Welcome to the Imaging Department at
Woodland Heights Medical Center.
 Woodland
Heights Medical Center is pleased to offer its patients
two state-of-the-art imaging facilities. Recently, The
Diagnostic Center opened to the community at 125
Gaslight Medical Parkway in Lufkin. This facility offers
convenient parking and curbside service. Our outpatient
guests more than likely will have diagnostic testing at
this facility. Please talk with your physician and/or
staff to understand where your testing will be
conducted.
The Imaging Center at Woodland Heights Medical Center is
located within the hospital. You are encouraged to park
in front of the hospital (Loop 287 entrance) and go to
the admissions entrance. This is where you will register
for radiology services. After you register, you will be
directed to the Diagnostic Center waiting room.
Services
Woodland Heights Offers the Only 64
Slice CT Scanner in Lufkin
Woodland Heights Medical Center continues to offer East
Texans cutting-edge technology in health care. The
hospital recently installed a state-of-the-art
multi-slice Computed Tomography (CT) scanner within its
facility. This is the first 64-slice CT available in
Lufkin.
The hospital’s new Brilliance CT scanner from Philips
Medical Systems features advanced technology that
produces split-second high quality images, permitting
doctors to see more anatomical detail in a fraction of
the time needed for other tests. With this new CT
scanner, Woodland Heights’ physicians are able to more
effectively detect and treat a range of life threatening
illnesses including cardiovascular disease, the nation’s
leading killer. The possibility of discovering heart and
vascular disease in an early stage, before the onset of
serious symptoms, helps doctors recommend the most
effective treatment options and lifestyle changes to
reduce risk and perhaps save lives.
The new technology’s leap in acquisition speed makes
advanced applications such as cardiovascular imaging and
whole body CT angiography (CTA) routine. According to
Woodland Height’s Chief Radiologist, Dr. Bill Kent, “We
can obtain whole heart examinations in just seconds.
With the speed and specialized software of this new
scanner, we can now overcome the challenges that
prevented us from being able to offer such definitive
and non-surgical cardiovascular exams in the past.”
Patients needing a CT scan will discover that Woodland
Heights’ new scanner offers a much more pleasant
experience. Having your heart and coronary arteries
evaluated using a CT scanner may reduce the need for
more invasive testing. With faster scan times patients
will usually be asked to carry out one brief breath hold
during each scan.
“Older patients and those with breathing difficulties or
some other distress will really appreciate the shorter
exams,” says Dr. Kent. “We’ll have them in and out much
faster, and their doctors will be able to access
detailed, definitive results in a short time.”
Another advantage the hospital anticipates is the
ability to provide more large patients with a CT scan
option. The new Brilliance scanner has a table weight
capacity of up to 440 lbs.
“In the past, being able to handle some larger patients
was sometimes a challenge, because most equipment simply
can’t accommodate them,” says Dr. Kent. “With the
Brilliance CT, we can handle the additional body weight,
and those patients will be able to benefit from this
great diagnostic technology as well.”
A CT scan produces a cross-sectional image of the human
anatomy, which helps the clinician to rule out or
confirm the presence of certain disease, and in some
cases to evaluate the extent of injuries to a trauma
patient, such as someone involved in an automobile
accident. During the non-surgical test, the patient is
placed on a table and moved incrementally through the
squared off donut-shaped scanner while an X-ray beam is
projected through cross sections of their anatomy. The
X-ray energy passes through the patient and is recorded
on electronic detectors in the scanner. This information
is then sent to a specialized computer that reconstructs
the information into individual slices and combines them
sequentially into a comprehensive volume image of the
entire area scanned. The thinner the slices, the more
revealing the detail is in the resulting images, and the
more definitive the exam results.
MAMMOGRAPHY
A mammogram is a safe, low dose X-ray
procedure to visualize the breast tissue. It is
performed to detect tumors, which may be too small to
feel during a physical examination. As a result, many
breast cancers can be found early, before they have
spread to other body parts.
How often should I have one?
The American Cancer Society
recommends a baseline mammogram at or before age 40 and
a screening mammogram every year after.
Is it painful? Some women experience discomfort because
the breast is compressed for a few seconds. The
discomfort is temporary and does not damage the breast
tissue.
How long does it take?
Approximately 15 minutes.
Are mammograms safe?
