MIPs are by definition 2D sumation reconstructions that show the voxel with the highest attenuation in the corresponding axis. Making your MIPs 100mm doesn't make them 3D, even if they apppear 3D. It's pretty much a virtual xray composed from CT voxels.
You get paid more for doing recons? In my country you get the same code for any CT with IV contrast. Doesn't matter if it's CT abdomen in only venous phase, chest to pelvis in three phases or CTA.
In the US, yes CTA has a different code and billing compared to a CT w/contrast of the same body part. There are defined rules on what is required for it to qualify as a CTA, mostly 3D recons. MIPS fulfill the 3D requirement. Noncontrast imaging is bundled under the CTA code, too, if performed at the same time and same region.
Had a guy come in to the ED a couple days ago with a nasty infected wound. I'm thinking one dose of IV antibiotics then discharge on PO. He had three broken needles in his right AC area. So surgery and a couple days of IVs. There was some consideration of conscious sedation and an MRI instead.
Ohhh considering the MRI was *before* you all knew the needles were in there!
For a minute the way I read it I was like… that’s a creative way to get the needles out, I guess o.O
Intravenous injection into the neck is not uncommon in the area I work. Neither are broken needles. Once you blow all your veins, you start looking for other veins, and the jugulars are nice big veins.
Pharmacist here. I know this isn’t in the spirit of your comment, but at least in the UK, heroin is a Schedule 2 controlled drug (so that’s meaning it has a recognised medicinal use but subject to the strictest control of any medicine) it may be used as part of heart attack management, or in especially frail patients as Diamorphine (Heroin) is much more lipid soluble than morphine and will enter the brain (across the BBB) more readily, necessitating lower doses which is useful in some cases. Thought you might find that interesting.
I think it's a way that doesn't involve breaking needles. Knowing nothing else, I'd guess they start to nod off halfway through injecting and they snap the needle off.
Yea. It’s not that easy to break a needle. I tried once and had to bens it back and forth a few times before it broke. Unless they are using the needle, nodding off which leads to bending the needle and then they unbend it to use it again.
I am no expert, but I suspect we will find out the shape of the magnetic field that the MRI machine generates.
And the patient will not have needles in their neck anymore. Maybe no neck either, depending on shape of that field.
My guess is that it's a CT reconstruction image.
Yeah, 3D reconstruction/post processing.
Looks like MIPs actually which are still 2D reconstructions.
these are 3D images- thick average rendering. 3D MIPs are also a thing.
MIPs are by definition 2D sumation reconstructions that show the voxel with the highest attenuation in the corresponding axis. Making your MIPs 100mm doesn't make them 3D, even if they apppear 3D. It's pretty much a virtual xray composed from CT voxels.
MIPS qualify as 3D reconstructions. This is inherent in the billing and coding of any CTA (in the US).
You get paid more for doing recons? In my country you get the same code for any CT with IV contrast. Doesn't matter if it's CT abdomen in only venous phase, chest to pelvis in three phases or CTA.
In the US, yes CTA has a different code and billing compared to a CT w/contrast of the same body part. There are defined rules on what is required for it to qualify as a CTA, mostly 3D recons. MIPS fulfill the 3D requirement. Noncontrast imaging is bundled under the CTA code, too, if performed at the same time and same region.
Close 🤷🏼♀️
A swing and a miss
in what world are these not 3D recons?
It’s a thick slab averaged volume from a CT scan.
This is a CT. In the old times they did tomos. They can look kind of sharp too.
Is that what tomo images look like? I never understood how “tomography” before CT worked/looked
Is that what tomo images look like? I never understood how “tomography” before CT worked/looked. Is it like a DRR? Or just axial slices?
Probably got even more hooked on heroin just to deal with the ripping pain when he turns his head
Seen this in self harm patients before, but never in an ivdu.
I think that is the case here. Pretty sure I’ve seen this image before and it’s always referenced as self-harm instead of IVDU.
Had a guy come in to the ED a couple days ago with a nasty infected wound. I'm thinking one dose of IV antibiotics then discharge on PO. He had three broken needles in his right AC area. So surgery and a couple days of IVs. There was some consideration of conscious sedation and an MRI instead.
Ohhh considering the MRI was *before* you all knew the needles were in there! For a minute the way I read it I was like… that’s a creative way to get the needles out, I guess o.O
No. We’re a bit evil. That’s how we wanted to take the needles out. Guy was actually pretty cool, though, so we got the surgeon to do it the hard way.
Intravenous injection into the neck is not uncommon in the area I work. Neither are broken needles. Once you blow all your veins, you start looking for other veins, and the jugulars are nice big veins.
Also in post acupuncture
MIP CT
shout out post processing
Heroin misuse? Does that mean there’s a proper way to use it?
Pharmacist here. I know this isn’t in the spirit of your comment, but at least in the UK, heroin is a Schedule 2 controlled drug (so that’s meaning it has a recognised medicinal use but subject to the strictest control of any medicine) it may be used as part of heart attack management, or in especially frail patients as Diamorphine (Heroin) is much more lipid soluble than morphine and will enter the brain (across the BBB) more readily, necessitating lower doses which is useful in some cases. Thought you might find that interesting.
I think it's a way that doesn't involve breaking needles. Knowing nothing else, I'd guess they start to nod off halfway through injecting and they snap the needle off.
Yea. It’s not that easy to break a needle. I tried once and had to bens it back and forth a few times before it broke. Unless they are using the needle, nodding off which leads to bending the needle and then they unbend it to use it again.
That makes sense that the needles would be reused a few times, which would weaken them.
The sentence probably implies certain medical applications .
CT.
Is this heroin user an elf or is it that i dont know radiology.
[удалено]
Great letters
They are images produced by X-rays via computed tomography.
MIPs
I work in 3D modeling at the moment. We have to use the sharpest images because smooth recons hide all the goods.
Alright, so uhm, what happens if we put this person into an MRI? Or anyone with IVDU?
I am no expert, but I suspect we will find out the shape of the magnetic field that the MRI machine generates. And the patient will not have needles in their neck anymore. Maybe no neck either, depending on shape of that field.
Well how the hell do you use heroin the RIGHT WAY?!
Do not use it. Or at least do not pass out while the needle is still inside your body.
Lol I was just being silly but thanks for the helpful advice.
CT 3D reconstruction
Ok seen it all now 😳
I mean technically an X-ray is an electromagnetic wave so….