MRI has become an important tool in musculoskeletal radiology and neuroradiology.
One disadvantage is the patient must be silent for a long time in a noisy and narrow space while imaging is done. Claustrophobia (fear of closed space) is severe enough to end the MRI examination reported to 5% of patients. Recent improvements in magnet design include a stronger magnetic field (3 teslas), shorten exam times, wider, shorter drill magnets and more open magnetic design, have brought some help to claustrophobic patients. However, for magnets with equivalent field strength, there is often a trade-off between image quality and open design. MRI has great benefits in brain, spine, and musculoskeletal imaging systems. The use of current MRIs is contraindicated for patients with pacemakers, cochlear implants, multiple deep-drug pumps, certain types of brain aneurysm clips, metal fragments in the eyes and some metal hardware due to strong magnetic fields and strongly fluctuating radio signals to which the body is exposed. Areas of potential progress include functional imaging, cardiovascular MRI, and MRI-guided therapy.
Nuclear medicine
Nuclear medicine imaging involves administration to radiopharmaceutical patients consisting of substances with affinity for certain tissues labeled with radioactive tracers. Most commonly used trackers are technetium-99m, iodine-123, iodine-131, gallium-67, indium-111, thallium-201 and fludeoxyglucose (18F) (18F-FDG). The heart, lungs, thyroid, liver, brain, gallbladder, and bone are usually evaluated for certain conditions using this technique. While the details of anatomy are limited in this study, nuclear drugs are useful in performing physiological functions. The function of renal excretion, the ability of iodine-concentrate from the thyroid, blood flow to the heart muscle, etc. can be measured. The main imaging device is a gamma camera and PET Scanner, which detects the radiation emitted by the tracker in the body and displays it as an image. With computer processing, information can be displayed as axial, coronal and sagittal images (one-photon emission computed tomography - SPECT or Positron-emission tomography - PET). In most modern devices, nuclear medicine images can be combined with simultaneous CT scans, so that physiological information can be coated or grouped with anatomical structures to improve diagnostic accuracy.
Positron emission tomography (PET) scans are associated with positrons rather than gamma rays detected by gamma cameras. The positron is gutted to produce two opposite gamma-ray trips to be detected by chance, thus increasing resolution. In PET scanning, a radioactive, active active substance, most often 18F-FDG, is injected into the patient and radiation emitted by the patient is detected to produce a multiplanar body image. More metabolically active tissues, such as cancer, concentrate more on active substances than normal tissue. PET images can be combined (or "fused") with anatomical imaging (CT), to more accurately localize the PET findings and thereby improve diagnostic accuracy.
The fusion technology has gone further to incorporate PET and MRI similar to PET and CT. PET/MRI fusion, which is mostly done in academic and research settings, could potentially play an important role in brain imaging, breast cancer screening, and small foot joint imaging. The technology has recently evolved after passing technical hurdles from positron changes in strong magnetic fields thus affecting PET image resolution and attenuation correction.
Maps Radiology
Interventional radiology
Interventional radiology (IR or sometimes VIR for vascular and interventional radiology) is a subspecialty of radiology where minimally invasive procedures are performed using image guidance. Some of these procedures are performed for pure diagnostic purposes (eg, angiogram), while others are performed for treatment purposes (eg, angioplasty)
The basic concept behind intervention radiology is to diagnose or treat pathology, with the least possible invasive technique possible. Minimally invasive procedures are currently performed more than ever. This procedure is often performed with fully awake patients, with little or no necessary sedation. Interventional Radiologist and Interventional Radiography diagnose and treat some disorders, including peripheral vascular disease, renal artery stenosis, inferior venous cava placement, placement of gastrostomy tubes, biliary stents and liver intervention. Images are used for guidance, and the main instruments used during the procedure are needles and catheters. The images provide a map that allows Doctors to guide these devices through the body to areas that contain the disease. By minimizing physical trauma to the patient, peripheral intervention can reduce infection rates and recovery time, as well as hospital stay. To become a trained interventionalist in the United States, an individual completes a five-year residency in radiology and a one or two year fellowship in IR.