Yes. Our facility is certified by the American College
of Radiology and the Food and Drug Administration. This
ensures that our equipment meets strict guidelines for
quality testing. The technologist performing the exam
and the radiologist who reads it have completed advanced
training and have surpassed minimum requirements for
certification.
What will the exam be like?
Your breast will be gently compressed on the image
plate. It is necessary to spread the breast tissue
evenly for better X-ray penetration and uniformity. You
will most likely have two images taken in slightly
different positions of each breast.
What if I have implants?
Women with breast implants should have mammograms
according to guidelines for non-augmented breasts. The
implant will be gently pushed back in order to visualize
the remaining breast tissue. The risk of rupturing the
implant is minimal.
How do I get the exam results?
The radiologist will read your films and the results
will be sent to your doctor. You also will receive a
letter in the mail informing you of your results. It
will recommend when you should return for another exam.
Why are six-month follow-ups sometimes recommended?
It is important to closely observe benign-appearing
conditions in the breast to confirm that there have been
no changes over time. Breast calcifications are the most
common cause. They are small deposits of calcium of
varying shapes and locations. Changes in the pattern, or
new calcifications, may indicate the presence of a small
cancer and may require a biopsy.
Preparing for a Mammogram
How do I prepare for a mammogram?
Wear
comfortable clothing, preferably a two-piece outfit. Do
not wear powder or deodorant in underarm area on the day
of the exam. Bring any previous mammogram films that you
may have to the Diagnostic Center.
BREAST BIOPSY INFORMATION
What is a breast biopsy?
It is a
tissue sample that is taken from your breast using a
biopsy needle (core needle biopsy) or it may be sampled
during surgery (excisional biopsy). The tissue gathered
is then examined under a microscope. This is the most
accurate method of diagnosing a breast mass. 80% of all
breast masses are benign (non-cancerous).
What can I expect from a core needle biopsy?
Your breast will be positioned as in a regular
mammogram. After compression, your skin will be cleaned
with an antiseptic solution. It will then be injected
with a local anesthetic agent. You may feel a mild sting
during the injection. The biopsy needle will be inserted
and small samples will be taken under guidance of the
radiologist and breast imaging technicians. This type of
biopsy requires no hospital stay, no general anesthetic,
and virtually no recovery time. If the results are
benign, it may replace an open surgical biopsy. Core
needle biopsy is less expensive and leaves almost no
external scarring. The procedure will take approximately
one hour. It will take a few days to receive the
results.
GENERAL BREAST HEALTH
- What is breast self-examination?
All women should perform self-examinations monthly
on a regular basis, preferably on the same day of
each month. Self-examination, mammograms, and yearly
physical exams collectively are the most effective
way to detect and treat breast cancer. About 96% of
all breast cancers can be detected when all three
methods are used together. Every woman should become
familiar with the look and feel of her own breasts
so that she will be able to recognize any changes.
- How do I perform breast
self-examinations?
In the shower: Examine entire breast for any lumps
or thickening. This is easier to feel when the skin
is wet.
- Lying down: Put one hand behind
your head. With your other hand on the opposite
breast, work in a circle to cover entire area of
breast including armpit area.
- Before a mirror: Raise both arms
above your head and visually examine your breasts
from the front and sides.
What causes lumps in my breasts?
Breast tissue is composed of
glandular and fatty tissue. This causes a lumpy
feel, which is normal. Both sides should be fairly
symmetrical. Lumpiness is sometimes caused by
fibrocystic disease. This is a benign condition
caused by pockets of fluid in the breast tissue.
Excess caffeine can aggravate this condition. Some
examples of foods or medications with caffeine are
coffee, tea, soft drinks, chocolate, nuts, Anacin,
Dexatrim, Excedrin, No Doz, and some medicines used
for breathing difficulties, such as Theophylline and
Theobromine.
ULTRASOUND
GENERAL INFORMATION
What is ultrasound?
A device
that uses sound waves to study internal
structures and tissue. A hand held device called
a transducer is used to transmit and receive
echo signals when placed against the skin. Clear
gel is applied to your skin to provide better
contact for the transducer. This gel wipes off
easily. Ultrasound imaging also is called sonography.
Is ultrasound painful?
