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Wednesday, 4 December 2024
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Arthrogram
An arthrogram is an x-ray fluoroscopy of a joint performed with a sequential digital subtracted spot films after injection of a contrast agent.

See Arthrography.
X-Ray Film
An x-ray film is a photographic film used to generate a visual x-ray image. X-ray films are rarely used as the only radiation detector. Commonly they are used in conjunction with intensifying screens placed in the film cassette, because high resolution films have a poor sensitivity to x-rays. At direct film exposure, only a small amount of x-ray photons will be absorbed and react with the film emulsion. An intensifying screen contains scintillating materials to convert x-ray radiation into light or lows electromagnetic energies.
X-ray films provide very good spatial resolution and contrast, but need long exposures times and chemical processing.

See also Conventional Radiography and Digital Radiography.
Conventional Radiography
Conventional (also called analog, plain-film or projectional) radiography is a fundamental diagnostic imaging tool in the detection and diagnosis of diseases. X-rays reveal differences in tissue structures using attenuation or absorption of x-ray photons by materials with high density (like calcium-rich bones).
Basically, a projection or conventional radiograph shows differences between bones, air and sometimes fat, which makes it particularly useful to asses bone conditions and chest pathologies. Low natural contrast between adjacent structures of similar radiographic density requires the use of contrast media to enhance the contrast.
In conventional radiography, the patient is placed between an x-ray tube and a film or detector, sensitive for x-rays. The choice of film and intensifying screen (which indirectly exposes the film) influence the contrast resolution and spatial resolution. Chemicals are needed to process the film and are often the source of errors and retakes. The result is a fixed image that is difficult to manipulate after radiation exposure. The images may be also visualized on fluoroscopic screens, movies or computer monitors.
X-rays emerge as a diverging conical beam from the focal spot of the x-ray tube. For this reason, the radiographic projection produces a variable degree of distortion. This effect decreases with increased source to object distance relative to the object to film distance, and by using a collimator, which let through parallel x-rays only.
Conventional radiography has the disadvantage of a lower contrast resolution. Compared with computed tomography (CT) and magnetic resonance imaging (MRI), it has the advantage of a higher spatial resolution, is inexpensive, easy to use, and widely available. Conventional radiography can give high quality results if the technique selected is proper and adequate. X-ray systems and radioactive isotopes such as Iridium-192 and Cobalt-60 for generating penetrating radiation, are also used in non-destructive testing.

See also Computed Radiography and Digital Radiography.
Filter Grid
Filter grids are used to reduce scattered noise and increase contrast in x-ray images. Primary radiation passing through an object gets scattered caused by the various density of different materials. Scatter radiation produces noise (radiographic fog) on the film or detector, which degrades the diagnostic quality. Anti-scatter grids act as filters between patient and film (or receiver) to remove scatter radiation. The use of a grid is recommended with body parts thicker than 10 cm and kVp values about 60 kV.
X-ray filter grids are available with focused or parallel strips. These two types are produced with linear or crossed grid configurations. The septa of filter grids consist of high radiation absorbing materials (e.g. lead) separated by permeable parts. During radiation exposure, movement of the grid blurs a projection of the septa.
If the image receptor and x-ray tube (with the focal spot) are in a fixed position relative to one another the grid is automatically aligned. In mobile radiography, the position of the focal spot and the image receptor is variable. Additionally cassettes incorporating anti-scatter grids are also available.
Diagnostic Imaging
Imaging refers to the visual representation of an object. Today, diagnostic imaging uses radiology and other techniques, mostly noninvasive, to create pictures of the human body. Diagnostic radiography studies the anatomy and physiology to diagnose an array of medical conditions. The history of medical diagnostic imaging is in many ways the history of radiology. Many imaging techniques also have scientific and industrial applications. Diagnostic imaging in its widest sense is part of biological science and may include medical photography, microscopy and techniques which are not primarily designed to produce images (e.g., electroencephalography and magnetoencephalography).
Brief overview about important developments:
Imaging used for medical purposes, began after the discovery of x-rays by Konrad Roentgen 1896. The first fifty years of radiological imaging, pictures have been created by focusing x-rays on the examined body part and direct depiction onto a single piece of film inside a special cassette.
In the 1950s, first nuclear medicine studies showed the up-take of very low-level radioactive chemicals in organs, using special gamma cameras. This diagnostic imaging technology allows information of biologic processes in vivo. Today, single photon emission computed tomography (SPECT) and positron emission tomography (PET) play an important role in both clinical research and diagnosis of biochemical and physiologic processes.
In the 1960s, the principals of sonar were applied to diagnostic imaging. Ultrasound has been imported into practically every area of medicine as an important diagnostic tool, and there are great opportunities for its further development. Looking into the future, the grand challenges include targeted contrast imaging, real-time 3D or 4D ultrasound, and molecular imaging. The earliest use of ultrasound contrast agents (USCA) was in 1968.
The introduction of computed tomography (CT/CAT) in the 1970s revolutionized medical imaging with cross sectional images of the human body and high contrast between different types of soft tissues. These developments were made possible by analog to digital converters and computers. First, spiral CT (also called helical), then multislice CT (or multi-detector row CT) technology expanded the clinical applications dramatically.
The first magnetic resonance imaging (MRI) devices were tested on clinical patients in 1980. With technological improvements including higher field strength, more open MRI magnets, faster gradient systems, and novel data-acquisition techniques, MRI is a real-time interactive imaging modality that provides both detailed structural and functional information of the body.

Today, imaging in medicine has been developed to a stage that was inconceivable a century ago, with growing modalities:
x-ray projection imaging, including conventional radiography and digital radiography;
scintigraphy;
single photon emission computed tomography;
positron emission tomography.

All these types of scans are an integral part of modern healthcare. Usually, a radiologist interprets the images. Most clinical studies are acquired by a radiographer or radiologic technologist. In filmless, digital radiology departments all images are acquired and stored on computers. Because of the rapid development of digital imaging modalities, the increasing need for an efficient management leads to the widening of radiology information systems (RIS) and archival of images in digital form in a picture archiving and communication system (PACS). In telemedicine, medical images of MRI scans, x-ray examinations, CT scans and ultrasound pictures are transmitted in real time.

See also Interventional Radiology, Image Quality and CT Scanner.
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