Diagnostic Imaging

X-Ray

What is an x-ray?

X-ray is the oldest and most frequently used form of medical imaging. X-rays can produce diagnostic images of the human body on film or digitally that allow doctors to view and assess broken bones. X-rays are an important tool in guiding orthopedic surgery and in the treatment of sports-related injuries. X-rays may uncover more advanced forms of cancer in bones, although early screening for cancer requires other methods.

What are some common uses of x-ray?

  • Assist doctors in identifying and treating bone fractures.
  • View, monitor or diagnose joint injuries and infections, arthritis, artery blockages, abdominal pain.
  • Detection and diagnosis of cancer, although usually computed tomography (CT) or Magnetic Resonance Imaging (MRI) is better at defining the extent and nature of a suspected cancer.

How should I prepare for an x-ray?

There is no special preparation required for most bone x-rays. You may be asked to change into a gown before your examination and remove jewelry, eyeglasses and any metal objects during the exam.

Women should always inform the technologist if there is any possibility that they are pregnant.

What can I expect during this procedure?

An x-ray exam usually takes five minutes to half an hour.

  • The technologist positions you on the exam table and places a film holder under the table in the area of the body to be imaged.
  • Pillows may be used to help you hold the proper position.
  • The technologist steps behind a radiation barrier and asks you to hold very still, without breathing for a few seconds.
  • The x-ray equipment is activated, sending a beam of x-rays through the body to expose the film.
  • The technologist then repositions you for another view, and the process is repeated as necessary.
  • When your x-rays are completed you will be asked to wait until the technologist checks the images.

What will I experience during an x-ray?

  • X-ray imaging is painless.
  • Some discomfort may result from lying on the table, a hard surface that may feel cold.
  • Sometimes, to get a clear image of an injury such as a possible fracture, you may be asked to hold an uncomfortable position for a short time. Any movement could blur the image and make it necessary to repeat the procedure.

For more information on this topic, please visit www.Radiologyinfo.org.

 

Computed Tomography (CT)

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What is Computed Tomography?

In simplified terms, a CT is a type of x-ray. During a CT, a thin beam of x-rays circles completely around the body, collecting a 360-degree view of the area being examined. This information is fed into a computer that produces a two-dimensional, cross-sectional “slice” of a portion of the body. Multiple slices are taken to cover the area of the body to be examined. These studies enable the radiologist to see structures inside the body, which makes diagnosis and treatment more accurate.

How do I prepare?

You may be asked to drink a special oral contrast material before the exam to improve visualization of your intestines. You should have nothing else by mouth for 4-6 hours prior to the exam.

What should I wear?

You should wear comfortable, loose-fitting clothing for your CT exam. Metal objects can affect the image, so avoid clothing with zippers and snaps. You may also be asked to remove hairpins, jewelry, eyeglasses, hearing aids and any removable dental work, depending on the part of the body that is being scanned. You may be asked to change into a gown.

What should I expect during the exam?

A technologist with special training in CT will perform your exam. Before the exam the technologist should explain the procedure to you and answer any questions that you have. He may start an IV catheter in your arm. You will be asked to lie on the CT scanner. The technologist will leave you alone in the CT room during the exam, but will be able to see you and talk to you at all times. The table you are on will move in and out of the scanner during the exam. The machine will not touch you, and you will not feel the x-rays, but you will hear whirling and clicking noises. The technologist may inject contrast material through your IV during the examination to improve visualization of the organs in the body. If so, you may feel hot and flush during the injection. You may have a metallic taste in your mouth. This is expected. You may be asked to hold your breath, usually for 20 seconds or less. You should hold your breath and be as still as possible during the exam or your pictures may be blurry and the exam may need to be repeated.

How long will it take?

You should allow approximately 30 minutes for the exam, although most of that time is in preparation. The amount of time the machine is actually scanning is usually only a minute or two.

What if I am pregnant?