Ultrasound is not painful. There may be feelings
of discomfort if you have a prostate or
transvaginal ultrasound because a thin probe
will be inserted into the vagina or rectum.
Why is ultrasound useful?
It has a wide variety of uses, as it does not
emit X-rays. It can image a growing fetus in the
womb or it can show motion of blood in veins and
arteries. It also is a widely used diagnostic
tool for understanding abnormalities of the
heart, abdomen and kidneys. Because ultrasound
does not penetrate well through bone or air, it
is difficult to assess lungs or bones.
What are different types and descriptions of
ultrasound?
- Obstetric - used to
determine size, anatomy and due date of an
unborn child. It also surveys the position
of the fetus and placenta. Exam length is
about one hour.
- Pregnancy diagnosis -
determines if the patient is pregnant and
the gestational age. This exam may require a
probe to be inserted into the vagina. Exam
length is approximately 30 minutes.
- Prostate - used to
evaluate the size of the prostate gland. A
thin probe will be inserted into the rectum
to better visualize the anatomy. Exam length
is about 30 minutes.
- Breast - used to
determine whether a lump is a cyst or solid
mass. Exam length approximately 20 minutes.
- Abdomen - used to study
the size and shape of internal organs.
Detects any abnormal growth. About 30
minutes to perform the exam.
- Pelvis - evaluate uterine
cavity. May require a thin probe to be
inserted into the vagina. Used to study the
ovaries and uterus. Exam length is
approximately 30 minutes.
- Cardiac - studies the
size and shape of the heart muscle.
Evaluates competency of the heart valves and
the condition of the heart walls. This exam
takes about one hour to perform.
- Arterial/Venous study -
to determine blood flow and look for
blockages. Also studies competency of vein
valves.
- Thoracentesis - used to
localize an area of fluid collection to be
drained, particularly in the lungs. This
procedure takes about 30 minutes.
What is Doppler ultrasound?
It is an ultrasound study of the arteries
that measures the speed of the blood flow.
It produces a graph that charts the systolic
and diastolic pressure of a blood vessel.
EXAM PREPARATION
How to Prepare for an
Ultrasound
Each exam is different; therefore, each
procedure calls for various preparations.
- Pelvic, pregnancy
diagnosis or obstetric under 16 weeks
gestation: You must have a full bladder.
Drink 48 oz. of water one hour prior to
appointment time. Please do not empty
your bladder until after the exam is
completed.
- Obstetric over 16
weeks gestation: no preparation.
- Abdomen, liver,
gallbladder: Do not eat or drink
anything six hours prior to exam time.
No smoking or gum chewing.
- Appendix, renal,
cardiac, testicular, breast: No
preparation.
- Thyroid, carotid: No
preparation.
- Arterial/venous: No
preparation.
- Prostate: Laxative of
your choice the night before the exam.
Fleet enema one hour prior to exam.
Patient may have a light breakfast.
- Prostate biopsy:
Laxative of your choice the night before
exam, no aspirin or aspirin-like
medicine 10 days prior to exam.
(Example: Advil, Motrin, Nuprin, Aleve).
Your doctor also will prescribe some
antibiotics to take prior to the exam.
- All other biopsies:
Nothing to eat or drink after midnight
the night before the exam.
BIOPSY INFORMATION
Why should I have
an ultrasound biopsy?
Ultrasound guidance in biopsies is
useful to accurately locate the
tissue in question. It provides a
safer way to obtain a tissue sample
since it does not require general
anesthesia. The recovery time is
much faster and the exam is less
expensive compared to a surgical
excisional biopsy.
What can I expect during a biopsy?
Your skin will be cleaned with an
antiseptic solution and injected
with a local anesthetic. You may
feel a mild sting upon injection.
The biopsy needle will be inserted
under the guidance of the ultrasound
transducer, and small samples will
be taken by the radiologist and sent
to the lab for microscopic
examination. This type of exam has
virtually no recovery time and will
leave very little, if any, scarring.
The procedure takes approximately
one hour and you will receive a
report from you doctor within a few
days.
What is the preparation for a
biopsy?
Nothing to eat or drink after
midnight. Prostate biopsies must
have a laxative the night before
followed by an enema the morning of
the exam. Take antibiotics as
directed.
MRI
GENERAL INFORMATION
What
is MRI?
