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I. OBJECTIVES o Tungsten
Explain how x-ray radiation is formed Vacuum tube
Describe how x-ray interacts with the body External energy source and controls
Describe the process of x-ray image
formation A. THERMIONIC EMISSION
A. ELECTROMAGNETIC ENERGY
i. TUNGSTEN
Electron source
o Cathode (-)
o Tungsten
Rare earth
Tangent material
Atomic #74
A change in mAs results in amplitude
ii. Tube Interactions change of the x-ray emission spectrum
Heat- 99% A change in kvP results in amplitude and
X-rays- 13% spectral change
A change in atomic number of target
X-RAY PRODUCTION material affects both quantity and quality of
Bremsstrahlung x-rays
Characteristic x-ray
Rare occurrence ii. FILTRATION
Selective process to remove low energy
B. BREMSTRAHLUNG electrons
Hardening the x-ray beam
o Increase in average energy
Maximum energy is not affected
Aluminum
2 Types:
Thomson scattering
o 1 orbital electron only is involved
Rayleigh scattering
iii. PHOTODISINTEGRATION
Incident photon interacts with outer shell
electron and ejects it from its shell (recoil
electron) continues on a deflected path as
a lower energy photon
Almost all the scattered radiation in
diagnostic radiation in diagnostic radiology
comes from Compton scattering
A major source of radiation to the
radiologist/rad tech
B. PHOTON IS ABSORBED
i. PHOTOELECTRIC EFFECT
D. DIAGNOSTIC RADIOLOGY
What matters?
o Photoelectric effect/ absorption
o Compton effect/ scattering
o Photons that pass through the body
Factors influencing photon-tissue interaction
o Photon energy (kvP)
o Atomic # of absorber (eg. Calcium=
20; lead = 82)
Incident photon interacts with inner shell
o Density and thickness of absorber
electron
Also occurs at diagnostic radiology range
IV. SCATTER RADIATION
Also called photoelectric absorption
These are secondary radiation resulting from
lower energy x-rays from deflected photons
ii. PAIR PRODUCTION
Image contrast is reduced depending on
the amount of scatter radiation
Contributes to film fog
many silver many silver silver halide
A. EFFECTS OF SCATTER RADIATION halide halide crystals not
Assumed that the object shown here is not crystals crystals are exposed
penetrated and would produce 100% exposed
contrast if no scatter radiation
V. IMAGE PRODUCTION
A. PHOTOGRAPHIC/X-RAY FILM
Silver halide
RECAP:
X-ray tube produces x-ray beam
Differential interactions of x-ray photons with
tissue
Information from transmitted x-rays are
converted into radiographic image
V. ARTIFACTS
1. Glue shoe mark
Latent Image
Air/ soft tissue Bone Amalgam/
gold
Many x-rays Fewer x-rays Few, if any, x-
penetrate penetrate rays
and expose and not as penetrate;
2. Water stain 6. Static
3. Double exposure
4. Finger marks
5. Hyporetention
INTERPRETATION OF CHEST X-RAY 2. Laterality
I. TECHNIQUE 3. Projection
1. 5 Radiographic Opacities o PA vs. AP
4. Artifacts
o Motion
C. PATIENT-DEPENDENT FACTORS
1. Rotation
o Non-rotated
2. Be systematic Spinous process equidistant
3. Scan the film to the medial clavicular ends
Both lungs equal in density
Ribs are symmetrical
o Rotated film
Lung is blacker in the side of
rotation
Ribs are longer
Clavicle is farther away from
the spinous process
A. STUDY PARAMETERS
1. Name
2. Date of procedure
3. Type of procedure
B. FILM QUALITY
1. Exposure
B. HILAR SHADOWS
Converging shadows
Concave
Similar density
Left higher or at level with the right
Right never higher than left
Con be tracted upwards or downwards
C. VASCULATURE
Tapering towards the periphery
Paucity in the periphery
Smooth distinct margins
En-face vessel
D. LUNG ZONES
A. TOO BRIGHT
4 parenchymal patterns
o Alveolar
o Interstitial
o Nodule/mass
o Atelectasis
Pleura
o Effusion
o Plaque formation
o Pleural mass
i. ALVEOLAR PATTERN
Normal lung architecture
o Alveoli
o Interstitium
o Airways
Alveoli can be filled with
o Fluid
o Pus
o Blood
o Cells
1. CONSOLIDATION (PUS/BACTERIA)
Infection starts from one alveolus
Spreads to another through Pores of Khon
Ill-defined borders
Delimited by fissures
Air-bronchogram
No loss of volume
Bulging fissures sign (Klebsiella)
Silhouette sign