Stiell IG et al (2001) The Canadian C-spine rule for radiography in alert and stable trauma patients. This process is experimental and the keywords may be updated as the learning algorithm improves. These keywords were added by machine and not by the authors. Single Photon Emission Compute Tomography.Magnetic resonance imaging (MRI) and ultrasound (US) do not use ionizing radiation, so radiation dose is not an issue when using these imaging techniques. Radiation dose should be taken into account when performing a medical imaging technique that utilizes X-ray or gamma ray to create images, such as radiography, CT, and nuclear medicine imaging modalities. Recently the Image Gently (pediatrics) and Image Wisely (adults) campaigns have emerged to further reinforce radiation dose reduction awareness. For years medical imagers have followed the ALARA principle (as low as reasonably achievable) with the knowledge that there is some qualitative increased cancer risk associated with any dose of radiation. The amount of radiation that is directly attributed to medical imaging continues to increase, raising attention to radiation dose control in medical imaging. When evaluating the risk and benefits of different imaging strategies, radiation dose needs to be considered. These radiopharmaceuticals then give off energy in the form of gamma rays detected by a gamma camera or a PET scanner. Nuclear medicine imaging, such as bone scan and positron emission tomography (PET), uses small amounts of radioactive materials called radiopharmaceuticals selected to accumulate in the target organ system. The relaxation times of these protons following the radio wave pulses can be measured and are tissue specific, allowing exquisite soft tissue contrast. While radiographic and CT imaging are obtained by passing photons (X-ray beam) through portions of a patient’s body, MRI uses pulses of specific radio wave frequencies within a constant magnetic field to change hydrogen atom alignment in the patient’s body. The main imaging techniques to evaluate the spine include conventional radiography, computed tomography (CT), magnetic resonance imaging (MRI), bone scan, and positron emission tomography–computed tomography (PET–CT). While conventional radiography and CT are effective in the evaluation of the osseous structures, MR is optimal for the evaluation of soft tissues, including, but not limited to, intervertebral disks, ligaments, paravertebral muscles, and the spinal cord. The osseous spine is connected by intervertebral disks and supporting ligaments. The spine is formed by 7 cervical vertebrae, 12 thoracic vertebrae, 5 lumbar vertebrae, 5 fused sacral vertebrae, and four small bones extending from the sacrum to form the coccyx. The purpose of this chapter is to discuss the different diagnostic imaging techniques and an imaging-based approach to common spine pathologies. I think they are really helpful.Imaging is an essential tool in diagnosis and management of spine pathology. So if you ask the MRI facility that you normally use or you have one yourself, I would really suggest distinguishing yourself from the rest of the units in your area by supplying oblique MRI views of the cervical spine. I think this is a much better representation of the size and how much this disc extrusion occupies the foraminal canal than a standard axial view. And if we take a look at the obliques of the foraminal canal, this is given a much larger appearance of the disc extrusion, and where we’re going to see it located is right there. Now look at how much larger this appears here at the 5/6th level with the oblique views. Let’s just take a look and see what happens when we take a look at an oblique picture. So I don’t think this is such a great revelation in terms of what’s happening in the Foraminal Canal. The radiologists have better equipment and magnification and resolution than I do on this reader, but I have probably the typical kind of reader that most of you all might have as well. And if you keep going again, everything sort of disappears. We can see it’s again smaller, but not really that big. We take a look at the axial slice, and we don’t really get a great sense of how big it is here. However, if you go to the sides, for example, we can see this protrusion here. Well, it’s got a little bit of protrusion and maybe a little indentation of the myelin, but nothing to write home about. In this case, we have a definite protrusion at cervical 5/6, and we can see it’s here, but we don’t really get a true sense of dimension using the the axial slices. One of the challenges when looking at cervical MRIs is really getting a proper look at the foraminal canals, particularly at the cervical levels 3/4 4/5 5/6, and even 6/7.
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