You should definitely inform both your doctor and the technologist if you are pregnant. Under most circumstances, CTs should NOT be performed on pregnant women due to the risk of radiation exposure to the baby. Your doctor may consult with the radiologist to determine if another study would be more appropriate for you.

Are there any limitations after the exam?

No. You may return to your normal activities, unless instructed otherwise by your doctor.

Is the exam safe?

Generally yes, but you should be aware of several risks.

  1. Radiation Exposure: CTs involve exposure to a small amount of radiation. Generally, it is considered that the small risk of the radiation exposure is outweighed by the potential benefits of the information gained by the exam, however you should consider discussing the need for the exam with your referring physician. Other tests may be available to you.
  2. Allergic Reaction: Iodinated IV contrast material is frequently used with CT. These contrast agents are generally safe, but, like all medications, side effects can occur. The incidence of side effects has decreased considerably over the years as newer contrast medicines have been developed. However, a small percent of patients may be allergic to the intravenous agent. Allergic reactions are usually mild (itching, flushing) but occasionally may be severe. If you have had allergic reactions to these agents before, or if you have asthma or multiple allergies, you may be at higher risk for a reaction. Let your doctor know if you have any of these conditions that would increase your risk.
  3. Kidney Failure: Iodine contrast can also rarely cause kidney toxicity in people with certain medical conditions, which include but are not limited to: kidney failure, diabetes, multiple myeloma, severe dehydration, hyperuicemia (seen with gout), and heart failure. If you fall into one of these categories, or if you are over age 60, a blood test may be needed prior to the study to measure your kidney function.

How do I get the results?

A radiologist will review and interpret the images from your exam. He or she will provide a written report to your referring physician which includes a description of the findings, any diagnosis that can be made from the exam, and a recommendation for further studies, if needed. Reports are usually available within 24 hours of completion of the examination, and are generally received by your physician within two working days. A report may be delayed if we are awaiting studies from an outside facility for comparison purposes. If the results are urgent or if you are seeing your doctor on the same day as your exam, your doctor may request that a preliminary report be phoned or faxed.

For more information on this topic, please visit www.Radiologyinfo.org.

 

Ultrasound

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What is Ultrasound Imaging?

Ultrasound imaging, also called sonography, is a method of obtaining diagnostic images from inside the human body through the use of high frequency sound waves. Ultrasonography is used as a diagnostic tool that can assist doctors with making recommendations for further treatment.

What are some common uses of Ultrasound?

  • Viewing an unborn fetus.
  • Examining many of the body’s internal organs, including the heart, liver, gallbladder, spleen, pancreas, kidneys, and bladder.
  • Show movement of internal tissues and organs, enable physicians to see blood flow and heart valve functions.
  • Guide procedures such as needle biopsies.
  • Image the breast and to guide biopsy of breast cancer.
  • Evaluate superficial structures, such as the thyroid gland and scrotum (testicles).

How should I prepare for an Ultrasound?

  • Wear comfortable, loose-fitting clothing.
  • Depending on the type of ultrasound exam you have, you will be asked:
    • Not to eat or drink for up to 12 hours before your appointment, or
    • Drink up to six glasses of water two hours prior to your exam and avoid urinating. This will ensure a full bladder when the exam begins.

What should I expect during this procedure?

The examination usually takes less than 30 minutes. After being positioned on the exam table, a clear gel is applied in the area being examined. This helps the transducer make contact with the skin. The technologist firmly presses the transducer against the skin and moves it back and forth to image the area of interest. Generally, the technologist is able to review the ultrasound images in real time.

What will I experience during the procedure?

Most ultrasound exams are painless. The gel applied to your skin may be a bit cold and there may be varying degrees of discomfort and pressure as the technologist guides the transducer over your abdomen, especially if you are required to have a full bladder.

For more information on this topic, please visit www.Radiologyinfo.org.

 

Fluoroscopy

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What is Fluoroscopy?