Magnetic Resonance Imaging is a way
to visualize anatomic structures
within the body by using radio waves
and a magnet. Exposing the body to a
strong magnetic field causes all of
the hydrogen atoms to be in
alignment. The machine then sends a
high frequency radio wave, which
causes these hydrogen atoms to
"resonate" or send back a signal
giving detailed information about
body structures. The image
resolution is high detail and is
useful for many parts of the body.
What to Expect During MRI
You will lie on a bed and the
technologist will position you
comfortably. Headphones or earplugs
will be placed over your ears.
The machine can be very
loud. Music will be provided through the
headphones if you desire. The
scanning bed will enter a large
cylinder that is open on both ends
and you will be kept in constant
communication with the technologist
because he/she will be able to hear
and see you at all times. Depending
on the scan you are having, the exam
will take 30 minutes to 2 hours.
Please lie still and relax, as
movement will impair the scan.
What if I'm afraid of closed in
spaces?
Claustrophobia is a common condition
that can cause difficulty during an
MRI exam. If you suspect that you
may have a problem, please contact
your doctor so that he/she may
prescribe a medication that will
help you relax and relieve anxiety.
Is MRI painful?
The MRI exam is not painful, but you
may be given an intravenous
injection during your scan to allow
for better visualization of certain
body structures. The contrast
injection may be slightly painful,
but the medication does not produce
any sensations.
What are some uses of MRI?
MRI gives unparallel quality in
imaging the brain, spine, bones and
joints. The clarity is superior and
enables the physician to diagnose
very small abnormalities.
Is MRI safe?
Because MRI uses no X-rays, it
presents no apparent health hazards.
If you are pregnant or nursing,
please consult your doctor before
having the exam.
EXAM
PREPARATION
How do I prepare
for an MRI?
Wear comfortable clothing with no
metallic buttons, zippers, or hooks
or you will be asked to change into
a gown. You may be asked to not eat
or drink two hours before the exam
if it is ordered "with contrast."
You will need to remove all metal
objects from your body. Glasses,
dentures, hearing aids, jewelry,
credit cards and barrettes will need
to be removed prior to the exam.
Who can have an MRI?
Anyone can have a MRI except those
with the following conditions: Heart
pacemaker, history of metal in your
body (except dental work),
artificial heart valves, previous
brain aneurysm surgery, and severe
claustrophobia. If you fall under
any one of these categories, please
consult with the MRI technologist
prior to the exam.
MRA
What is MRA?
Magnetic Resonance Angiography is an
imaging method used to visualize
certain blood vessels in the body.
It is used as an alternative to
angiography, which requires needles
and catheters to be inserted into
the vessels. MRA is painless and is
used to visualize blood flow in the
head, neck, aortic arch, kidneys and
femoral arteries.
How long does the exam last?
Most MRAs last anywhere from 45
minutes to two hours depending on
the exam. It is very important that
you remain absolutely still during
the entire exam.
Is there any preparation involved?
There is no preparation needed for a
MRA.
Why is MRA useful?
It provides a high quality tool for
the radiologist to make a diagnosis
of vessel disease. It shows
abnormalities, such as stenosis
(narrowing of a vessel) or aneurysm.
It is a safe alternative to
angiography, which is a surgical way
to examine the blood vessels using
iodine contrast.
CAT SCAN
What is a CAT
Scan?
A Computed Axial Tomography scan is
a test that combines X-rays with
digital computer technology. The
X-ray beam rotates around the
patient and the many different
angles are used to create
cross-sectional images of the
patient's body. These images are
formed into a 2D or 3D image that
has superior soft tissue and bone
detail.
What can I expect during a CAT scan?
The scanner consists of a larger
donut-shaped machine and a table
that moves through the middle of it.
The exam takes about 15 minutes and
you will be asked to lie very still.
You will be given breathing
instructions and may have to drink a
contrast agent or have it injected
into your vein.
Is a CT scan painful?
No, you will be made as comfortable
as possible.
Why is a CT scan useful?
It produces high quality images of
the head, spine, chest, abdomen and
pelvis. It determines size and
location of organs, tumors or
infections. It also is useful as a
follow up tool in cancer patients.
What is Dye?
