Anda di halaman 1dari 92

0

Dent 545 Radiology


Dr. Robert M. Jaynes

Office: 3001L
Radiology Clinic: 1117
E-mail: jaynes.1@osu.edu
Phone: 688-3374 (Office)
292-0874 (Clinic)

Office hours: 7:00 any morning


or by appointment.
0

Websites
Page 3 of syllabus

College of Dentistry Homepage


Academic Sections
Radiology
Resources
Topic of interest
Need PowerPoint
Anatomy
Intraoral and panoramic radiographic
anatomy will be covered online (website
in syllabus). Review material at any time.
Testing will be on Final.

Textbook not required


0

Exams
Midterm (Room 1183) Mon., July 27
8:00 AM 1 hour
Final (Room 1183) Mon., August 31
1:30 PM; 1 hour
40 questions: MC/ T-F (each
question worth 1.25 points)
Technique lectures (3 and 4) on
both midterm and final
Grading
0

Total of 50 points for both midterm


and final. Add both scores to get
total for course.

A = 90-100
B = 80-89
C = 70 -79
D = 60 – 69
E = 59 or below
Early Clinic Radiography
Wednesday mornings, 7:30-9:15

Starts fourth week of the quarter


0

Radiology
The study and application of the
imaging technology used to
diagnose and treat disease.
0

Clinical Exam + Radiographic Imaging*

Diagnosis

Treatment

*Dentistry: X-rays

*Medicine: X-rays, Ultrasound, MRI, NM


0

Bitewing Radiograph Periapical Radiograph


(X-ray Film, “X-ray”)
0

Panoramic Radiograph
0

Cephalometric Radiograph
0

TMJ Radiograph
Cone Beam CT
First Radiograph
Dec. 22,1895
Taken by Wilhelm Conrad Roentgen, who
discovered X-rays on Nov. 8, 1895.
0

X-ray
A form of electromagnetic radiation with a
short wavelength that can cause ionization
and can penetrate through solids.

Electromagnetic Radiation
• X-ray • Microwaves
• Gamma ray • Radio waves
• Visible light
0

A W B

F
Wavelength x Frequency = Speed of light
Electromagnetic Spectrum 0

radio microwaves visible x-rays gamma


light rays
W: 103 m 10-2 m 0.5x10-6 m 10-10 m 10-12 m
F: 104 Hz 108 Hz 1015 Hz 1018 Hz 1020 Hz
0

ENERGY
Ability to penetrate

Shorter wavelength, higher energy

Higher frequency, higher energy


0

X-ray Characteristics
High energy waves

No mass
No charge (neutral)
Travel at speed of light
Invisible
0

X-ray Characteristics
Travel in straight line
Cannot be focused to a point
Differentially absorbed
Cause fluorescence
Harmful to living tissue
Dr. C. Edmund Kells took the first intraoral
radiograph in early 1896; had numerous
cancerous growths due to x-ray effects.
0

X-ray Production
0

X-ray Tube
3 4
1 6

5
2 7

8 9

Cathode (1, 2) Anode (3,4)


1 = filament 6 = vacuum
2 = focusing cup 7 = leaded glass
3 = target 8 = x-rays
4 = copper sleeve 9 = beryllium window
5 = electron flow
0

Anode
side view front view

Tungsten Target
Copper stem Tungsten Target

Dental x-ray machines have stationary anode


Atom (electrically neutral) 0

K-shell
protons
L-shell
neutrons
M-shell
electrons

Atomic Number (Z) = # of protons


0

Electrostatic Force

Attraction between protons


and electrons
0

Centrifugal Force

Pulls electrons away


from nucleus
0

EF CF

Balance between electrostatic force


and centrifugal force keeps
electrons in orbit around nucleus
0

Binding Energy

The amount of energy required


to remove an electron from its
orbit (= electrostatic force).
Depends on atomic number (Z)
(# of protons).
0

X-ray Production

Bremmstrahlung
Characteristic
0

Bremsstrahlung Radiation
(Braking radiation, general radiation)

X-rays produced when high-speed


electrons from the filament are slowed
down as they pass close to, or strike,
the nuclei of the target atoms
0

Bremsstrahlung X-ray Production

Electron slowed
down by positive
charge of
nucelus; energy
released in form
High-speed
electron from + of x-ray

filament enters
tungsten atom

Electron continues on to
other atoms until all of its
energy is lost
Bremsstrahlung X-ray Production 0

Maximum energy

+
High-speed electron
from filament enters
tungsten atom and
strikes nucleus,
losing all its energy
The x-ray produced has energy
and disappearing
equal to the energy of the
high-speed electron; this is the
maximum energy possible
0

Characteristic Radiation
X-rays have energies characteristic of the
target material (energy = difference
between binding energies of target
electrons involved, e.g., K & L, K & M, etc.)

