B5401 - Tecniche di imaging TC, body e articolare (BO)

Learning outcomes

The student acquires the technical-practical and methodological knowledge necessary to perform a CT examination using appropriate protocols based on the patient's clinical question, pathology, and the type of equipment available.
They will also learn to recognize artifacts and apply image quality criteria.

Course contents

Fundamentals and Physical Principles

1. Physical principles of CT image formation
2. Main components of a CT scanner
3. Structural and technological requirements of a CT room
4. CT image formation process: acquisition, processing, and visualization
5. Technological evolution of CT systems
6. From spiral CT to multi-slice CT (MSCT)
7. Principles of sequential and spiral CT
8. Multi-slice CT vs spiral CT: advantages and limitations

Image Characteristics and Technical Parameters

1. Basic characteristics and acquisition methodologies in CT imaging
2. Reconstruction matrix, pixels, and voxels
3. Image quality descriptors
4. CT technical parameters:

• Scan parameters
• Reconstruction parameters
• Visualization parameters

1. Scan parameters: kV, mA, scan time
2. Geometric parameters: Field of View (FOV), slice thickness, slice increment, pitch factor, gantry tilt
3. Reconstruction parameters (matrix)
4. Visualization parameters

Image Quality and Dose

1. Main CT image artifacts
2. Radiation dose in CT: dosimetric descriptors and dose reduction strategies
3. Optimization of CT techniques
4. Factors influencing dose and image quality

Advanced Image Processing Techniques

1. Post-processing techniques in MSCT:

• MPR (Multiplanar Reconstruction)
• MIP (Maximum Intensity Projection)
• MinIP (Minimum Intensity Projection)
• SSD (Shaded Surface Display)
• VR (Volume Rendering)

CT Study ProtocolsHead, Neck, and Spine

1. CT of the maxillofacial region with and without contrast media
2. Cervical spine CT
3. Thoracic spine CT
4. Lumbosacral spine CT
5. Neck CT with and without contrast media

Chest

1. Chest CT HRCT (High-Resolution CT)
2. Standard chest CT with and without contrast

Abdomen

1. Low-dose abdominal CT
2. Monophasic full abdominal CT
3. Biphasic full abdominal CT
4. Triphasic full abdominal CT
5. Targeted abdominal CT based on clinical indication
6. CT urography (Uro-CT)

Musculoskeletal System

1. CT scan of the pelvis and hip joints
   CT scan of the knee
   CT scan of the femur
   CT scan of the leg (lower leg)
   CT scan of the ankle
   CT scan of the foot
   CT scan of the shoulder
   CT scan of the humerus / upper arm
   CT scan of the forearm
   CT scan of the elbow

CT Angiography

1. Upper limb CT angiography
2. Lower limb CT angiography
3. Thoracic aorta CT angiography
4. Thoracoabdominal aorta CT angiography
5. Abdominal aorta and iliac vessels CT angiography
6. Pulmonary embolism CT angiography
7. Whole-body CT angiography in emergency settings

 

 

Readings/Bibliography

2. Golfieri R., Trenti R., Maccione A.G. – CT Manual for Radiologic Technologists (Spiral Edition)
3. Faggioni L., Paolicchi F., Neri E. – Elements of Computed Tomography
4. Dal Pazzo G. – Compendium of Computed Tomography and Spiral CT
5. Netter F.H. – Atlas of Human Anatomy
6. Prokop M., Galanski M. – Spiral and Multislice Computed Tomography
7. Cei L. – CT and MRI Techniques in Diagnostic Imaging
8. Emilia-Romagna Regional Health Service – CT Quality Guidelines
9. Fishman E.K., Jeffrey R.B. – Multislice CT: Principles, Techniques, and Clinical Applications
 

Teaching methods

For each CT protocol, students are required to acquire competencies related to all phases of the radiological process, with emphasis on best clinical practices.

Patient Management

• Patient reception and identification
• Clear explanation of the procedure
• Informed consent acquisition
• Evaluation of allergies, renal function, and pregnancy

Radiological Request Verification

• Verification of completeness and correctness
• Consistency between clinical question and requested exam
• Consultation with the radiologist when necessary

Patient Preparation

• Fasting (if required)
• Removal of metallic objects
• Venous access placement (if needed)
• Administration of pre-exam medications

Contrast Media Management

• Selection of contrast type (intravenous iodinated or oral)
• Evaluation of renal function (eGFR)
• Administration protocol (dose, flow rate, timing)
• Management of adverse reactions

Positioning and Acquisition

• Proper patient positioning and anatomical centering
• Protocol selection based on clinical indication
• Adjustment of technical parameters

Technical Parameters

• Acquisition: slice thickness, pitch, kV, mAs
• Processing: MPR, MIP, 3D reconstructions
• Visualization: appropriate window settings (parenchymal, bone, vascular)

Image Quality Assessment

• Absence of artifacts
• Proper anatomical coverage
• Adequate contrast and spatial resolution
• Correct timing of contrast enhancement

Assessment methods

• Learning assessment is conducted through a final oral examination, aimed at verifying:
  • Theoretical and practical knowledge
  • Ability to apply concepts in clinical practice (Evidence-Based Practice)
  • Critical thinking and reflective skills
  • Proper use of technical-scientific terminology

Teaching tools

Teaching Materials

Lecture materials (PowerPoint presentations) will be provided in digital format (PDF) via institutional platforms (OneDrive/Virtuale).

Students may use these materials in either digital or printed format during lectures.

Inclusion and Student Support

Students with disabilities or specific learning disorders (SLD), whether temporary or permanent, are encouraged to contact the dedicated university service as soon as possible: https://site.unibo.it/studenti-con-disabilita-e-dsa/it/per-studenti

Requests for accommodations must be submitted at least 15 days before the exam date, allowing the instructor to evaluate and implement appropriate measures consistent with course learning objectives.

Office hours

See the website of Antonella Mangione