Iodine contrast is an intravenous
media used to delineate certain
areas of the body. You may feel a
warm sensation as it is being
injected. There is no pain involved
except for the needle stick during
the injection. There are a few
instances of allergic reaction, but
please let the technologist know if
you experience any of the following:
itching, swelling, hives,
nausea/vomiting, and shortness of
breath or chest pain. If you have
ever experienced an allergic
reaction to iodine, please let the
technologist know before the exam
begins.
What is a bone density scan?
Quantitative Computed Tomography (QCT)
is performed on the lower spine to
determine the level of calcium
content in the bones. The computer
evaluates the bone density for the
patient's age and the radiologist
will report if the patient has
osteoporosis. Since there are new
treatments for osteoporosis, QCT can
be used as a screening exam yearly
to detect any improvement in bone
density.
EXAM PREPARATION
How will I prepare for the exam? Let
the technologist know ahead of time
if you are pregnant, diabetic, have
sickle cell disease, kidney failure
or are allergic to iodine contrast.
The following preps are listed:
- Head -
nothing to eat or drink two
hours prior to the exam.
- Sinus - No
preparation.
- Spine - No
preparation.
- Soft tissue
neck - nothing to eat or drink
two hours prior to the exam.
- Chest -
nothing to eat or drink two
hours prior to the exam.
- Abdomen-You
will need to pick Barium up from
the hospital in advance. For
those patients with morning
appointments - nothing to eat or
drink after midnight. Drink half
the bottle of Barium one hour
prior to exam. Drink a half
bottle immediately before the
exam. Afternoon appointments -
Early breakfast. Nothing to eat
or drink afterward. Drink a half
bottle of Barium one hour prior
to exam and half bottle
immediately before the exam.
-
Abdomen/Pelvis - Follow the
abdomen only instructions.
However, drink half of the
Barium bottle 6-8 hours before
the scan and half the bottle one
hour prior to the exam. Nothing
to eat or drink six hours before
the exam.
- Pelvis only -
Drink one whole bottle 6-8 hours
before exam. Do not eat or drink
anything six hours before the
exam.
- Bone density
scan - No preparation.
- CT guided
biopsy - Nothing to eat or drink
after midnight.
- Any extremity
or bone - No preparation.
What is CT
guided biopsy?
The insertion of
a biopsy needle into a
particular tissue in order to
obtain a tissue sample. The
position of the needle is guided
by CT imaging to determine exact location(s) of the tissue in
question.
Why do I need a biopsy?
Some tissue abnormalities are
difficult to distinguish;
therefore, it is important to
obtain a tissue sample and have
it analyzed in the lab. Some
infections, cysts, or
inflammations may show up that
are indistinguishable from
cancer.
What are the risks involved?
- Bleeding
- small risk because of the
needle puncture.
-
Pneumothroax - this partial
or whole collapse of the
lung can occur when a needle
is passed through lung
tissue. The risk is higher
with people who have lung
disease. If this happens, a
tube will be inserted
through your side into your
lung to evacuate the air
leak until it is sealed.
- Infection
- very rare, but can be
introduced into the body
cavity from germs on the
outside of the skin.
How can
the risks be decreased?
Please let us know if you
have any history of
irregular bleeding. Your
bleeding time also will be
checked prior to the exam by
having blood drawn. Do not
take aspirin containing
medicines such as Motrin. Do
not take Coumadine (blood
thinner) prior to the
procedure. Please consult
with your doctor before
stopping any prescription
medicine.
Is a biopsy painful?
Most pain is usually avoided
by using conscious sedation
and a local anesthetic. The
injection of the anesthetic
may cause a slight
discomfort but will soon be
relieved.
How long does a biopsy take?
Most biopsies require the
patient to arrive in the
outpatient surgery
department at least one hour
prior to the biopsy. The
patient will be assessed and
given the sedation
medication. The procedure
itself usually takes about
one hour and the normal
recovery time is about two
hours for most biopsies.
Lung biopsies require a
longer recovery time of
about four hours if there
are no complications.
NUCLEAR
MEDICINE
What
is a Nuclear Medicine
Scan?
A Nuclear Medicine
Scan is a procedure that
uses small amounts of
radioactive material to
diagnose or treat a
disease. The radioactive
tracer is injected
intravenously into the
patient and a special
device called a gamma
camera detects the
radiation emitted by the
patient's body. The
information is then used
to form an image.
What does it show?
It shows the function of
the organ being studied.
