GRACIOUS COLLEGE OF NURSING

ABHANPUR, RAIPUR

ASSIGNMENT
ON
“COMPUTED TOMOGRAPHY SCAN (CT)
MAGNETIC RESONANCE IMAGING (MRI)
ELECTROENCEPHALOGRAM (EEG)”

SUBMITTED TO
MR. SANTHOSH KUMAR, M. Sc (N),
LECTURER,
DEPT. OF MENTAL HEALTH NURSING

SUBMITTED BY
DURWENDRA NARAYAN JAISWAL,
M.SC NURSING II YEAR,
DEPT OF MENTAL HEALTH NURSING

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 COMPUTED TOMOGRAPHY SCAN

INTRODUCTION

X-ray computed tomography (x-ray CT) is a technology that uses computer-processed

x-rays to produce tomographic images (virtual 'slices') of specific areas of the scanned object,
allowing the user to see what is inside it without cutting it open. Digital geometry
processing is used to generate a three-dimensional image of the inside of an object from a
large series of two-dimensional radiographic images taken around a single axis of
rotation. Medical imaging is the most common application of x-ray CT. Its cross-sectional
images are used for diagnostic and therapeutic purposes in various medical disciplines.

ETYMOLOGY

The word "tomography" is derived from the Greek tomos (slice) and graphein (to

write). Computed tomography was originally known as the "EMI scan" as it was developed
in the early 1970s at a research branch of EMI, a company best known today for its music
and recording business. It was later known as computed axial tomography (CAT or CT
scan) and body section röntgenography.

Although the term "computed tomography" could be used to describe positron

emission tomography or single photon emission computed tomography (SPECT), in practice
it usually refers to the computation of tomography from X-ray images, especially in older
medical literature and smaller medical facilities.

TYPES OF MACHINE

 Spinning tube:- commonly called spiral CT, or helical CT in which an entire X-ray

tube is spun around the central axis of the area being scanned.
 Electron beam tomography (EBT):- is a specific form of CT in which a large
enough X-ray tube is constructed so that only the path of the electrons, travelling
between the cathode and anode of the X-ray tube, are spun using deflection coils.

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PURPOSE

CT scan to help:

 Diagnose muscle and bone disorders, such as bone tumors and fractures
 Pinpoint the location of a tumor, infection or blood clot
 Guide procedures such as surgery, biopsy and radiation therapy
 Detect and monitor diseases and conditions such as cancer, heart disease, lung
nodules and liver masses
 Detect internal injuries and internal bleeding

PREPRATION

 Before CT scan

Preparation for a CT scan depends on which part of the body is being scanned.

 Take off some or all of your clothing and wear a hospital gown.
 Remove any metal objects, such as a belt or jewelry, which might interfere with
image results.
 Stop eating for a few hours before your scan.

Preparing small child for a scan

 If infant or toddler is having the CT scan, the doctor may recommend a sedative to
keep the child calm and still. Movement blurs the images and may lead to inaccurate
results

 During the CT scan

 CT scanners are shaped like a large doughnut standing on its side. Patient will lie on a
narrow table that slides into the "doughnut hole," which is called a gantry. Straps and
pillows may help to stay in position. During a CT scan of the head, the table may be
fitted with a special cradle that holds your head still.
 The table will move slowly through the gantry during the CT scan, as the gantry
rotates in a circle around the patient. Each rotation yields several images of thin slices
of the body.

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  A technologist will be nearby, in a separate room. Patient will be able to communicate
with the technologist via intercom. The technologist may ask the patient to hold his
breath at certain points to avoid blurring the images.
 After the CT scan
 After the exam patient can return to your normal routine. After the scan, ask the
patient to drink lots of fluids to remove the contrast material from the body.