Analysis of images
Teleradiology
Teleradiology is the transmission of radiographic images from one location to another to be interpreted by a trained professional, usually a radiologist or radiography reporting specialist. It is most commonly used to allow rapid interpretation of emergency room, ICU and other emergency checks after ordinary hours of operation, at night and on weekends. In this case, images can be sent across time zones (eg to Spain, Australia, India) with Doctors who accept work during normal daytime hours. But today, the major private teleradiology company in the US currently provides most hours of after-hours work using radiologists working in the US. Teleradiology can also be used to get consultations with experts or subspecialists about complicated or confusing cases.
Teleradiology requires delivery stations, high-speed internet connections, and high-quality receiving stations. At transmission stations, plain radiography is passed through a digitizing machine before transmission, while CT, MRI, ultrasound and nuclear drug scans can be sent instantly, as they are already digital data. The computer at the receiving end must have a high quality display screen that has been tested and cleaned for clinical purposes. The report is then sent to the requesting physician.
The main advantage of teleradiology is the ability to use different time zones to provide real-time emergency radiology services over time. Disadvantages include higher costs, limited contact between referrer and Clinical reporting, and inability to cover procedures requiring a doctor reporting on the spot. Laws and regulations regarding the use of teleradiology vary among states, with some requiring licenses for medical practice in the states sending radiological tests. In the US, some states require teleradiology reports to be preliminary with official reports released by Radiologist hospital staff.
Artificial Intelligence
The existing AI system can outperform radiologists on many diagnostic tasks, and by 2017, the AI ​​system continues to increase rapidly. Many economists and AI researchers believe that most tasks consisting of visual medical images tend to be automated in the near future.
Professional training
United States
Radiology is a growing field in medicine. Applying for residency positions in radiology is competitive. Applicants are often near their medical school class, with high USMLE (board) scores. This field is growing rapidly due to the advancement of computer technology, which is closely related to modern imaging. Diagnostics Radiologists must complete undergraduate prerequisite education, four years of medical school to obtain a medical degree (D.O. or M.D.), one year of internship, and four years of residency training. After residency, the radiologist can follow one or two years of special additional training.
The American Board of Radiology (ABR) manages professional certifications in Radiology Diagnostics, Radiation Oncology and Medical Physics as well as sub-specialty certification in neuroradiology, nuclear radiology, pediatric radiology and vascular radiology and intervention. "Board Certification" in diagnostic radiology requires the completion of two successful examinations. The Core Exam is awarded after 36 months of residency. This computer-based examination is given twice a year in Chicago and Tucson. It covers 18 categories. The 18th graduation is a pass. Failure in 1 to 5 categories is a Conditional exam and the resident needs to retrieve and resume the failed category. Failure in more than 5 categories is a failed exam. Certification Exam, can be taken 15 months after completion of Radiology residency. This computer-based examination consists of 5 modules and is rated pass-failed. It is given twice a year in Chicago and Tucson. The resertification exam is taken every 10 years, with the addition of the necessary advanced medical education as outlined in the Certification Maintenance document.
Certification can also be obtained from the American Osteopathic Board of Radiology (AOBR) and the American Board of Physician Specialties.
After completing the residency training, the radiologist may begin practicing as a general diagnostic radiologist or enter into a subspecialty training program known as fellowship. Examples of subspecialty training in radiology include abdominal imaging, chest x-ray, cross-sectional/ultrasound, MRI, musculoskeletal imaging, interventional radiology, neuroradiology, interventional neuroradiology, pediatric radiology, nuclear medicine, emergency radiology, breast imaging and female imagery. The fellowship training program in radiology is usually one or two years long.
Several medical schools in the US have begun to incorporate basic introduction of radiology into their core MD training. New York Medical College, Wayne State University School of Medicine, Uniformed Services University, and the University of South Carolina School of Medicine offer radiology recognition during their respective MD programs. Campbell University School of Osteopathic Medicine also integrates imaging materials into their curriculum early in the first year.
