Hi,
I've noted a phenomenon that I don't know how to explain, and would highly appreciate your advice on the matter.
When measuring the contrast density (Hounsfield units) in the pulmonary trunk in CTPA scans - the variability between patients is very large.
In certain scans the contrast density is in the range of 100-200 HU, in others 200-300 HU, in others 300-400 HU, and in others it's over 400. The contrast density is relatively evenly spread between the ranges I've specified.
To clarify - these measurments are all from a single institution.
If there are several chest CTA series for the same patient - I've always looked for the series with the highest contrast density, and still see this phenomenon (i.e. it's not due to me looking at a series with a random contrast phase - I always measured the series dedicated for PE).
I know that CTPA scans are triggered by the contrast density in the pulmonary trunk, and to my knowledge the formal threshold is 150-200 HU.
My questions:
What causes the variability in contrast density (in the pulmonary trunk) between different patients?
Is it intentional to have stronger contrast density?
If so - in which cases will you aim for stronger contrast density, and why not always?
To what extent is this controllable?
Hello r/Anatomy!
I'm just stopping by with some rookie questions lol.
I've been studying the heart and I can name everything just fine when looking at diagrams, but I struggle when having to identify structures on animal models.
What are some features to help differentiate between the aorta and the pulmonary trunk? What about the aorta and the esophagus? I remember them being somewhat similar during my dissections.
Edit* I want to thank you all for taking the time to lend me advice and tips, I really appreciate it and will take everything you guys have said and put them to practice
Greetings all, I'm at the end of my rope here about CTA Chest exams and the timing for getting optimal contrast in the pulmonary arteries. With the rise of covid, our small facility, 4 bed ER docs have become obsessed with CTA Chest for PE's and we have been doing more lately (compared to what we usually do as a small facility). We also have been getting, more than we would like, reports back with suboptimal contrast timing. I personally feel like I'm just shooting in the dark on most of mine and I simply don't even know what I'm doing wrong. We have a GE Revolution EVO scanner. Just to get some things out of the way, we have very little control over a lot of things such as protocols due to our manager. We use 125 mL syringes of Optiray 320 as our contrast injected at 4 - 4.5 ml/s for CTA's and we do not use saline with out contrast because of our manager. I've been taught by another tech to do smart prep with the monitor slice set just below the corina and the ellipse ROI in the pulmonary artery and the dynamic transition is set default to go at 100 HU. I've also tried no dynamic transition and waiting for the first sign of flush and manually scanning. Sometimes they are ok, other times it's awful. Just this morning I had one that was completely and utterly non diagnosistic and I have no clue what happened. I had my monitor phase set up very clearly in the pulmonary artery and it went at 100 HU and it was just awful. I'm not the only one getting suboptimal studies for CTA Chests but im just so frustrated because I don't like sending shit, but I haven't got a clue what I'm doing wrong to fix it. I work PRN and usually get 1-2 full days a week right now and a few nights on call a week and don't actually get too terribly many CTA Chests, I've probably done under 20 total by myself and it used to be weeks/months in between but we have been doing more and more. Any and a tips, tricks, or anything I can read and study because I simply am lost and it's stressing me out.
I don't want to step on anybody's toes here, but the amount of non-dad jokes here in this subreddit really annoys me. First of all, dad jokes CAN be NSFW, it clearly says so in the sub rules. Secondly, it doesn't automatically make it a dad joke if it's from a conversation between you and your child. Most importantly, the jokes that your CHILDREN tell YOU are not dad jokes. The point of a dad joke is that it's so cheesy only a dad who's trying to be funny would make such a joke. That's it. They are stupid plays on words, lame puns and so on. There has to be a clever pun or wordplay for it to be considered a dad joke.
Again, to all the fellow dads, I apologise if I'm sounding too harsh. But I just needed to get it off my chest.
Alot of great jokes get posted here! However just because you have a joke, doesn't mean it's a dad joke.
THIS IS NOT ABOUT NSFW, THIS IS ABOUT LONG JOKES, BLONDE JOKES, SEXUAL JOKES, KNOCK KNOCK JOKES, POLITICAL JOKES, ETC BEING POSTED IN A DAD JOKE SUB
Try telling these sexual jokes that get posted here, to your kid and see how your spouse likes it.. if that goes well, Try telling one of your friends kid about your sex life being like Coca cola, first it was normal, than light and now zero , and see if the parents are OK with you telling their kid the "dad joke"
I'm not even referencing the NSFW, I'm saying Dad jokes are corny, and sometimes painful, not sexual
So check out r/jokes for all types of jokes
r/unclejokes for dirty jokes
r/3amjokes for real weird and alot of OC
r/cleandadjokes If your really sick of seeing not dad jokes in r/dadjokes
Punchline !
Edit: this is not a post about NSFW , This is about jokes, knock knock jokes, blonde jokes, political jokes etc being posted in a dad joke sub
Edit 2: don't touch the thermostat
Do your worst!
The doctor says it terminal.
How the hell am I suppose to know when it’s raining in Sweden?
We told her she can lean on us for support. Although, we are going to have to change her driver's license, her height is going down by a foot. I don't want to go too far out on a limb here but it better not be a hack job.
Ants don’t even have the concept fathers, let alone a good dad joke. Keep r/ants out of my r/dadjokes.
But no, seriously. I understand rule 7 is great to have intelligent discussion, but sometimes it feels like 1 in 10 posts here is someone getting upset about the jokes on this sub. Let the mods deal with it, they regulate the sub.
They were cooked in Greece.
I'm surprised it hasn't decade.
He lost May
Now that I listen to albums, I hardly ever leave the house.
Don't you know a good pun is its own reword?
Two muffins are in an oven, one muffin looks at the other and says "is it just me, or is it hot in here?"
Then the other muffin says "AHH, TALKING MUFFIN!!!"
For context I'm a Refuse Driver (Garbage man) & today I was on food waste. After I'd tipped I was checking the wagon for any defects when I spotted a lone pea balanced on the lifts.
I said "hey look, an escaPEA"
No one near me but it didn't half make me laugh for a good hour or so!
Edit: I can't believe how much this has blown up. Thank you everyone I've had a blast reading through the replies 😂
It really does, I swear!
And now I’m cannelloni
Because she wanted to see the task manager.
But that’s comparing apples to oranges
And boy are my arms legs.
Put it on my bill
Heard they've been doing some shady business.
but then I remembered it was ground this morning.
Edit: Thank you guys for the awards, they're much nicer than the cardboard sleeve I've been using and reassures me that my jokes aren't stale
Edit 2: I have already been made aware that Men In Black 3 has told a version of this joke before. If the joke is not new to you, please enjoy any of the single origin puns in the comments
They’re on standbi
A play on words.
Calcium, nickel, neon
My daughter, Chewbecca, not so much.
Pilot on me!!
The bartender says, "Sorry, no minors”
Nothing, he was gladiator.
Dad jokes are supposed to be jokes you can tell a kid and they will understand it and find it funny.
This sub is mostly just NSFW puns now.
If it needs a NSFW tag it's not a dad joke. There should just be a NSFW puns subreddit for that.
Edit* I'm not replying any longer and turning off notifications but to all those that say "no one cares", there sure are a lot of you arguing about it. Maybe I'm wrong but you people don't need to be rude about it. If you really don't care, don't comment.
