Module 4/diagnostic Tests And Procedures/radiology, Ultrasound And Imaging Procedures

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FLUOROSCOPY flur-OS-ko-pe): 

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X-ray procedure that uses a fluorescent screen rather than a photographic plate to show images of the body. X-rays that have passed through the body strike a screen covered with a fluorescent substance that emits yellow-green lights. Internal organs are seen directly and in motion. Fluoroscopy is used to guide the insertion of catheters and during barium tests.

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ANGIOGRAPHY (an-je-OG-rah-fe) or ANGIOGRAM (AN-je-o-gram): 

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X-ray recording of blood vessel.  Involves passing a catheter through a vein or artery in the arm or leg to the site to be studied and injecting a contrast medium to make x-ray visualization easier.
IN CEREBRAL ANGIOGRAPHY, x-ray pictures are taken of blood vessels in the brain. Angiography is used to detect abnormalities in blood vessels, such as blockage, malformation and arteriosclerosis. Angiography is performed most commonly to view arteries and is often used interchangeably with arteriography.

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BARIUM ENEMA: 

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See LOWER GASTROINTESTINAL EXAMINATION and BARIUM TESTS.

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BARIUM SWALLOW: 

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See ESOPHAGOGRAPHY and BARIUM TESTS.

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ARTERIOGRAPHY (ar-ter-e-OG-rah-fe) or ARTERIOGRAM (ar-TER-e-ohgram): 

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*x-ray study to detect a blockage or defect of an artery
**Body area tested: any artery in the body;commonly in the brain, heart,kidneys,aorta or legs
X-ray recording of arteries after injection of a contrast medium into an artery.
CORONARY ARTERIOGRAPHY is the visualization of arteries that bring blood to the heart muscle.

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BARIUM TESTS (BAR-re-um tests):

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X-ray examinations using a liquid barium mixture to locate disorders in the esophagus (esophagogram), duodenum, small intestine (small bowel follow through) and colon (barium enema). Taken before or during the examination, barium causes the intestinal tract to stand out in silhouette when viewed through a fluoroscope or seen on an x-ray film. THE BARIUM SWALLOW is used to examine the upper gastrointestinal tract and
THE BARIUM ENEMA is for examination of the lower gastrointestinal tract.

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CARDIAC CATHETERIZATION (KAR-de-ak cath-eh-ter-i-ZA-shun):

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*cardiac catheterization (venous and arterial)allows the visualization of the heart and the coronary arteries that supply blood to the heart muscle.
A catheter (tube) is passed via vein or artery into the chambers of the heart. This procedure is used to measure the blood flow out of the heart and the pressures and oxygen substance in the heart chambers. Contrast medium is also introduced into heart chambers and x-ray images are taken to show heart structure.

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CHEST X-RAY:

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X-ray of the chest may show infection (as in pneumonia or tuberculosis), emphysema, occupational exposure (asbestosis), lung tumors, or heart enlargement.

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CHOLANGIOGRAPHY (kol-an-je-OG-rah-fe) or CHOLANGIOGRAM (kol-an-je-o-gram):

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X-ray recording of bile ducts after administration or injection of contrast medium, orally, by intravenous injection or percutaneously.
X-rays are taken of the bile ducts to identify obstructions caused by tumors or stones.

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CORONARY ARTERIOGRAPHY: 

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See ARTERIOGRAPHY

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CT SCAN, CAT SCAN:

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Also know as: Computed Tomography (CT), Computed Axial Tomography (CAT)
*x-ray tube housed inside a doughnut-sized machine called a gantry rotates around your body and sends radiation through it at various angles.
*uses computer-enhanced x-ray images to assemble cross-sectional images or "slices" of the body. These images can be made into 3-dimensional pictures.
Contrast material may be used (injected into the bloodstream) to highlight structures such as the liver, brain, or blood vessels, and barium can be swallowed to outline gastrointestinal organs.
*used to detect structural abnormalities and give excellent information on anatomical features and tissue density (for detection of tumors). Can also detect calcium deposits, cysts and abscesses.
**scans expose patients to more radiation than conventional x-rays.
**CT scans are more expensive than x-rays, but cheaper than an MRI

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CYSTOGRAPHY (sis-TOG-rah-fe) or CYSTOGRAM (SIS-to-gram):  

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*assessment of the urinary bladder and urethra is commonly performed for the investigation of urinary tract infections.
X-ray recording of the urinary bladder using a contrast medium, so the outline of the urinary bladder can be seen clearly. 
Contrast is injected via catheter, into the urethra and urinary bladder and x-ray images are taken.