Radiographs are usually performed by radiographers. Qualifications for Radiographers vary by country, but many radiographers are now required to hold a degree.
Veterinary Radiologists are veterinarians specializing in the use of X-rays, ultrasound, MRI and nuclear medicine for diagnostic imaging or treatment of diseases in animals. They are either certified diagnostic radiology or radiation oncologists by the American College of Veterinary Radiology.
United Kingdom
Radiology is a competitive specialty in the UK, attracting applicants from diverse backgrounds. Applicants are welcomed directly from foundation programs, as well as those who have completed higher training. Recruitment and selection to training posts at clinical radiology posts in England, Scotland, and Wales are conducted with an annual annual coordination process that runs from November to March. In this process, all applicants are required to pass the Special Recruitment Assessment (SRA) exam. Those who had a test score above a certain limit were offered a single interview in London and the South East Recruitment Office. At a later stage, applicants state what programs they like, but may in some cases be placed in neighboring territories.
The training program lasts for a total of five years. During this time, doctors rotate into various sub-specialties, such as pediatrics, musculoskeletal or neuroradiology, and breast imaging. During the first year of training, radiology participants are expected to pass the first part of the Fellowship of the Royal College of Radiologists (FRCR) exam. It consists of physical examination and medical anatomy. After completing their Part 1 exam, they are then required to pass six written examinations (part 2A), which includes all sub-specializations. The success of this settlement allows them to complete the FRCR by completing section 2B, which includes quick reporting, and long case discussions.
After getting a training completion certificate (CCT), many post scholarships are in specialties such as neurointervention and vascular intervention, which will allow the Doctor to work as an Interventional Radiologist. In some cases, CCT dates can be suspended a year to include this fellowship program.
British radiology registries are represented by the Society of Radiologists in Training (SRT), founded in 1993 under the auspices of the Royal College of Radiologists. Society is a nonprofit organization, run by a specialized radiology registrar to promote radiology and education training in the UK. Annual meetings are held where trainees across the country are encouraged to attend.
Currently, the shortage of radiologists in the UK has created opportunities in all specialties, and with increasing dependence on imaging, demand is expected to increase in the future. Radiographers, and less frequent Nurses, are often trained to do many of these opportunities to help meet demand. Radiographers can often control the "list" of a specific set of procedures after being approved locally and signed by the Consultant Radiologist. Similarly, radiographers can only operate the list for radiologists or other doctors on their behalf. Most often if a Radiographer operates an autonomous list then they act as Operators and Practitioners under Ionizing Radiation (Exposure of the Medical) Regulation 2000. Radiography is represented by various bodies, most often the Society and the College of Radiographers. Collaboration with Nurses is also common, where lists can be arranged together between Nurses and Radiographers.
German
After obtaining a medical license, the German Radiologist completed a five-year residency, culminating with a council check (known as FacharztprÃÆ'¼fung ).
Italy
Radiology training programs in Italy increased from four to five years in 2008. Further training is required for specialization in radiotherapy or nuclear medicine.
Netherlands
Dutch radiologist completed a five-year residency program after completing the 6-year MD program.
India
The radiology training course is a 3-year postgraduate program (MD/DNB Radiology) or a 2-year diploma (DMRD).
See also
- Digital mammography: computer use to generate breast images
- Global radiology: increasing access to radiological sources in poor and developing countries
- Medical radiography: the use of ionizing electromagnetic radiation, such as X-rays, in medicine
- Radiation protection: science prevents humans and the environment from suffering the harmful effects of ionizing radiation
- Radiosensitivity: measures the susceptibility of organic tissue to harmful radiation effects
- X-ray image intensifier: x-ray equipment to generate image feeds displayed on TV screen
- International Day of Radiology: awareness day for medical imaging
References
External links
- Radiology at Curlie (based on DMOZ)
Source of the article : Wikipedia
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