Brain Scan

Recently, a women came into the ER with a severe headache. This was her only complaint and this headache was of sudden onset. The doctor ordered a CT head w/o contrast. When checking the images, the technologist who performed the exam noticed an area that looked abnormal in the lower right quadrant of the brain. It was not very noticeable to me, if noticeable at all. This technologist called the radiologist to mention the findings. After looking at the images, the radiologist ordered a CT head w/ contrast. The patient was given contrast and the abnormal area became very bright and noticeable. This patient was diagnosed with a brain tumor. This was a very good observation by the technologist. Because the technologist noticed this abnormality while the patient was still on the table, she did not have to be moved and her diagnoses was not delayed. It was very interesting what a huge difference the contrast made to the exam.

Clinicals

Clinicals have been very busy lately. I am getting lots of experience and learning many different exams. I am getting very used to running the scanner and working independently. I have been able to do exams from start to finish with minimal help. The different protocols in CT are still very hard to learn. Every doctor has a different protocol and every exam has a specific way that it has to be done. I have been seeing lots of extremity work and countless sinuses. I have been enjoying all of it. Recently, I saw an interesting abdomen/pelvis with contrast case. The patient was female in her 60's with several health problems. The patients kidneys did not pick up any contrast during the exam. It seemed strange that the kidneys would be completely void of contrast. I then noticed that the patient had an additional functioning kidney in her RLQ. This kidney was full of contrast and seemed to be the only functioning kidney the patient had. I was unable to find out the specifics of her case. I do not know if the patient just had an extra kidney from birth, or if she had a kidney transplant with her existing kidneys remaining. It was very interesting and I was surprised to see an extra kidney inside a patient.

Stellate Ganglion

I have been doing several pain injections during clinical. In addition to SI joint injections, I have been doing some Stellate Ganglion injections. A Stellate Ganglion Injection is an injection of local anesthetic in the "sympathetic nerve tissue." These nerves are located in the neck, bilaterally around C6-C7. The purpose of these injections are to reduce pain, swelling, and sweating changes in the upper extremity and to improve mobility. These injections are usually done as a series with up to 10 injections per patient. The patient that I have been working with is experiencing pain in her left arm/elbow after her arm was smashed in a car door. This procedure is set up like most pain injections and the local anesthetic is injected directly into the patient’s neck. The patient has to stay very still once we scan the first series of images so that the doctor will be in the correct area. Occasionally the doctor will inject contrast to track the path of the medicine. This procedure looks very uncomfortable and sometimes the patient has to be sedated.

"Whirl Sign"

A woman came in to clinical that presented with severe abdominal pain. She was 43 years old and was 5 years post gastric bypass. Her exam was an abdomen for stone protocol. Her exam was negative for stone but showed a mid-gut volvulus, inflamed bowl, and possible ischemia. The patient’s exam also showed a “whirl sign” that is a characteristic of a gastrointestinal volvulus. The “whirl sign” is a loop of bowl that presents in a whirl or swirl pattern on CT abdominal imaging. A “whirl sign” is usually associated with rotation of the superior mesenteric vein around the superior mesenteric artery or any mesenteric rotation or looping. The radiologist then ordered a dual phase contrast study of the abdomen and pelvis. The “whirl sign” with a gastrointestinal volvulus is a possible side effect of gastric bypass surgery. This problem can present itself 3-5 years post-surgery in some cases.

CT Spine Work

I have been very busy with spine work. I have several spine patients everyday. This can range from routine spine, post-myelogram spine, SI joint injections, or spine imaging for a pars defect. Each one of these exams have completely different protocols. It has been hard keeping all of these protocols straight, but I'm working on it. Most of the pars defect patients that I have seen have been teenagers. Most of them are athletes and have a sports-related injury. A pars defect is easiest for me to see on sagittal reformats.

Intro

Hello...I live and work in the Indianapolis area as a general x-ray tech. I am currently doing clinical training in CT. I am interested in both CT and MR but I am focusing on CT right now. I plan to finish my Imaging Sciences Degree from USI and become CT registered.