Fluoroscopy is a radiological technique where a low dose of x-rays are combined with an image intensifier to create an image on a monitor which allows real-time evaluation of several parts of the body. The most common exams are:

  • Barium Swallow
  • Upper GI
  • Small Bowel Follow Through
  • Lower GI (Barium Enema)

With the assistance of a radiology technologist, the radiologist will perform the examination, take several films for review and documentation, and send a report to your physician.

For more information on this topic, please visit www.Radiologyinfo.org.

 

Barium Swallow

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What is a Barium Swallow?

The Barium Swallow is an examination to evaluate the swallowing function of the upper esophagus. Patients having this study often have complaints of difficulty swallowing, a sensation of a lump in the throat, or coughing while eating or drinking that might indicate aspiration.

You are placed on the fluoroscopy table and examined in several positions, usually upright and lying on the stomach. In order to visualize the anatomy, you will make several swallows of an oral contrast material called barium. The radiologist will monitor the flow of the contrast and make a videotape or a series of images for analysis and to create a permanent record. The radiologist will interpret the images and send a report to your physician.

Is the examination safe?

During the study you will be exposed to a very low dose of x-ray radiation. The radiologist and technologist will make every effort to limit the dose of radiation administered to you. The risk from this low dose of radiation is very slight and greatly outweighed by the benefits of the information gained by performing the examination. Pregnant women, women of childbearing age, and children are further protected by lead shielding during the examination.

What should I wear?

You are usually asked to remove clothing from the waist up and given a hospital-type gown for the examination. You should remove all metal jewelry that may interfere with the study. You should wear clothing that is easily removed. Necklaces, other jewelry, and valuables can be left at home.

What preparation is needed?

The examination is usually performed in the morning. Please have nothing to eat or drink after midnight prior to the examination. Medications can be taken with a small amount water.

How long will the examination take?

The examination usually takes about 20 minutes. Once the images are obtained, you may leave the imaging center.

What can be expected after the examination?

Following the examination, you should resume a normal diet with plenty of liquids. Some patients find that the barium can be constipating. You will be offered a stool softener but a normal diet with normal liquid intake is usually sufficient.

When will my physician get the results?

A Phoenix Radiology radiologist will study the images and provide a written report which includes a description of the findings, any diagnosis that can be made from the exam, as well as a recommendation for further studies if needed. Our reports are usually available within 24 hours of completion of the examination, and are generally received by your physician within two working days. A report may be delayed if we are awaiting studies from an outside facility for comparison purposes. If the results are urgent or if you are seeing your doctor on the same day as your exam, your doctor may request that a preliminary report be phoned or faxed.

For more information on this topic, please visit www.Radiologyinfo.org.

 

Upper GI

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What is an Upper GI?

An upper gastrointestinal series (Upper GI) is an x-ray examination of the esophagus, stomach, and the first part of the small intestine. The procedure is performed to investigate digestive function or possible abnormalities such as ulcers, inflammation or tumors. Patients who undergo this procedure may have difficulty swallowing, complain of chest or upper abdominal pain, have gastroesophogeal reflux, or unexplained vomiting, indigestion, blood in the stool, or anemia.

You will be placed on the x-ray table and asked to drink a liquid contrast material called barium which will coat the intestinal tract and allow visualization of the esophagus, stomach, and first part of the small intestine. The radiologist will monitor the flow of the contrast into the gastrointestinal tract on a fluoroscope. X-rays will be made for analysis and creation of a permanent record.

Is the examination safe?

During the study you will be exposed to a very low dose of x-ray radiation. The radiologist and the technologist will make every effort to limit the dose of radiation you receive. The risk from this amount of radiation is very low and is far exceeded by the benefits of the information learned by the study. Pregnant women should not have this study unless absolutely necessary. Women of childbearing age and children will be further protected with lead shielding during the examination. Pregnant women should not have this study unless absolutely necessary.

What should I wear?