ADVERSE EFFECT

 Cancer
The ionizing radiation in the form of x-rays used in CT scans are energetic
enough to directly or indirectly damage DNA. This and other types of DNA
damage are occasionally not corrected properly by cellular repair mechanisms. Such
damage to the DNA occasionally leads to cancer.
 Contrast

The most common reactions from these agents are mild, including nausea,
vomiting and an itching rash; however, more severe reactions may occur. Skin rashes
may appear within a week to 3% of people.

MAGNETIC RESONANCE IMAGING (MRI)

INTRODUCTION
Magnetic resonance imaging (MRI) is the newest, and perhaps most versatile, medical
imaging technology available. By using strong magnets and pulses of radio waves to
manipulate the natural magnetic properties in the body, this technique makes better images of
organs and soft tissues than those of other scanning technologies. MRI is particularly useful
for imaging the brain and spine, as well as the soft tissues of joints and the interior structure
of bones. The entire body is visible to the technique, which poses few known health risks.
MRI was developed in the 1980s. The latest additions to MRI technology are
angiography (MRA) and spectroscopy (MRS). MRA was developed to study blood flow,
while MRS can identify the chemical composition of diseased tissue and produce color
images of brain function

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DEFINITION
Magnetic resonance imaging (MRI) is a noninvasive nuclear procedure that uses a
magnetic field and pulses of radio wave energy to make pictures of organs and structures
inside the body and tissues of high fat and water content that cannot be seen with other
radiologic techniques. In many cases MRI gives different information about structures in the
body than can’t be seen with an X-ray, ultrasound, or computed tomography (CT) scan.

PURPOSE

 MRI of the brain and spinal cord

MRI is the most frequently used imaging test of the brain and spinal cord. It's often
performed to help diagnose:

 Aneurysms
 Disorders of the eye and inner ear
 Multiple sclerosis
 Spinal cord injuries
 Stroke
 Tumors

Functional MRI of the brain (fMRI) can be used to identify important language and
movement control areas in the brain in people who are being considered for brain surgery.

 MRI of the heart and blood vessels

An MRI that focuses on the heart or blood vessels can assess:

 The size and function of the heart's chambers

 Thickness and movement of the walls of the heart
 The extent of damage caused by heart attack or heart disease
 Structural problems in the aorta, such as aneurysms or dissections
 Inflammation or blockages in the blood vessels

 MRI of other internal organs

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 An MRI may be used to check for tumors or other abnormalities of many organs in the
body, including the:

 Liver
 Kidneys
 Spleen
 Pancreas
 Uterus
 Ovaries
 Prostate
 Testicles

 MRI of bones and joints

MRI may be used to help evaluate:

 Joint disorders, such as arthritis

 Joint abnormalities caused by traumatic or repetitive injuries
 Disk abnormalities in the spine
 Bone infections
 Tumors of the bones and soft tissues

 MRI of the breasts

MRI may be used in addition to mammography to detect breast cancer, particularly in

women who have dense breast tissue or who may be at high risk of the disease.

MECHANISM OF MRI
MRI produces a map of hydrogen distribution in the body. Hydrogen is the simplest
element known, the most abundant in biological tissue, and one that can be magnetized. It
will align itself within a strong magnetic field, like the needle of a compass. The earth's
magnetic field is not strong enough to keep a person's hydrogen atoms pointing in the same
direction, but the superconducting magnet of an MRI machine can. This comprises the
"magnetic" part of MRI.

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 Once a patient's hydrogen atoms have been aligned in the magnet, pulses of very
specific radio wave frequencies are used to knock them back out of alignment. The hydrogen
atoms alternately absorb and emit radio wave energy, vibrating back and forth between their
resting (magnetized) state and their agitated (radio pulse) state. This comprises the
"resonance" part of MRI.
The MRI equipment records the duration, strength, and source location of the signals
emitted by the atoms as they relax and translates the data into an image on a television
monitor. The state of hydrogen in diseased tissue differs from healthy tissue of the same type,
making MRI particularly good at identifying tumors and other lesions. In some cases,
chemical agents such as gadolinium can be injected to improve the contrast between healthy
and diseased tissue.
A single MRI exposure produces a two-dimensional image of a slice through the
entire target area. A series of these image slices closely spaced (usually less than half an inch)
makes a virtual three-dimensional view of the area.
RISKS

The presence of metal in your body may be a safety hazard or affect a portion of the MRI
image.