Many abnormalities can
be detected in the early
stages before it has had
a chance to progress to
a level that can be
imaged by other areas.
Does the procedure hurt?
The scan is not painful
although the injection
of the radioactive
isotope may be
uncomfortable.
What is a radioisotope?
Radioisotope is
radioactive material
that is injected. It
consists of tiny
particles with a tracer
that is specific to the
body part being studied.
The radioactive dose
received by the patient
is very small and
comparable to many X-ray
procedures. The tracer
material is eliminated
from the body in a day
or two.
What can I expect?
The nuclear medicine
technologist will
position you on the
imaging table. The
radioisotope will then
be injected or taken
orally. Most scans
require several images
and you may be asked to
move into different
positions during the
scan. The machine will
come very close to you
but it is very important
not to move. The machine
resembles a large donut
with the scanning table
in the middle.
Why are some scans
longer than others?
Depending on the organ
that is studied, the
tracer is absorbed more
slowly into some body
parts. Some exams
require a wait between
the time of the
injection and the time
of the scan.
Where do you give the
injection, and will I
have any side effects?
The injection is given
into a vein in the arm,
much like having your
blood drawn. You will
not feel the injection
of the isotope. Side
effects are very rare.
EXAM PREPARATION
How do I prepare for my
exam?
Exam preps are as
follows:
-
MUGA (ventriculography,
gated blood pool
scans): no
preparation, exam
takes about one
hour.
-
Bone scan: Normal
diet, but drink
32-48 ounces of
water between
injection time and
scan time. Exam
length is
approximately 30
minutes.
-
Spect: No
preparation, exam
length 20 minutes.
-
Thyroid - Nothing to
eat or drink four
hours prior to
exam. X-ray
procedures
containing iodine
are prohibited for
eight weeks and
thyroid medications
aren’t allowed for
six weeks. It takes
two days to complete
this scan. Day 1 -
15 minutes in the
morning, one hour in
the afternoon. Day 2
- 15 minutes in the
morning. Patient may
eat at noon and
after on the first
day.
-
Lung: No
preparation, exam
length 30-45
minutes.
-
Liver/sleen: No
preparation, exam
length 30 minutes.
-
Liver hemangioma: No
preparation, scan is
completed about four
hours after the time
of injection. Exam
time is one hour.
-
Gallium: May have to
take laxatives the
night before exam to
clean the colon.
(Technologist will
instruct). This exam
takes 1-4 days to
complete. Day 1 -
Injection of
isotope. Day 2 -
scan length one
hour. Day 3 - scan
length one hour. Day
4 - not likely to
happen, but could be
one hour.
-
White blood cell
localization: no
preparation. You
should plan to spend
most of the day in
the department.
Blood will be drawn
early that morning
and you will be
ready for another
injection and scan
about six hours
later. The scan will
take about two
hours.
-
Captopril renal
scan: Patient needs
to be well hydrated.
Do not take any
blood pressure
medications the
night before the
exam, no diuretics (Lasix)
the morning of the
exam. No ACE
inhibitors for 24
hours prior to the
exam. List of ACE
inhibitors: Lotensin,
Capoten, Vasotec,
Monopril, Prinivil,
Univasc, Accupril,
Altace. Scan time is
two hours for
Captopril scan. Scan
time is one hour for
baseline renal scan.
-
Venogram: No
preparation. Exam
length approximately
two hours.
-
DMSA renal scan: No
preparation. Two
hour wait for
injection. Scan
length is one hour.
-
Bile Duct: Nothing
to eat or drink 6-8
hours before scan.
No gum chewing or
smoking. Exam length
is approximately 1-2
hours.
-
Iodine Therapy 131:
Nothing to eat or
drink four hours
prior to the exam.
Exam time is 15
minutes.
-
Thallium or
Sestamibi (Mibi)
Scan: Nothing to eat
or drink four hours
prior to scan. See
section under
Cardiac Studies.
Preparation for this
exam can be
extensive. Some
medications may need
to be withheld
before the exam.
Plan to spend most
of the day for your
test. The test is
administered in two
parts. Part one
takes about 1.5
hours, and Part 2
will be about 3-4
hours later and will
take approximately 30
minutes.
-
GI bleeding scan: No
preparation.
