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    How To: Produce A Good Quality Diagnostic Radiograph: I Nursing

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    Anna Pratiwi
    PENENTUAN KONDISI SINAR-X Kondisi sinar-X yang dihasilkan oleh statu pesawat sinar-X adalah : kV, mA, & sec. Pada umumnya pesawat sinar-X baik sudah mempunyai kV, dan mA yang sudah distandarisasi, sehinggga pada waktu melakukan pemotretan hanya diubah waktunya saja.

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    How To: Produce A Good Quality Diagnostic Radiograph: I Nursing

    Uploaded by

    Anna Pratiwi
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    PENENTUAN KONDISI SINAR-X Kondisi sinar-X yang dihasilkan oleh statu pesawat sinar-X adalah : kV, mA, & sec. Pada umumnya pesawat sinar-X baik sudah mempunyai kV, dan mA yang sudah distandarisasi, sehinggga pada waktu melakukan pemotretan hanya diubah waktunya saja.

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    Nurse_mar_2011

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    PENENTUAN KONDISI SINAR-X Kondisi sinar-X yang dihasilkan oleh statu pesawat sinar-X adalah : kV, mA, & sec. Pada umumnya pesawat sinar-X baik sudah mempunyai kV, dan mA yang sudah distandarisasi, sehinggga pada waktu melakukan pemotretan hanya diubah waktunya saja.

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    Download as PDF, TXT or read online from Scribd
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    45 views3 pages

    How To: Produce A Good Quality Diagnostic Radiograph: I Nursing

    Uploaded by

    Anna Pratiwi
    PENENTUAN KONDISI SINAR-X Kondisi sinar-X yang dihasilkan oleh statu pesawat sinar-X adalah : kV, mA, & sec. Pada umumnya pesawat sinar-X baik sudah mempunyai kV, dan mA yang sudah distandarisasi, sehinggga pada waktu melakukan pemotretan hanya diubah waktunya saja.

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    148 Veterinary Ireland Journal Volume 64 Number 3 Veterinary Ireland Journal Volume 64 Number 3