The energy of the high-speed electron from


the filament must be higher than the
binding energy of the target electron with
which it interacts in order to eject the target
electron
0

Characteristic X-ray Production

Ejected electron
leaves atom

vacancy
M
High-speed electron
L
with at least 70 keV K
of energy (must be
more than the
binding energy of k-
shell Tungsten atom)
Recoil electron
strikes electron in
(with very little
the K shell
energy) exits
atom
0

Characteristic X-ray Production


X-ray with 59
Outer-shell electron
keV of energy
drops into vacant spot
produced. 70
(binding energy
of K-shell
electron) minus
11 (binding
M energy of L-
shell electron) =
L K 59.
0

X-ray Spectrum
(variable x-ray energies)

average energy of
x-ray beam

# of characteristic
x-rays x-rays
(59 & 67 keV)
Bremsstrahlung
x-rays

X-ray energy (keV)


0

X-ray Spectrum results from:

Varying electron/nucleus
distances

Multiple electron
interactions

Varying voltage (AC)


0

X-ray Machine

support arms

tubehead
electricity

control panel
Electrical Connection – 110/220 volts 0

60-cycle Alternating Current


(60 cycles per second)

+ 110 or 220
positive

- 110 or 220
negative
Constant Potential (Direct Current) 0

60-cycle AC converted to DC

+ 110 or 220
positive

- 110 or 220
negative Less patient exposure!
0

X-ray Tubehead

degrees

PID, BID
(cone)

PID = position indicating device


BID = beam indicating device
X-ray Tubehead Components 0

PID
barrier

oil

X-ray Tube
Electrical connections
Step-up transformer
Step-down transformer
Oil
PID
0

Control Panel

Exposure Time

exposure time 70 kVp 7 mA

adjustment
0

Control Panel
kVp readout
mA control (50-100) kVp control
(10-15)

timer (3 impulses - 5 minutes)


Control Panel 0
0

Control Panel Components

Timer (all machines)


mA control (some machines)
kVp control (some machines)
Autotransformer (some machines)
Exposure switch (all machines)
Either on, or connected to, the
control panel
0

Timer
Impulses or seconds
1/60 0

Number of Impulses
= Seconds
60
60 impulses/60 = 1.0 second
30 impulses/60 = 0.5 second
15 impulses/60 = 0.25 second
Normal exposure time: 10-30 impulses.
(Varies with kVp, mA, and film type)
Dr. Otto Walkhoff took first dental
radiograph; 25-minute exposure
0

mA setting

milliAmpere (mA) control


Filament current
0

Cathode
Side, crosscut view Front view

Filament
(tungsten)

Focusing
cup
Thermionic Emission 0

Release of electrons from hot filament


when current flows after depressing
exposure switch

x-section
hot
of
filament
filament electrons

The hotter the filament gets (increased


current), the greater the number of electrons
produced.
0

mA control

100 volts 80 volts To step-down


transformer
110 volts

resistor
0

Step-Down Transformer
Primary
current flow

80-100
volts
current flow

8-10 volts

Secondary
0

kiloVolt peak (kVp) control

kVp control

kVp readout

Controls voltage (current flow) across


x-ray tube.
0

kVp = kiloVolt peak

AC Constant Potential
0

Autotransformer
Determines voltage across x-
ray tube.

Regulated by kVp control


(Similar to a rheostat)
Autotransformer 0

110 V
current flow

65 V
80
0
Step-Up (High-voltage) Transformer

Primary
current flow
65-90 volts
current flow

Secondary
65,000 to 90,000 volts
(65 kVp to 90 kVp)
0

Exposure Switch

Allows current to flow to heat filament


and complete exposure.
Indicator light on control panel and
audible signal
You cannot overexpose by holding
the exposure switch down too long!
0

timer

filter PID
110 barrier
220

filament

collimator

exposure
button

Control panel Tubehead


0
kVp/Auto Step-up

Timer

Exp.
Switch
mA Step-down
8-10 volts
65-90 volts
filament
<110 volts
110 volts
65,000 to
90,000 volts
Tungsten
0

(Filament and Target)

• High atomic number (Target)


• Transfers heat readily (Target)
• High melting point (Target, Filament)
• Can be drawn into fine wire (Filament)
0

Electron interactions with target atoms:


1 % produce x-rays
99 % produce heat
The excess heat is controlled by high melting point
of tungsten, conductive properties of copper sleeve,
line-focus principle, and cooling from oil
surrounding x-ray tube.
0

Line Focus Principle

The smaller the focal spot (target),


the sharper the image (teeth) will be.

