Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Introduction
- The SBAR Tool
- Introduction
- Initial Primary Assessment
- Secondary Assessment
- Continuing Assessment
- Introduction
- Common Immediate Tests
- ECG Modes and Configurations
- Rate
- Cardiac Axis
- Bundle Branch Block
- QT Interval
- Other Abnormalities
- ST Abnormalities and Ischaemic Changes
- Inherited Disorders
- Introduction
- Types of Infection and Related Organisms
- Surveillance
- General Principles of Sampling
- Special Tests – Lumbar Puncture
- Introduction
- Indications for Arterial Blood Gas Samples
- Contraindications
- Sampling Sites
- Technique (Follow Local Hospital Procedure)
- Problems
- Complications
- Potential Sources of Error
- ABG Interpretation
- A Quick Approach to Deciphering the ABG
- Some Caveats
- Stewart’s Physicochemical Approach to Acid–Base
- Plain Film Radiographs (X-ray)
- Computed Tomography
- Magnetic Resonance Imaging
- Radiation
- Introduction
- Challenges of Portable Chest Radiography in ICU
- Systematic Assessment of ICU CXRs
- The ‘LLL’ Approach
- Pneumonia versus Pulmonary Oedema versus ARDS – Which Is It?
- Introduction
- CT Head Anatomy
- Meninges
- CT Checklist: ‘AB BCS’
- Grey–White Matter Differentiation
- CSF Spaces
- Skull/Scalp
- Introduction
- Systematic Assessment of the Abdominal X-ray: BBC
- B: Bones/Soft Tissue
- C: Calcifications/Artefacts
- Abdominal Pathology on CT
- Introduction
- Features of NEWS Scoring Systems
- Updated NEWS 2 Scoring System
- Advantages
- Disadvantages
- Introduction
- Clinical Reasoning and Critical Thinking
- The Clinical Reasoning Process
- Important Steps to Making a Differential Diagnosis
- Acknowledgements
- 2.1 Principles of Obtaining a History
- 2.2 Principles of Performing an Accurate Clinical Examination
- 2.3 How to Undertake Timely and Appropriate Investigations
- 2.4 General Principles of Performing and Interpretation of Electrocardiography Results
- 2.5 General Principles of Obtaining Appropriate Microbiological Samples and Interpretation of Results
- 2.6 Obtaining and Interpretation of Results from Blood Gas Samples (Acid–Base Balance and Disorders)
- 2.7 Principles of Interpreting Imaging Studies (X-ray/CT/MRI)
- 2.8 Imaging of the Chest
- 2.9 Imaging of the Head
- 2.10 Imaging of the Abdomen
- 2.11 Importance of Monitoring and Responding to Trends in Physiological Variables
- 2.12 How to Integrate Clinical Findings with Laboratory Investigations to Form a Differential Diagnosis
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Index
- References
2.7 - Principles of Interpreting Imaging Studies (X-ray/CT/MRI)
from Section 2 - Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
Published online by Cambridge University Press: 27 July 2023
Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Introduction
- The SBAR Tool
- Introduction
- Initial Primary Assessment
- Secondary Assessment
- Continuing Assessment
- Introduction
- Common Immediate Tests
- ECG Modes and Configurations
- Rate
- Cardiac Axis
- Bundle Branch Block
- QT Interval
- Other Abnormalities
- ST Abnormalities and Ischaemic Changes
- Inherited Disorders
- Introduction
- Types of Infection and Related Organisms
- Surveillance
- General Principles of Sampling
- Special Tests – Lumbar Puncture
- Introduction
- Indications for Arterial Blood Gas Samples
- Contraindications
- Sampling Sites
- Technique (Follow Local Hospital Procedure)
- Problems
- Complications
- Potential Sources of Error
- ABG Interpretation
- A Quick Approach to Deciphering the ABG
- Some Caveats
- Stewart’s Physicochemical Approach to Acid–Base
- Plain Film Radiographs (X-ray)
- Computed Tomography
- Magnetic Resonance Imaging
- Radiation
- Introduction
- Challenges of Portable Chest Radiography in ICU
- Systematic Assessment of ICU CXRs
- The ‘LLL’ Approach
- Pneumonia versus Pulmonary Oedema versus ARDS – Which Is It?
- Introduction
- CT Head Anatomy
- Meninges
- CT Checklist: ‘AB BCS’
- Grey–White Matter Differentiation
- CSF Spaces
- Skull/Scalp
- Introduction
- Systematic Assessment of the Abdominal X-ray: BBC
- B: Bones/Soft Tissue
- C: Calcifications/Artefacts
- Abdominal Pathology on CT
- Introduction
- Features of NEWS Scoring Systems
- Updated NEWS 2 Scoring System
- Advantages
- Disadvantages
- Introduction
- Clinical Reasoning and Critical Thinking
- The Clinical Reasoning Process
- Important Steps to Making a Differential Diagnosis
- Acknowledgements
- 2.1 Principles of Obtaining a History
- 2.2 Principles of Performing an Accurate Clinical Examination
- 2.3 How to Undertake Timely and Appropriate Investigations
- 2.4 General Principles of Performing and Interpretation of Electrocardiography Results
- 2.5 General Principles of Obtaining Appropriate Microbiological Samples and Interpretation of Results
- 2.6 Obtaining and Interpretation of Results from Blood Gas Samples (Acid–Base Balance and Disorders)
- 2.7 Principles of Interpreting Imaging Studies (X-ray/CT/MRI)
- 2.8 Imaging of the Chest
- 2.9 Imaging of the Head
- 2.10 Imaging of the Abdomen
- 2.11 Importance of Monitoring and Responding to Trends in Physiological Variables
- 2.12 How to Integrate Clinical Findings with Laboratory Investigations to Form a Differential Diagnosis
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Index
- References
Summary
Key Learning Points
1. For X-rays, denser tissue (i.e. bone) absorbs more X-rays and therefore is whiter on the final image.
2. In CT imaging, different contrast media are used, depending on the clinical question. Normally oral/nasogastric contrast is given to detect intraluminal bowel pathology, and intravenous contrast is given to delineate the vasculature and lesions.
3. When looking at CT images, the process of windowing is used to optimally display the desired set of tissues. Sequential windows should be reviewed to assess the desired structures.
4. Magnetic resonance imaging works by utilising the magnetic properties of hydrogen ions (protons), which are found in high concentration in water and fat.
5. Different tissues can be characterised by different relaxation times – T1 and T2.
- Type
- Chapter
- Information
- Intensive Care MedicineThe Essential Guide, pp. 43 - 46Publisher: Cambridge University PressPrint publication year: 2021
References
References and Further Reading
Allisy-Roberts, P, Williams, J. Farr’s Physics for Medical Imaging, 2nd edn. Edinburgh: Elsevier; 2008.Google Scholar
Darby, MJ, Barron, D, Hyland, RE. Oxford Handbook for Medical Imaging. Oxford: Oxford University Press; 2011.Google Scholar
Public Health England. 2008. Patient dose information: guidance. www.gov.uk/government/publications/medical-radiation-patient-doses/patient-dose-information-guidanceGoogle Scholar
Raby, N, Berman, L, de Lacey, G. Accident & Emergency Radiology: A Survival Guide, 2nd edn. Edinburgh: Elsevier; 2005.Google Scholar
Radiology Masterclass. 2008. Basics of X-ray physics. www.radiologymasterclass.co.uk/tutorials/physics/x-ray_physics_introductionGoogle Scholar