    I NURSING
    In this article, Orla OReilly RVN offers a recap on the principals of producing
    good quality radiographs using traditional ionising radiation methods. The
    article provides refresher points on radiographic principals, and explores
    what can go wrong during the process and how to correct these problems.
    How to: produce a
    good quality diagnostic
    radiograph
    Key prINCIpALS
    In order to be of diagnostic value, radiographs have to be
    of good technical quality. A good radiograph should show
    accurately the structure under examination, the quality of
    both contrast and detail should be good and there should
    be no misleading artefacts on the film. Many factors
    influence the formation of the image:
    Positioning;
    Screen and film combinations;
    Exposure factors; and,
    Processing.
    X-rays are a form of ionising radiation and they can be
    potentially harmful to living tissue, so personal protection
    is very important. A radiograph is the picture produced on
    film when an object/patient is exposed to this radiation.
    The varying levels of absorption of x-rays by different
    tissue types produces five radiographic opacities:
    Black - gas;
    Dark grey fat;
    Light grey soft tissue and fluid;
    Nearly white bone; and,
    White metal.
    Kilovoltage (kV) refers to the penetrating power of the
    beam and the speed of the x-rays. Thicker tissues and
    those with a higher specific gravity will require a higher kV
    setting. The normal range of kV settings on a veterinary
    x-ray machine is 40 125kV with 50 70kV being
    adequate for most small animal radiography.
    Milliamperes (mAs) refers to the exposure time in
    seconds. This dictates the number of x-rays and affects
    the density, or the degree of blackening of the film.
    NB: If kV is increased by 10, the mAs can be
    halved (and vice versa) to produce the same quality
    radiograph. This can be important when performing
    thoracic radiographs when there is a need to keep
    mAs low in order to minimise movement blur from
    respiration.
    All exposures should be recorded in an exposure book
    which should be referred to prior to any radiographic
    investigation to compare with previous exposures. Keeping
    such a record should minimise the need for repeat
    radiographs due to poor choice of exposure factors, thus
    reducing unnecessary radiation exposure to staff and the
    patient.
    Film-focal distance (FFD) is the distance between the
    x-ray tube and the cassette. This should be either 70cm
    (small animal) or 100cm (large animal) depending on
    model. Distance should be kept constant for all x-rays in
    order to minimise variables.
    Object-film distance (OFD) is the distance between the
    part of the patient being radiographed and the cassette.
    This should be kept to a minimum (directly on plate as
    much as possible) to avoid magnification and distortion of
    the image also know as the penumbra effect.
    Film/screen Combination (Fast/slow). Cassettes with
    intensifying screens contain crystals that emit light when
    exposed to radiation. Fast screens produce more light for
    a set exposure level then slow screens but have larger
    crystals. This means that fast screens cause higher
    density but poorer detail compared with slow screens
    (similar to the pixels of a television; the smaller the pixels
    the finer the detail).
    light Beam Diaphragm (lBD) refers to an area of light
    which directly corresponds to the area or beam of direct
    radiation. This allows tight collimation over the specific
    area of interest.
    NB: To test that the LBD is working effectively, place
    metal paperclips on a cassette at the corners of the
    light beam. When a radiograph is exposed the clips
    should appear white at the corners of the image.
    scatter radiation is the term used to describe secondary
    radiation. This is a form of radiation with lower energy
    than direct or primary radiation. It is produced when the
    primary radiation interacts with the object and is reflected
    in infinite directions. This can adversely affect the quality
    of the radiograph by causing a general blackening of the
    film and reduced contrast or fogging. Scatter radiation is
    March VJrnl.indd 148 23/02/2011 12:12:12
    Veterinary Ireland Journal Volume 64 Number 3
    NURSING I
    149 Veterinary Ireland Journal Volume 64 Number 3
    an important health and safety concern and so protective
    lead clothing and screens are essential to protect
    personnel from repeated exposure to scatter radiation. The
    amount of scatter increases as both patient size and area
    of collimation increases. A grid should be used to absorb
    scatter radiation when the area being radiographed is
    thicker than 10cm.
    NB: Lead clothing only protects against scatter
    radiation and not against primary radiation. For this
    reason, personnel should never hold an animal for a
    radiograph in the primary beam.
    Manual Processing involves chemicals (developer and
    fixer) in either horizontal or vertical tanks. Developing
    stage takes 5 minutes at 20C, fixing approximately 10
    minutes and then the film is washed in cold running water
    for 1530 minutes. This method is very time consuming
    and labour intensive and requires good management of
    chemicals in order to avoid significant processing film
    faults.
    Automatic Processing uses the same chemicals but
    the film is loaded into an automatic processor. The
    temperature is higher and consequently processing is time
    reduced. This method requires machine and chemical
    maintenance.
    Digital Processing is the quickest and cleanest method
    of processing. The contrast of the image can be altered, a
    specific area magnified for examination and images saved
    to computerised files to avoid multiple storage boxes. The
    fact that the image can be edited post processing means
    that it reduces the number of repeat radiographs being
    carried out which saves on time and personal exposure to
    radiation.
    reCAp:
    Sedate/anaesthetise patient as necessary.
    Know exactly what area of the patient is to be
    radiographed and what views are required.
    Have good knowledge of the anatomy of the relevant
    area.
    Have equipment ready e.g. cassettes, positioning aids,
    markers and grid if applicable.
    Wear protective clothing and a personal
    thermoluminescent dosimeter.
    Ensure automatic/digital processor switched on
    (automatic processing).
    Ensure chemicals are not exhausted and are at the
    correct temperature (manual processing).
    Check exposure chart for appropriate settings.
    Ensure access to room by other staff and clients is
    restricted and that safety light is working.
    March VJrnl.indd 149 23/02/2011 12:12:14
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    I NURSING
    150 Veterinary Ireland Journal Volume 64 Number 3
    Troubleshooting - What can go wrong and how to correct it:
    Exposure and processing faults
    Problem Cause Solution
    Dark flm Over exposure
    Over developed
    Developer temperature too high
    Excessive fogging
    Reduce exposure factors
    Use automatic timer
    Use thermometer in tank
    Use automatic timer
    Pale flm Under exposed
    Developing time too short
    Developer temprtature too cold
    Exhausted developer
    Developer too dilute
    Incorrect flm-screen combination
    Increase exposure factors
    Use automatic timer
    Use insulating temperature jacket and thermometer in tank
    Keep developer covered to prevent oxidation and water
    contamination
    Keep record of flm-screen combinations
    Poor detail FFD too short
    OFD too long
    Uneven screen contact
    Increase FFD
    Reduce OFD
    Check screens regularly
    High contrast
    Low contrast
    Insuffcient kV
    High kV
    Incorrect processing
    Excessive fog
    Increase kV/grid
    Reduce kV
    Review processing procedures
    Blurring Movement
    Poor flm/screen contact
    Use sedation/GA as required
    Take exposure at expiratory pause except when radiographing
    lungs when it should be done at peak inspiration
    Keep mAs low and increase kV when imaging the thorax to
    avoid movement blur from respiration
    Use new cassette and/or repair
    Edge of flm underex-
    posed
    Grid cut off Correct FFD
    Lines on flm when using
    grid
    Primary beam not perpendicular to cassette/grid or grid is
    upside down
    Ensure 90 angle
    Ensure correct way up
    General fog
    Chemical fog
    Radiation fog
    Localised fog
    Prolonged storage of flms
    Developer time too long, temperature too high or developer
    exhausted
    Pre-exposure to radiation
    Excessive secondary radiation
    Exposure to white light
    Incorrect safelight
    Prolonged inspection during development
    Damaged cassette
    Rotate stock
    Use automatic timer, thermometer and replace or replenish
    developer solution.
    Review storage facilities
    Reduce exposure factors
    Ensure darkroom light proof
    Refer to flm type
    Review manual processing
    Check cassettes regularly
    Stains and artefacts
    Problem Cause Solution
    Yellow stains Prolonged development in exhausted solutions
    Developer temp. too high
    Films stuck together
    Change or replenish developer solution
    Use thermometer in tank
    Agitate in developer
    Brown stains Deposits of oxidised developer
    Deposits of silver sulphide
    Replace developer solution and wash properly
    Wash for appropriate times
    Blue-green stains Exhausted chrome alum. fxer Replace fxer solution
    Streaking Lack of agitation
    Dirty processing hangers
    Insuffcient rinsing
    Drying marks
    Agitate in developer and fxer
    Clean regularly
    Review processing protocols
    White splashes
    Black splashes
    Fixer
    Developer
    Review processing protocols
    White specks and marks Dirt, dust or stains on intensifying screens
    Finger prints
    Crimp marks
    Clear marks surrounded by a ring
    Lightening static marks
    Metal tag on collar
    Microchip
    Clean regularly with proprietary cleaner
    Work with clean dry hands
    Hold by edges only
    Bubble marks- agitate flm during processing
    Remove flm slowly from box and place in cassette without
    dragging across surface
    Remove collar
    Scan
    Scratching Emulsion sensitive when wet Care with adjacent hangers
    Drips and stains Contrast media, urine, blood or water on cassette surfaces Clean cassette surfaces if soiled or use protective radiolucent
    covers
    March VJrnl.indd 150 23/02/2011 12:12:16

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