Before receiving an MRI, tell the technologist if you have any metal or electronic devices
in your body, such as:

 Metallic joint prostheses

 Artificial heart valves
 An implantable heart defibrillator
 A pacemaker
 Metal clips
 Cochlear implants
 A bullet, shrapnel or any other type of metal fragment
 Pregnancy

PREPARATION

 Before MRI

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  The patient must remove all metal objects (watches, jewelry, eye glasses, hair clips,
etc). Any magnetized objects (like credit and bank machine cards, audio tapes, etc.)
should be kept far away from the MRI equipment because they can be erased. The
patient cannot bring their wallet or keys into the MRI machine. The patient may be
asked to wear clothing without metal snaps, buckles, or zippers, unless a medical
gown is worn during the procedure. The patient may be asked to remove any hair
spray, hair gel, or cosmetics that may interfere with the scan.
 During MRI
 The MRI machine looks like a tube that has both ends open. Patient lie down on a
movable table that slides into the opening of the tube. A technologist monitors from
another room.
 The MRI machine creates a strong magnetic field around, and radio waves are
directed at patients body. The procedure is painless.
 During the MRI scan, the internal part of the magnet produces repetitive tapping,
thumping and other noises. Earplugs or music may be provided to help block the
noise.
 In some cases, a contrast material, typically gadolinium, may be injected through an
intravenous (IV) line. The contrast material enhances the appearance of certain
details. The material used for MRIs is less likely to cause an allergic reaction than the
material used for CT scans.
 An MRI can last up to an hour or more. Ask the patient to be very still because
movement can blur the resulting images.
 During a functional MRI, patient may be asked to perform a number of small tasks
— such as tapping your thumb against your fingers, rubbing a block of sandpaper or
answering simple questions. This helps pinpoint the portions of the brain that control
these actions.
 After MRI
 If the patient was sedated check the patient’s consciousness. Once oriented shift the
patient from the MRI room.

CONCLUSION

MRI test, the area of the body being studied is placed inside a special machine that
contains a strong magnet. Pictures from an MRI scan are digital images that can be saved and

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stored on a computer for more study. The images also can be reviewed remotely, such as in a
clinic or an operating room.

ELECTROENCEPHALOGRAM (EEG)

INTRODUCTION

Electroencephalography (EEG) is the recording of electrical activity along

the scalp. EEG measures voltage fluctuations resulting from ionic current flows within
the neurons of the brain. In clinical contexts, EEG refers to the recording of the brain's
spontaneous electrical activity over a short period of time, usually 20–40 minutes, as
recorded from multiple electrodes placed on the scalp. Diagnostic applications generally
focus on the spectral content of EEG, that is, the type of neural oscillations that can be
observed in EEG signals.

DIFFERENT TYPES OF NORMAL BRAIN WAVES

An EEG records patterns of brain activity. Among the basic waveforms are the alpha,
beta, theta, and delta rhythms.

 Alpha waves occur at a frequency of 8 to 12 cycles per second in a regular rhythm.

They are present only when you are awake but have your eyes closed. Usually they
disappear when you open your eyes or start mentally concentrating.

 Beta waves occur at a frequency of 13 to 30 cycles per second. They are usually
associated with anxiety, depression, or the use of sedatives.

 Theta waves occur at a frequency of 4 to 7 cycles per second. They are most common
in children and young adults.

 Delta waves occur at a frequency of 0.5 to 3.5 cycles per second. They generally
occur only in young children during sleep.

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During an EEG, typically about 100 pages or computer screens of activity are evaluated.
Special attention is paid to the basic waveforms, but brief bursts of energy and responses to
stimuli, such as light, are also examined.