What can I expect
from my exam? A
complete list of
exam descriptions
follows:
-
MUGA (Ventriculography,
gated blood
pool) Used to
measure the
heart's function
by determining
the ejection
fraction. This
is the
percentage of
blood that is
ejected from the
heart with each
beat. Blood will
be drawn from
the patient and
a small amount
of radioactive
material will be
mixed with it.
It will then be
reinjected into
the bloodstream.
You will have
EKG patches put
on your chest
and small wires
will be
connected that
measure your
heartbeats. You
will be placed
on the imaging
table for about
one hour while
the area is
scanned.
-
Bone scan - Used
to determine
bone cancer,
fractures, sport
injuries,
arthritis, and
osteomyelitis
(bone
infection).
-
You will be
given an
injection of a
small amount of
radioactive
isotope. The
scan will follow
three hours
later. You will
need to lie very
still on the
imaging table
for about 20
minutes while
pictures are
taken.
-
Spect scan -
This test is
usually done in
combination with
another scan to
obtain cross
sectional images
that are similar
to a CAT scan.
It does not
require any
additional
injections, but
may add another
20 minutes to
your scan time.
-
Thyroid Scan and
Uptake - This
test measures
thyroid
function. It
also may be used
to diagnose
causes of
thyroid swelling
or trouble
swallowing. You
will be given a
radioactive
iodine pill in
the morning. You
will return
about six hours
later for a scan
and uptake
measurement.
This takes a
little more than
one hour. You
will return the
next morning for
the uptake only.
The uptake
measures how
well your
thyroid is
working. This
is accomplished
by placing a
metal probe
close to your
neck, which
detects the
radioactivity.
This second part
of the exam only
takes about 15
minutes.
-
Lung scan - Used
to determine if
there are blood
clots (pulmonary
emboli) in the
lungs. The lung
scan consists of
two parts Part 1
- Ventilation -
requires you to
breathe
radioactive gas
through a tube
for about 10
minutes. It
reveals how
air is moving
through the
lungs. You will
be scanned
afterward for
about 15
minutes. Part 2
- perfusion -
requires an
injection. It
determines if
blood is flowing
normally through
the lungs.
Scanning takes
an additional 15
minutes.
-
Liver/Spleen
scan - Used to
detect masses,
abscesses, or
cirrhosis of the
liver. It
measures liver
and spleen size.
You will receive
an injection and
30 minutes later
the scan will
begin. You will
lie very still
on the scanning
table. It takes
about 30 minutes
to perform the
scan.
-
Liver hemangioma
scan - Used to
determine if a
liver tumor is
benign (noncancerous).
You will have
blood drawn,
which is added
to a small
amount of
radioactive
material. It is
reinjected back
into the
bloodstream and
a scan is
performed
immediately
after the
injection and
again about 3-4
hours after
injection. Total
scan time is
about one hour.
-
Gallium scan -
Used to detect
tumors,
infection or
inflammation.
This scan will
take 3-4 hours
to complete. Day
1 consists of an
injection only.
Day 2, 3 and 4
consists of a
scan that lasts
about one hour
each. You will
lie still on the
image table each
time.
-
White blood cell
localization -
This scan is
done to look for
infection. White
blood cells
fight infection
and this scan
detects where
large amounts of
white blood
cells are
located within
your body. You
will have your
blood drawn and
it will be mixed
with a small
amount of
radioactive
material. It
will be
reinjected 4-6
hours later. A
scan will follow
30 minutes and 2
hours after
reinjection.
Each scan takes
about 30
minutes.
-
Renal scan (Captopril
or Baseline) -
Used to diagnose
kidney blockage
or urine flow,
abnormal kidney
function, and
causes of high
blood pressure.
If you are
having a
Captopril Renal
scan you will be
given a Capoten
pill one hour
before the
procedure. Your
blood pressure
will be
constantly
monitored since
this is a highly
effective blood
pressure
medication. This
type of scan is
conducted to
determine the
cause of high
blood pressure.
You will then be
given an
injection of a
radioactive
material and
scanned for 30
minutes. If you
are having a
baseline renal
scan then you
will be given an
injection and
scanned for 30
minutes. No
Capoten pill
will be given.
Please be sure
to follow proper
preparation
prior to the
scan.
