Bonn Uniklink Radiology Department Visit

Last Friday I was able to visit the radiology dept. here in Bonn. I had no idea what to expect except that I was going to meet up with Dr. Greschus to talk about radiology and maybe sit in on a review of the weeks images. Well....I showed up about twenty minutes early and asked for Dr. Greschus. Apparently she wasn't there yet but would be in about 5 minutes so I was told to wait. One hour later I asked and the man told me 5 more minutes haha. So I waited a little longer and someone came out and told me they were taking me to meet with Michael. I was thinking, "who's Michael?? I thought I was supposed to meet with Susanne?" But I didn't worry about it and thought they just had something else planned for me. And they did!!! An entire day of touring basically everything a radiology dept. has to offer in a hospital, which is a ton. I started out meeting some people in the office. Everyone was so nice! But I did get the mandatory German joke... Once someone figures out where I'm from (Texas) they always have to ask if I had to leave my guns outside. They think it's hilarious and it's actually grown on me. After I laughed at the jokes I scrubbed out and was sent to the MRI room for about an hour. I saw two MRIs and got to watch the images coming into the computer. I didn't know why they were scanning the first man but the second women had been complaining of schwindel (dizziness). So she was getting a scan of her brain done to see if there was anything wrong. Everyone moved so efficiently in the dept. Each person has a job, whether it's prepping the patient or the machine or setting boundary lines on the images. They tried to point out areas of the brain to me on the computer they might look at further. In nuclear medicine there are two major paths, imaging and therapy. Now, I've kind of known that I don't really want to be a radiologist, which is imaging, I'd rather work in radiation therapy. But all of this was still really interesting!! There is still some patient work (although not as intimate) and the work seemed intersting. After an hour in the MRI room, Michael came to get me and brought me to the CT room. Everyone in the CT lab was even nicer!! CTs go by much faster then MRIs. Images can be taken within minutes versus the avg 30 minute MRI scan. So I got to see a lot. I walked into the room when the CT group was trying to insert local antesthetic needles into someones back to treat lower back pain. They were using the CT scanner to get the placement exactly right. Took about 7 different scans to finally get both needles in place but because of the speed of the CT, it wasn't an issue. After the back pain patient left they prepped the scanner for another patient. This lady only had one lung because of lung cancer. It was really cool to see the scan of her chest. One side was all air but on the other you could see her other organs. The next patient was an emergency stroke victim. Everyone was a little frantic before this scan because it was unexpected but they prepped the scanner and went about their business like usual. So by this point, I'm definitely glad I'm going for a career in medical physics. I don't think I could scan patient after patient and not really get to get to know them. The radiologists are doing a very important job but I just don't think it's for me. I want something a little more challenging and patient related. Also after the stroke victim there was a really long break because there was no one else scheduled to scan. So all of us (5 people in the lab) took a coffee break and looked up houses online (one of the workers was looking for a new place) until I left for lunch. Michael came to get me around 12:30 and treated me to lunch in the cafeteria and we chatted about differences between American and German schooling, daily life of a radiologist, and other random things. He was ready to answer anything so it was really good to get to talk to him. After lunch we toured the radiology dept. a littler more. I saw a couple more scanning machines, including one specifically for blood vessel imaging. After the final tour we went to his office and we browsed some of the scans I saw during the day. He showed me what was what on the brain scans and told me some basic differences between MRIs and CTs. He told me that anything more in depth would involve another visit so I learned some important basics.
So the MRI uses strong magnets to image atomic nuclei in the body which can then be read by the scanner due to radio frequency magnets that can alter the alignment of the atomic nuclei. Advantages for the MRI include good imaging for soft tissue, good CSF analysis and being non-radioactive always helps. However, the MRI machine shows more artifacts (elements in the images that do not exist in the person) and it takes a pretty long time to get the scan. However, Michael showed me a way to find artifacts. If something in the scan is bright and symmetrical it is most likely an artifact; however, more analysis is necessary to confirm this. He also talked a bit about FLAIR (fluid attenuated inversion recovery) which is used to null the fluid interference. There are also differently weighted scans an MRI can give. He showed me the difference between T1 and T2. For example, in the brain image we were looking at, the T1 weighted image contrasted the white and dark matter very well. The T2 weighted image has the ability to make fat look darker and water look lighter. So T2 is especially useful for tissue edema imaging. These weighted images are accomplished by using contrast agents which alter the relaxation times of atoms in the body.
CT (computed tomagraphy) are a bit different. It uses computer processed x-rays to gather 2D slice images of the body, which the computer can then create an insanely accurate 3D image of. The CT scanner is a better imaging system for bone and is completed much faster than the MRI.
All in all, my trip to the radiology dept. was amazing! Everyone tried to show me around the best they could and it turned out to be a great learning experience for me. I have high expectations for my internship this summer now. If I can learn that much in a day, who knows how much I'll know when the summer is over.