You are usually asked to remove clothing from the waist up and given a hospital-type gown for the examination. You should remove all jewelry, necklaces, and metal objects such as belt buckles that may interfere with the examination. Wear clothing that is easily removed and leave necklaces, jewelry, and other valuables at home.

What preparation is needed?

The Upper GI is performed with your stomach empty since food and liquids may interfere with visualizing the gastrointestinal tract. The examination is usually performed in the morning. Please have nothing to eat or drink after midnight. Medications may be taken in the morning with a small amount of water.

How long will it take?

The examination usually takes about 20 minutes. Once the films are developed, you will be able to leave the department.

What can be expected after the examination?

Following the examination, you should resume a normal diet with plenty of liquids. Some patients find that the barium can be constipating. You will be offered a stool softener, but a normal diet with normal liquid intake is usually sufficient.

When will my physician get the results?

A Phoenix Radiology radiologist will study the images and provide a written report which includes a description of the findings, any diagnosis that can be made from the exam, as well as a recommendation for further studies if needed. Our reports are usually available within 24 hours of completion of the examination, and are generally received by your physician within two working days. A report may be delayed if we are awaiting studies from an outside facility for comparison purposes. If the results are urgent or if you are seeing your doctor on the same day as your exam, your doctor may request that a preliminary report be phoned or faxed.

For more information on this topic, please visit www.Radiologyinfo.org.

 

Small Bowel Follow Through

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What is a Small Bowel Follow Through?

A Small Bowel Follow Through is an x-ray examination of the small intestine. The exam is usually performed to evaluate for inflammatory bowel disease, obstruction of the small intestine, or gastrointestinal bleeding. Patients who undergo this procedure may have abdominal pain, unexplained vomiting, blood in the stool, or anemia.

You will be placed on the x-ray table and asked to drink a liquid contrast material called barium which will coat the intestinal tract. The radiologist will monitor the flow of the contrast with x-rays every 15-30 minutes. Towards the end of the exam, the radiologist or technologist may use fluoroscopy to further visualize the small intestine.

Is the examination safe?

During the study you will be exposed to a very low dose of radiation. The radiologist and technologist will make every effort to limit the dose of radiation you receive. The risk from this amount of radiation is very low and is far exceeded by the benefits of the information learned by the study. Pregnant women should not have this study unless absolutely necessary.

What should I wear?

You are usually asked to remove clothing from the waist up and given a hospital-type gown for the examination. You should remove all jewelry, necklaces, and metal objects such as belt buckles that may interfere with the examination. Wear clothing that is easily removed and leave necklaces, jewelry, and other valuables at home.

What preparation is needed?

The exam is performed with your stomach empty since food and liquids may interfere with visualizing the gastrointestinal tract. The examination is usually performed in the morning. Please have nothing to eat or drink after midnight. Medications may be taken in the morning with a small amount of water.

How long will it take?

The examination length is variable, since the time of transit through the gastrointestinal tract is variable. Generally the exam takes approximately 2 hours, though exams lasting 3-4 hours are not uncommon. X-rays are generally obtained every 15-30 minutes, so there is a considerable amount of waiting time during the exam. You are encouraged to bring reading material to pass the time. Once the films are developed, you will be able to leave the department.

What can be expected after the exam?

Following the examination, you should resume a normal diet with plenty of liquids. Some patients find that the barium can be constipating. You will be offered a stool softener, but a normal diet and normal liquid intake is usually sufficient.

When will my physician get the results?

A Phoenix Radiology radiologist will study the images and provide a written report which includes a description of the findings, any diagnosis that can be made from the exam, as well as a recommendation for further studies if needed. Our reports are usually available within 24 hours of completion of the examination, and are generally received by your physician within two working days. A report may be delayed if we are awaiting studies from an outside facility for comparison purposes. If the results are urgent or if you are seeing your doctor on the same day as your exam, your doctor may request that a preliminary report be phoned or faxed.

For more information on this topic, please visit www.Radiologyinfo.org.

