Radiology: Textbook of
Radiology: Textbook of
Radiology: Textbook of
Textbook of
provides an in-depth knowledge of latest imaging technology like interventional radiology, PAC system,
Textbook of
radiological physics. It attempts to serve as an essential guide for radiological procedures, darkroom procedures
and positioning, basic and surface anatomy, and radiological protection. It also provides detailed knowledge on
nuclear medicine in its simplest and practical form to the residents, radiographers and radiologists.
Keeping in view the importance of the latest imaging technology, the text has been revised and essential
chapters like “Artificial Intelligence”, “Bone Age Estimation”, “Artifacts” (ultrasound, MRI, color Doppler), “Dual
Source CT”, have been incorporated in concise form. It initiates the reader to imbibe good radiological practices.
Satish K Bhargava MBBS, MD (Radiodiagnosis), MD (Radiotherapy), DMRD, FUSI, FCCP, FICRI, FIAMS, FAMS, FIMSA is currently Director, KB
Healthcare Diagnostic Centre, Greater Noida. He has served as Head, Department of Radiology and Imaging, Rama Medical
College Hospital and Research Centre, Hapur, UP; University College of Medical Sciences (Delhi University), Delhi; and Sharda
University, Greater Noida, UP. He was Head, Department of Radiology, Radiotherapy and Nuclear Medicine, University of Delhi,
and Consultant Radiologist, WUS Health Centre, North Campus, University of Delhi. He was deputed by Government of India to
Homs (Syria) and also as an advisor to set up Department of Radiology, BPKIHS, Dharan, Nepal, in which he is still serving as Visiting
Professor. Radiology
Radiology
He is author of 14 books including Clinical Sonography, Colour Doppler Imaging, Diagnostic Radiology & Imaging, Textbook of
Radiology and Imaging; has contributed many chapters in textbooks of paediatrics, orthopaedics, obstetrics & gynaecology;
for the benefit of technologists and ultrasonologists; and has to his credit more than 325 research papers published in various
national and international journals. He has been on the editorial boards of a number of national and international journals.
Sumeet Bhargava MBBS, DNB is currently Associate Professor, Department of Radiology, MS Medical College, Hapur Road,
Meerut, UP. He passed his MBBS from LLRM Medical College, Meerut, and Diplomate National Board (DNB), Radiodiagnosis,
National Board of Examinations, Delhi. He was trained at Dewan Chand Satya Pal Aggarwal Imaging Centre, New Delhi; Rajeev
Gandhi Superspeciality Hospital, Tahirpur, Delhi; All India Institute of Medical Scieneces; and UCMS (Delhi University) and GTB
Hospital, Delhi. He has to his credit 42 research papers published in national and international journals, besides contributing many
chapters in books. He is a life member of Indian Radiological and Imaging Association, IMA College of General Practitioners, ICRI
and National Academy of Medical Sciences, India. He has been awarded Dr N Ramdas Best Research Paper Award of ICRI in
2009; Fellowship of the College of General Practitioners in 2010, German Remedies Travelling Fellowship in Radiodiagnosis and
Imaging of ICRI in 2011, and Fellowship of ICRI 2011. He was Treasurer, ICRI, 2015-2016.