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Cholangiography (Intravenous)

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Contrast medium is given by intravenous injection and collects in the gallbladder and bile ducts.
X-rays are taken of the bile ducts to identify obstructions caused by tumors or stones

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Cholangiography (Percutaneous Transhepatic)

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Also called: PTC
*This is a contrast x-ray study of the bile duct often used to diagnose causes of jaundice.
*PTC distinguishes between obstructive and nonobstructive jaundice. Determines the location, extent and cause of obstruction.
Patient lies on a tilting x-ray table and a local anesthetic is injected into the skin covering the liver and the capsule surrounding it. A long flexible needle (guided by a fluoro-scope)is inserted through the skin (of abdomen) into the liver in an attempt to find a dilated bile duct, and contrast medium administered through it directly into the liver. A series of x-rays are then taken.

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DIGITAL SUBTRACTION ANGIOGRAPHY (DIJ-i-tal sub-TRAK-shun-an-je-OG-rah-fe):  

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Also called: DSA
A unique x-ray technique for viewing blood vessels by taking two images and subtracting one from the other.
A modern method permitting sparing use of radiation and contrast media. DSA no longer uses a directly exposed X-ray film, the image is stored in a computer.
First, a so-called mask image is taken (prior to the injection of the contrast medium), on which the bones and shadows of the soft tissures appear. The computer will then subtract this image from a "filled" image taken thereafter (after the contrast medium has been administered). As a result, a very clear image of the vessels appears without any overlay of other body structures. The final image (sharp and percise) shows only contrast-filled blood vessels minus surrounding tissues.

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ECHOCARDIOGRAPHY (eh-ko-kar-de-OG-rah-fe):

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Images of the heart are produced by introducing high-frequency sound waves through the chest into the heart. The sound waves are reflected back from the heart and echoes showing heart structure are displayed on a recording machine. It is a highly useful diagnostic tool in the evaluation of diseases of the valves that separates the heart chambers and diseases of the heart muscle.

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ECHOENCEPHALOGRAPHY (eh-ko-en-sef-ah-LOG-rah-fe):

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An ultrasound recording of the brain. Sound waves are beamed at the brain and the echoes that return to the machine are recorded as graphic tracings. Brain tumors and hematomas can be detected by abnormal tracings.

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ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (en-do-SKOP-ik REH-tro-grad kol-an-je-o-pan-kre-ah-TOG-rah-fe):  

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Also called: ERCP
X-ray recording of the bile ducts, pancreas and pancreatic duct.
A flexible fiberoptic tube is passed trhough the mouth, esophagus and stomach into the duodenum. The opening into the bile duct is identified and a small plastic cannula (tube) is advanced into the duct. Contrast media is then injected through the cannula into the duct. X-rays are then taken. Any necessary treatment can be performed at this time.

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ESOPHAGOGRAPHY (eh-sof-ah-GOG-rah-fe) or ESOPHAGOGRAM (eh-SOF-ah-go-gram): 

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Also called: Barium Meal
*part of an upper gastrointestinal examination or Upper GI Series.
Barium sulfate is swallowed and x-ray images are taken of the esophagus.

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Barium Swallow

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*part of an upper gastrointestinal examination for the esophagus only
Barium sulfate is swallowed by the patient. X-rays are taken while the patient is swallowing.
*Barium outlines the esophagus to detect abnormalities (ulcers and strictures)

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GALLBLADDER ULTRASOUND (gawl BLA-der UL-tra-sownd):  

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Sound waves are used to visualize gallstones. This procedure has replaced cholecystography, which required ingesting an iodine-based contrast substance.

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HYSTEROSALPINGOGRAPHY (his-ter-o-sal-ping-OG-rah-fe) or HYSTEROSALPINGOGRAM (his-ter-o-sal-PING-o-gram):

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*used to confirm tubal abnormalities or obstructions that may cause infertility.
X-ray recording of the uterus and fallopian tubes. Contrast medium is inserted through the vagina into the uterus and fallopian tubes and x-rays are taken to detect blockage or tumor.

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INTRAVENOUS PYELOGRAPHY: 

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See UROGRAPHY

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LOWER GASTROINTESTINAL EXAMINATION (Lower gas-tro-in-TES-tinal ek-zam-ih-NA-shun): 

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Also called: Barium Enema
Liquid contrast called barium sulfate is inserted through a plastic tube (enema) into the rectum and large intestine (colon). X-ray pictures of the colon are then taken. If tumor is present in the colon, it may appear as an obstruction or irregularity.

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LYMPHANGIOGRAPHY (limf-an-je-OG-rah-fe) or LYMPHANGIOGRAM (limf-AN-je-o-gram): 

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Also called: Lymphography
*used to diagnose causes of intractable edema in the legs and feet, and the presence or spread of cancer in the lymphatic system.
X-ray recording of lymph nodes and lymph vessels after contrast is injected into lymphatic vessels in the feet. The contrast medium travels upward through the lymphatic vessels of the pelvis, abdomen and chest and outlines the architecture of lymph nodes in all areas of the body. This procedure is used to detect tumors of the lymphatic system.