 

Lower GI

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What is a lower GI?

The lower GI procedure (Barium Enema) is performed to investigate possible abnormalities of the colon or large intestine. Patients who undergo this procedure often complain of constipation, diarrhea, irritable bowel syndrome, unexplained abdominal pain, or blood in the stool. The study can be used to diagnose inflammatory bowel disease or screen for colon cancer.

Prior to the procedure, you will need to take laxatives to cleanse the colon of fecal material. In order to visualize the anatomy, the colon must be filled with contrast material (barium) and usually distended with air. A small tube is placed into the rectum by the technologist and the flow of barium monitored by the radiologist using a fluoroscope. Air is instilled to distend the colon for the most accurate films. During the procedure, detailed films of portions of the colon are obtained by the radiologist and additional films of the entire colon are then obtained in several positions by the technologist.

Is the examination safe?

During the study you will be exposed to a very low dose of radiation. The radiologist and technologist will make every effort to limit the dose of radiation you receive. The risk from this amount of radiation is very low and is far exceeded by the benefits of the information learned by the study. Pregnant women should not have this study unless absolutely necessary.

What should I wear?

You will be asked to remove all clothing and be given a hospital-type gown for the examination. You should remove all jewelry and metal objects that may interfere with the examination. Wear clothing that is easily removed and leave jewelry and other valuables at home.

What preparation is needed?

The lower GI is performed after cleansing of the colon to remove fecal material which will interfere with creating accurate images for interpretation. At the time of scheduling you will be given instructions for the preparation which includes a liquid diet and laxatives. You should not eat or drink after midnight the evening before the examination. Medications can be taken the morning of the study with a small amount of water.

How long will it take?

The examination usually takes about 30 minutes. Once the films are developed, you will be able to leave the department.

What can be expected after the examination?

Following the examination, you should resume a normal diet with plenty of liquids. Over the course of 2-3 days the barium will pass from the system. Some patients find that the barium can be constipating. A normal diet with normal liquid intake is usually sufficient.

When will my physician get the results?

A Phoenix Radiology radiologist will study the images and provide a written report which includes a description of the findings, any diagnosis that can be made from the exam, as well as a recommendation for further studies if needed. Our reports are usually available within 24 hours of completion of the examination, and are generally received by your physician within two working days. A report may be delayed if we are awaiting studies from an outside facility for comparison purposes. If the results are urgent or if you are seeing your doctor on the same day as your exam, your doctor may request that a preliminary report be phoned or faxed.

For more information on this topic, please visit www.Radiologyinfo.org.

 

Nuclear Medicine

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What is Nuclear Medicine?

Nuclear medicine examinations evaluate both body anatomy and function. The images are produced by x-ray emissions from radioactive substances given to the patient, either intravenously or by mouth. Generally, radiation to the patient is similar to that resulting from standard x-ray examinations. During the imaging, you will be lying on a table while a “camera” creates a picture from the radiation coming from your body. Since the pictures can take an extended period to acquire, it is necessary to remain still. The camera is silent.

Is the exam safe?

The doses of radiation used for diagnostic tests are quite small. The substances (radiopharmaceuticals) are very safe and allergic reactions are quite rare. Because the radiopharmaceuticals are designed to be handled the same way naturally occurring compounds are, side effects are extremely rare.

What should I wear?

Comfortable, loose fitting clothing should be worn.

What preparation is needed?

In general, for the more common examinations, no special preparation is needed.

How long will it take?

Total time varies by exam. See below.

What can be expected after the exam?

There are no physical changes to be noted following the examination. Your nuclear medicine examination will be transferred to films, similar in appearance to an x-ray film, for your referring physician if requested. If necessary, there is ample opportunity to have consultation between radiologists, which improves your final report.

When will my physician get results?