Dedicated to Education
Bhargava
Bhargava
ISBN: 978-93-5466-389-5
Satish K Bhargava | Sumeet Bhargava
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Sixth Edition
Textbook of
Radiology
for Residents and Technicians
Sixth Edition
Textbook of
Radiology
for Residents and Technicians
Satish K Bhargava
MBBS, MD (Radiodiagonsis), MD (Radiotherapy)
DMRD, FICRI, FIAMS, FCCP, FUSI, FIMSA, FAMS
Ex-Head, Department of Radiology and Imaging
JN Medical College, AMU, Aligarh
Ex-Professor and Head, Department of Radiology and Imaging
University College of Medical Sciences (Delhi University), and
GTB Hospital, Dilshad Garden, Delhi
Ex-Head, Department of Radiology and Imaging
School of Medical Sciences and Research (SMSR)
Sharda University, Greater Noida
Head, Department of Radiology and Imaging
Rama Medical College Hospital & Research Centre
Delhi-Hapur Road, Hapur (UP)
Sumeet Bhargava
MBBS, DNB (Radiodiagnosis), MNAMS, FCGP, FICRI, FCCP
Associate Professor
Department of Radiology and Imaging
MS Medical College Hospital and Research Centre
Hapur-Road, Meerut
Approved by CBSE
First Edition Sponsored by World Health Organization
ISBN: 978-93-5466-389-5
Copyright © Authors & Publisher
Sixth Edition: 2023
First Edition: 1992
Reprint: 1997, 1999
Second Edition: 2001
Reprint: 2003, 2004
Third Edition: 2007
Reprint: 2008, 2010
Fourth Edition: 2011
Fifth Edition: 2016
Reprint: 2016, 2017, 2018, 2019, 2020
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Printed at
to
My granddaughter
Myesha Bhargava
List of Contributors
Prof Satish K Bhargava Dr Ashok Saxena
Professor and Head Professor and Head
Department of Radiology and Imaging Department of Anaesthesiology and Critical Care
Rama Medical College Hospital & Research Centre University College of Medical Sciences and associated
Delhi-Hapur Road, Hapur, UP GTB Hospital, Delhi
Dr Madhur Gupta
Ms Sarbari Saha
Ex-Professor and Head, Department of Anatomy
Post Graduate Institute of Medical Sciences and Research Assistant Professor-Grade 1
Chandigarh Tripura Institute of Paramedical Sciences
Tripura
Dr Shalini Singh
Radiologist, Department of Radiology, Aarhus University Mr Parshuram Mavi Teela
Hospital, Aarhus Sygehus, Nfrrebrogade 44 Technologist, Lal Bahadur Shastri Hospital
Aarhus C 8000, Denmark Khichirpur, New Delhi
Contents ix
D ue to the enormous demand by the residents, postgraduate students of MD and DNB courses, and
technologists from India and abroad, and keeping in view the recent advancements in the field of radiology
and imaging, the book has been completely updated with addition of a few chapters like “Artificial Intelligence”,
“Artifacts”, “Bone Age Estimation”, etc. Additions have been made in some chapters with more illustrations so
that the readers get benefitted.
We are sure the book in the present form will be very useful to students of MD and DNB courses, students of
diploma, BSc, MSc, residents and technologists and also physiotherapy students.
We are also thankful to all the contributors for their wholehearted support and help at every stage as and
when required.
Satish K Bhargava
Sumeet Bhargava
Preface to the First Edition
T he medical science has made tremendous progress during the last decade and it has been observed that diagnosis
by X-rays and other imaging modalities plays a vital role in modem era. To provide better interpretation, a
good quality radiograph is essential. Hence, a more exhaustive training is required in all aspects right from basic
anatomy to radiation protection and planning of the department. The present book is aimed to fulfil this need.
This book covers a broad spectrum of subjects including basic anatomy, physiology, positioning, dark room
procedures, radiation protection, planning of the department and radiotherapy. The radiographers will find the
book very useful for its comprehensive and authoritative information.
I acknowledge my gratitude to all my colleagues Dr MM Saha, Dr VK Bhargava, Dr KK Bishnoi, Dr I Sahai, Dr
A Hasija, Dr Pratibha Gupta, Dr N Bhattacharya, Dr KTaneja, Dr VK Shiv and Dr Gopesh Mehrotra, who gave
timely support and stood solidly in our joint endeavour in bringing out this book, which was inspired by Mr MS
Dayal, Additional Secretary, Ministry of Health & Family Welfare, Govt. of India and Dr KK Jain, DDG (Medical),
Ministry of Health & Family Welfare, Govt. of India. I am grateful to Prof KN Sharma, Principal, UCMS & GTB
Hospital, who was always a great source of inspiration in completion of this book. I am thankful to Ms Sarita for
her secretarial assistance and Mr Kewal Sharma, Incharge, Audiovisual Section, for assistance in making quality
photographs. Thanks are also due to Mr Satish Jain and Mr VK Jain of CBS Publishers and Mr Sunil Dhir of Super
Computers who took special interest in bringing out the book. I am specially thankful to them and his team for
their help at all stages of technical preparation. Lastly, I am thankful to WHO to provide financial grant for its
publication.
7. Attenuation 155–156
Attenuation Coefficients, Factors Affecting Attenuation, Application in Diagnostic Radiology
Satish K Bhargava and Sumeet Bhargava
8. Filters 157–159
Inherent Filtration, Added Filtration, Wedge Filter, Heavy Metal Filters
Sumeet Bhargava and Satish K Bhargava
xii Textbook of Radiology for Residents and Technicians
Index 671–682