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LYMPHOGRAPHY:

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See LYMPHANGIOGRAPHY

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MAMMOGRAPHY (mah-MOG-rah-fe) or MAMMOGRAM (MAM-o-gram):

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X-ray recording of the breast. X-rays of low voltage are beamed at the breast and images are produced. Mammography is used to detect abnormalities in breast tissue, such as early breast cancer.

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MAGNETIC RESONANCE IMAGING (mag-NET-ik Resonant IM-a-jing):  

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Also called: MRI
*more sophisticated and detailed than from CT scanning.
*use in examining the central nervous system (brain,spinal cord),to identify tumors,strokes,degenerative diseases, inflammation, and abnormalities in organs and other soft tissue of the body.
*Unit is a closed cylindrical magnet which fully enclose the patient (may feel claustrophobic).
*exposure to radiation is avoided
*patients with implants that contain magnetic materials (pacemakers) are generally advised not to undergo MRI.
*MRIs cost a lot more than CT scans
Uses computer-controlled radio waves and very big magnets, which create a magnetic field. After the machine creates a magnetic field, it sends radio waves into the body and then measures the response of its cells (how much energy they release) with a computer. Frequency pulses, not x-rays, are used to create a 3-dimensional picture of the inside of the body. MRI makes use of the fact that all living cells have a certain magnetic quality to them: because of this, MRI can provide a look at the biochemistry of living cells.
The images can be taken in several planes of the body frontal, sagittail(side), and transverse (cross-section)

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MYELOGRAPHY (mi-eh-LOG-rah-fe) or MYELOGRAM (MI-eh-lo-gram):  

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*to diagnose herniated disks, spinal nerve injury and tumors.
X-ray recording of the spinal cord.
A lumbar puncture is performed, a small amount of spinal fluid is removed, and the contrast medium is injected at the same site (between the membranes surrounding the spinal cord) at the lumbar level of the back. A series of x-rays is taken with the table in various positions, and all or part of the contrast medium may be removed by aspiration afterward. Myelography detects spinal tumors or ruptured, "slipped," disks that lie between the backbones (vertebrae) and press on the spinal cord.

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T-tube Cholangiogram

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Performed on patients whose gallbladder has been removed.
When gallbladder was removed a special tube known as a T-tube was inserted into the duct that connects your liver to your small intestine. The T-tube Cholangiogram is an x-ray examination of this passage. During the test, contrast dye is injected through the the T-tube and x-rays are then taken.
Test is used to identify obstructions caused by tumors or stones

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TOMOGRAPHY (to-MOG-rah-fe) or TOMOGRAM (to-mo-gram):  

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Also called: CT scan
X-ray recording that shows an organ in depth. Several pictures taken in cross-sections ("slices") are taken of an organ by moving the x-ray tube and film in sequence to blur out certain regions and bring others into sharper focus. Tomograms of the kidney and lung are examples.

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ULTRASONOGRAPHY (uI-tra-so-NOG-rah-fe) or ULTRASONOGRAM (uI-tra-SON-o-gram): 

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Images are produced by beaming sound waves into the body and capturing the echoes that bounce off organs. These echoes are then processed to produce an image, not in the sharpest detail, but showing the difference between fluid and solid masses and the general position of organs.

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UPPER GASTROINTESTINAL EXAMINATION (UP-er gas-tro-in-TES-tin-al ek-zam-ih-NA-shun): 

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Also called: Barium Milk Shake or Barium Swallow.
A liquid contrast substance called barium sulfate is swallowed and x-ray pictures are taken of the esophagus (barium meal or barium swallow), duodenum and small intestine. In a small bowel follow-through, pictures are taken at increasing time intervals to follow the progress of barium through the small intestine. Identification of obstructions or ulcers is possible.

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UROGRAPHY (u-ROG-rah-fe) or UROGRAM (UR-o-gram):

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Also called: Intravenous Pyelography (IVP)
X-ray recording of the kidney and urinary tract. If x-rays are taken after contrast medium is injected intravenously, the procedure is called intravenous urography (descending or excretion urography) or intravenous pyelography (IVP).

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Retrograde Urography or
Retrograde Pyelography

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*x-ray pictures to provide visualization of structural problems or injuries to the urethra (almost exclusively men, who may have structural problems of the urethra)
a flexible rubber or plastic catheter is inserted into the urethra, and dye is injected into the catheter. A clamp is applied to hold the dye in place while x-ray pictures are taken of the urethral structure

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Voiding Cystourethrography

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Also called: Voiding Urethrogram
*provides an x-ray picture of the bladder and urethra during urination and is used to diagnose abnormalities, infection or other disorders of the urinary tract.
A catheteris inserted into the urethra and into the bladder,which, after it is drained of any urine, is filled with contrast dye until the patient has the urge to void. Still or moving x-ray pictures are taken of the urinary tract as the patient voids.