INDICATION-

 The EEG is used to evaluate several types of brain disorders. When epilepsy is
present, seizure activity will appear as rapid spiking waves on the EEG.

 Patients with lesions of the brain, which can result from tumors or stroke, may have
unusually slow EEG waves, depending on the size and the location of the lesion.

 The test can also be used to diagnose other disorders that influence brain activity,
such as Alzheimer's disease, certain psychoses, and a sleep disorder called narcolepsy.

 The EEG may also be used to determine the overall electrical activity of the brain (for
example, to evaluate trauma, drug intoxication, or extent of brain damage in comatose
patients). The EEG may also be used to monitor blood flow in the brain during
surgical procedures.
 The measurements given by an EEG are used to confirm, rule out, or provide
information about disorders such as:
 seizure disorders, including epilepsy
 head injury
 encephalitis, or inflammation of the brain
 brain tumor
 encephalopathy, or brain dysfunction resulting from various causes
 memory problems
 stroke
 sleep disorders
 An EEG can be used to monitor activity during brain surgery
PROCEDURE

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 Electrical impulses in the brain are evaluated using an EEG. The test measures this
electrical activity through several electrodes placed on your scalp. An electrode is a
conductor through which an electric current can pass safely. The electrodes transfer
information from your brain through wires to an amplifier and a machine that measures and
records the data.

Before the procedure

 Explain the procedure to the patient and obtain written informed consent.

 Clean the hair with shampoo to remove dirt and oil.

 Administer the medications as per order. Do not stop medications without consulting
doctor.

 Avoid consuming any food or drinks containing caffeine for eight to12 hours before
the test.

 Avoid fasting the night before or day of the procedure, since low blood sugar may
influence the results.

During the procedure

An EEG may be performed on an outpatient basis or as part of your stay in a hospital.

Procedures may vary depending on the condition.

Generally, an EEG procedure follows this process:

 Ask the patient to lie on a bed.

 Between 16 and 25 electrodes will be attached to the scalp with a special paste, or a
cap containing the electrodes will be used.

 Ask the patient to close his eyes, relax, and be still.

 Once the recording begins ask the patient to remain still throughout the test. He may
be monitored through a window in an adjoining room to observe any movements that can
cause an inaccurate reading, such as swallowing or blinking.

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 After the initial recording performed at rest, he may be tested with various stimuli to
produce activity that does not show up while the patient is on rest. For example, breathe
deeply and rapidly for three minutes, or exposed to a bright light.

 This study is generally performed by an EEG technician and may take approximately
45 minutes to two hours.

After the procedure

 Once the test is complete, the electrodes will be removed and the electrode paste will
be washed off with warm water, acetone, or witch hazel.

 If any sedatives were administered for the test, wait until the sedatives have worn off.

 Check for any skin irritation or redness at the locations where the electrodes were
placed.

 Advice the patient not to drive immediately after the test.

ADVANTAGES OF EEG

 Low cost than other techniques such as fMRI, SPECT, PET.

 EEG is silent, which allows for better study of the responses to auditory stimuli.
 EEG does not aggravate claustrophobia, unlike fMRI, PET, MRS, SPECT.
 EEG does not involve exposure to high-intensity magnetic fields.
 Extremely noninvasive
DISADVANTAGES OF EEG

 Low spatial resolution on the scalp. For example, fMRI can directly display areas of
the brain that are active, while EEG requires intense interpretation just to hypothesize
what areas are activated by a particular response.
 EEG poorly determines neural activity that occurs below the upper layers of the brain
(the cortex).
 Unlike PET and MRS, cannot identify specific locations in the brain at which various
neurotransmitters, drugs, etc. can be found.

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 Need more time for the procedure.
 Signal-to-noise ratio is poor, so sophisticated data analysis and relatively large
numbers of subjects are needed to extract useful information from EEG

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