Need MR or CT to see intervertebral discs accurately. This is only a practice exercise. Try moving mouse down and to the left while right clicking (depends on PACS using) to try to window to see soft tissue structures such as intervertebral discs against adjacent fat on Xray. The best way to increase manual windowing skills on PACS in my opinion is to challenge yourself to find normal subtle soft tissue density structures that are not immediately obvious on initial review/default settings. Try to exploit differences in contrast density between a soft tissue density structure and adjacent fat. I find that right clicking and moving mouse down and to the left helps do this. These corresponding actions on many PACS CT default settings decrease window level and narrow window width respectively to improve soft tissue contrast. A similar principle for Xray as above applies for trying to view other soft tissue structures like muscles, tendons, ligaments, menisci, and bowel wall against fat on Xray which you can practice as well. If you practice doing this case after case, Xray after Xray, your ability to window and level effectively will compound over time. You will in addition find that you will also be able to similarly window and level better across other modalities particularly CT (similar mouse actions to improve soft tissue contrast resolution by decreasing window level and narrow window width), but also more intuitively in MRI and ultrasound as well. Try also increasing the mouse sensitivity to more rapidly change window and level settings. Not sure how long it will be for AI/deep learning to overtake this but I feel like this is a good bridge to that.
Can try W:200 to 250 L:30 to 60 as a starting point to see intervertebral discs on CT as well as spinal cord, epidural space, and neuroforamen. This window setting is also helpful to see ligaments, tendons, menisci, and articular cartilage on musculoskeletal CT examinations to identify abnormalities on these studies as well. Need to view on soft tissue algorithm. It is necessary to experiment for yourself to see what works for you in or outside of this range if you decide to save any particular window/level setting. Hope this helps and thank you for watching.
Негізгі бет Ғылым және технология lumbar spine intervertebral discs on lumbar spine Xray- windowing with CT correlation
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