A Phoenix Radiology radiologist will study the images and provide a written report which includes a description of the findings, any diagnosis that can be made from the nuclear medicine exam, as well as a recommendation for further studies if needed. Our reports are usually available within 24 hours of completion of the nuclear medicine examination, and are generally received by your physician within two working days. A report may be delayed if we are awaiting studies from an outside facility for comparison purposes. If the results are urgent or if you are seeing your doctor on the same day as your exam, your doctor may request that a preliminary report be phoned or faxed.

Common procedures

Bone scan – this is used to evaluate for bone lesions from arthritis, tumor or infection. There is a 3-to-4 hour delay between receiving the radioactive material and scanning. The scan takes between 20 and 60 minutes depending on the areas of interest and the degree of detail required. No special preparation is needed.

Thyroid uptake and scan – this is performed to evaluate thyroid function, and to look for activity within thyroid nodules. At St. Joseph Regional Medical Center, this is done with a single small dose of radioactive iodine. Uptake is measures at 6 and 24 hours.

Renal function – this is performed to determine if the kidneys function equally. The examination can assess for obstruction.

Cardiac left-ventricular function and coronary blood flow – this is performed for assessment of chest pain and requires 2 doses of radiopharmaceutical, one given with the patient at rest, the other at peak exercise. If you cannot exercise on a treadmill, drugs can be given instead to assess blood flow.

Tagged white cell scan – this is performed to look for infection. The test involves blood being drawn from your body, the white blood cells separated and labeled with a small amount of radioactivity. This examination often requires imaging at 24 and 48 hours.

Gallbladder scan – this is to assess for blockage to the gallbladder and involves injection of a small amount of a radioactive compound. Images are then obtained over an hour, or more.

Gastric emptying – this is performed to measure how the stomach empties. Usually an egg is given with a small amount of radioactive material. Imaging is then performed for 90 minutes.

For more information on this topic, please visit www.Radiologyinfo.org.

 

Positron Emission Tomography (PET)

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What is Positron Emission Tomography?

Positron emission tomography, also called a PET scan, is a nuclear medicine exam that produces a three dimensional image of functional processes in the body. A PET scan uses a small amount of a radioactive drug to show differences between healthy and diseased tissue. The diagnostic images produced by PET are used to evaluate a variety of diseases.

What are some common uses of PET?

  • to detect cancer
  • to evaluate the heart for:
    • blood flow
    • heart function
  • to evaluate the brain for:
    • memory disorders
    • brain tumors
    • seizure disorders

How should I prepare for this procedure?

PET is usually done on an outpatient basis. You should:

  • wear comfortable clothes
  • not eat for four to six hours before your scan
  • drink plenty of water
  • consult with your doctor regarding the use of medications before the test

What should I expect from this procedure?

  • You receive an intravenous (IV) injection of the radioactive substance. However, for some patients, you may be asked to inhale the substance.
  • The radioactive substance will then take approximately 30 to 90 minutes to travel through your body and be absorbed by the tissue under study. During this time, you will be asked to rest quietly and avoid significant movement or talking, which may alter the localization of the administered substance.
  • You will be positioned on the PET scanner table and be asked to lie still during your exam.
  • Scanning takes 30 to 45 minutes.
  • Some patients who are being evaluated for heart disease may undergo a stress test in which PET scans are obtained while they are at rest, and again after undergoing the administration of a pharmaceutical to alter the blood flow to the heart.
  • Usually, there are no restrictions on daily routine after the test. You should drink plenty of fluids to flush the radioactive substance from your body.

What will I experience during the procedure?

  • If given an intravenous injection, you will feel a slight prick. However, you will not feel the substance in your body.
  • You will be made as comfortable as possible on the exam table before you are positioned in the PET scanner for the test.
  • You will hear buzzing or clicking sounds during the exam.
  • Patients who are claustrophobic may feel some anxiety while positioned in the scanner.
  • Some patients find it uncomfortable to hold still in one position for more than a few minutes.

For more information on this topic, please visit www.Radiologyinfo.org.

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