By Anthony G. Alessi, MD – Healthy Rounds
The field of diagnostic imaging has become increasingly complex.
Choosing the correct diagnostic imaging study can expedite making a correct diagnosis and initiating treatment. Unfortunately, this complexity has lead to confusion for many patients.
The earliest diagnostic images in medicine were x-rays. These were first used in the late 19th century and continue to be helpful today. Among the biggest breakthroughs has been the advent of scanning images. The specific advantages of the computerized tomography (CT) scan and the magnetic resonance imaging (MRI) scan requires some clarification.
CT scans use x-rays for imaging and several detectors are used to produce images in multiple planes. The first CT scans were performed in the early 1970s. Since then the technology has advanced to image the entire body. CT scans best show the most definition with dense objects such as bone and blood. This makes the CT scan ideal for the investigation of fractures and hemorrhages. Intravenous iodine-based contrast enhances the ability to visualize blood vessels, tumors and vital organs.
MRI scans are performed using radio waves and magnetic fields. There is no exposure to radiation with an MRI. MRIs first came into wide usage in the 1980s. Tissues rich in protons have the most distinction on an MRI image.
Soft tissues, ligaments and cartilage can be examined in detail making an MRI a preferred method for imaging complex joints like the knee and shoulder. An MRI arthrogram is performed with dye injected into a joint to reveal subtle tears.
A CT scan of the brain is ideal when looking for a fracture or hemorrhage while an MRI can best image inflammation or a tumor.
Future imaging studies will probably be more dynamic and depict organs and joints as they are functioning.
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