However, due to the heat generated


during x-ray production, a target that
is too small may overheat and burn
up.
Decrease focal spot size, increase sharpness
Line Focus Principle
0

Target
Anode
(+)
Cathode
(-)
Apparent (effective)
focal spot size

Actual focal
spot size
PID
Line Focus Principle
0

Actual focal spot size Apparent (effective) focal


(looking perpendicular spot size (looking at target
to the target surface) surface through PID)

PID
0
Oil in the X-ray Tubehead:
Insulates the electrical components
Cools the anode
Filters the x-ray beam

Step-up
Trans

oil

Step-down
Trans
Medical Radiography 0

Front view Side view

Anode (blue
edge is
tungsten)

Filament/
Electron beam strikes Focusing Cup
target in this area only
0

X-ray Beam Modifiers


0

Exposure Factors

kVp
mA
Exposure time
0
Incorrect exposure factors
(too many x-rays or too
much energy; film too dark)

Correct exposure factors

Incorrect exposure factors


(not enough x-rays or
energy too low; film too
light)
0
kVp (kiloVolt peak)
Number of X-rays

85 kVp

70 kVp

maximum energy

70 85
average energy
X-ray Energy (keV)
0

Increasing kVp results in:


• Higher average energy of x-rays

• Greater maximum energy x-rays


(Maximum energy = kVp setting)

• More x-rays
0
mA (milliamperes)

Number of X-rays

10 mA

5 mA

maximum energy
(no change)

70
average energy X-ray Energy (keV)
(no change)
0
Exposure time

Number of X-rays

10 impulses

5 impulses

maximum energy
(no change)

70
average energy X-ray Energy (keV)
(no change)
0

Increasing mA or Exposure
Time results in:

• An increase in the number of

x-rays produced

• No change in the energy of the


x-ray beam
0

mAs or mAi
milliamperes (mA) x seconds (s)
milliamperes (mA) x impulses (i)
60 impulses = 1 second
10 mA x .5 seconds = 5 mAs
20 mA x .25 seconds = 5 mAs
mAi = 60 x mAs
Constant patient size 0

1. Proper kVp, mA, exposure time (e.t.) B


2. Increase mA; no change in kVp, e.t. A
3. Decrease e.t.; no change in kVp, mA C
4. Increase kVp; no change in mA, e.t. A
5. Double mA, halve e.t.; no change in kVp B

A B C
0

Filtration

The process of removing


low-energy x-rays from
the x-ray beam
0

PID

The aluminum filter


is usually located
in the end of the filter
PID which attaches
to the tubehead.
Total Filtration 0

Glass window of Oil/Metal


x-ray tube barrier

Inherent + Added = Total


(Aluminum filter)

70 kVp and above


2.5 mm aluminum equivalent
oil
Below 70 kVp
1.5 mm aluminum equivalent
0
Collimation: Regulates the size
and/or shape of the x-ray beam.

filter PID

Collimator
Collimation 0

front views collimator

target collimated
(x-ray source) beam

2.75 inches (7 cm) = maximum diameter of circular beam or maximum


length of long side of rectangular beam at end of PID.
0

Purpose of Collimation

Decrease area covered (less


patient exposure)

Decrease scatter radiation


0

Scatter Radiation

primary x-ray

scattered x-ray
0

7 cm
6 cm If you switch from 7
7 cm cm diameter round
6 cm round collimation to 6 cm
diameter round
collimation, the
patient receives 25%
film less radiation.
(4.5 cm long)

If you switch from 7


cm diameter round
entrance collimation to
entrance
rectangular
exit
collimation, the
exit
patient receives 55%
less radiation.
0

Collimated film holder


0

Quality
average energy

Quantity
number of x-rays
0

Quality vs. Quantity


kVp (10) (20)

mA No change

Time No change

Filtration

Collimation No change
0

Inverse Square Law


The intensity of radiation varies
inversely as the square of the
*
target-film distance
* target = source, focal spot, focus
0

D1

D2

D4