Another one

This is another wild and crazy image from the radiology department. This comes from a patient who had a collapsed vertebral body in the thoracic spine. The patient had previously had surgery to repair an aortic aneurysm - the dotted circle is a cross-section of the prosthetic aortic graft. The big grey thing in front of the dotted white circle is the heart.



The needle enters the collapsed vertebral body. We took samples to look for evidence of infection or tumor. In this case, the bone was not so much a sheet of bone as a bunch of bony fragments held loosely together with inflammatory tissue, so it was easy to get the needle through. Had the bone been more solid, we would have used a bigger needle and a mallet.

You can see the spinal cord unusually well - it is the darker area within the lighter area of the spinal canal, looking almost like an eye. This is not what the spinal cord normally looks like on a CT; usually the spinal cord and the fluid surrounding it are nearly identical in color. But, this patient had a myelogram prior to the procedure, in which we do a spinal tap and inject material that shows up well on x-rays. Thus, on this image we get a really good shot of the spinal cord.

Not just a pretty picture!

For those who think that radiologists sit around all day looking at pictures, I invite you to consider the attached picture. This is a patient who had a mass in her neck just behind her throat. This is what I did to get a piece of it: under CT guidance, I stuck a needle through her cheek down to the back of her throat just in front of her spine. The following is one of the images from the procedure. It is a slice through the patient's head.



Note that the carotid artery is directly adjacent to the mass. This is not an activity for the faint of heart or the weak of sphincter.