-
DMSA renal scan
- Used to
diagnose causes
of kidney
infection. It is
usually only
performed on
children. The
radioactive
material will be
administered and
the scan
follows. The
child may need a
mild sedative
during the
procedure.
Parents or
family members
can stay with
the child during
the procedure.
-
Venogram - used
to determine if
a blood clot in
the leg is new
(acute) or old
(chronic). A new
clot needs
instant
attention and
must be
diagnosed
properly. This
scan will be
performed with
the patient on
the scanning
table. An
injection will
be given and
pictures will be
made of the
legs. The
patient must
hold still
during the
procedure. The
scan is done in
two parts: one
part takes
approximately 10
minutes
following the
injection. One
at 90 minutes
after the
injection.
-
Bile Duct scan -
This scan is
performed to
determine if the
gallbladder and
the associated
bile ducts are
working
correctly. A
normal
(non-diseased)
gallbladder
should contract
when prompted
and empty the
bile into the
bowel. This
helps to digest
foods. The
patient will
receive an IV
for this
procedure
because several
injections will
be given. After
injection,
pictures will be
taken every 15
minutes for one
hour. This
injection allows
physicians to
clearly see the
gallbladder.
When it becomes
full, another
injection (Kinevac)
will be
administered.
This causes the
gallbladder to
contract.
Kinevac can
sometimes cause
abdominal pain
and cramping,
but it will be
injected very
slowly to avoid
these side
effects. If a
gallbladder is
sick, then it
will not
contract
normally, but
this function
will be measured
after the exam
is completed.
Not all bile
duct scans
require the use
of Kinevac, but
the scan time
will still last
between one and
two hours.
Occasionally
some patients
have to return
several hours
later for a
follow up scan.
-
I
131 Therapy -
This radioactive
pill is given to
reduce the
function of the
thyroid gland in
cases of over
activity
permanently.
There is no scan
involved for
this test and
you may leave
soon after the
pill is given.
-
GI bleed - This
test determines
the cause of
gastrointestinal
bleeding. It
requires an
injection of
radioactive
material and the
scan follows
immediately.
Several pictures
will be taken
during a one to
two hour period
and the patient
may have to
return several
hours later for
a follow up
scan.
-
Thallium or
Sestamibi (Mibi)
scan - This test
is conducted to
determine if
there is chronic
damage to the
heart or if
there is a
blockage in a
coronary artery
resulting in
decreased blood
flow to the
heart. This is
called ischemia.
This scan is
performed in two
parts: Part 1 -
If you are able
to walk on a
treadmill - an
IV will be
started and an
EKG (monitor of
heart rhythm
with patches
that are stuck
on your chest
with wires
connected to
them) will be
performed. You
will be asked to
start walking on
the treadmill
with a
cardiologist
(heart doctor)
present. The
radioactive
material will be
injected and you
will be scanned
soon afterwards.
This images your
heart in the
stress or
working phase.
Part 1 if you
are unable to
walk on a
treadmill -you
will be given a
medication as an
alternative to
walking. It will
speed up your
heart and make
it work. You
will have an IV
and an EKG.
Images will be
recorded. You
will return 3-4
hours later for
an additional
scan. Another
injection will
be given at that
time. You will
be asked to lie
on the imaging
table for about
20 minutes each
time for the
scan. You also
will need to
keep your arms
above your head.
The technologist
will make you as
comfortable as
possible. For
more cardiac
information,
please see the
section on
cardiac studies.
CARDIAC STUDIES
A cardiac
(heart)
study is
conducted to
evaluate the
blood supply
to the heart
muscle. The
heart
receives
blood from
the coronary
arteries. If
these
arteries
become
blocked or
clogged by
plaque, the
heart may
not receive
adequate
blood
supply. As a
result, a
person may
experience
chest pain,
while others
may not
experience
any symptoms
related to
the
condition.
Whether or
not symptoms
are present,
the results
are the
same—damage
to the heart
muscle.
What should
I wear the
day of the
exam?
You
should wear
a
comfortable
two-piece
outfit. You
will
probably be
asked to
replace the
top portion
of clothing
with a
hospital
gown. If
you are able
to exercise
on the
treadmill,
you will
need to wear
comfortable
walking
shoes.
What if I
cannot walk
on the
treadmill?
If you have
a physical
disability
that
prevents you
from
exercising
on the
treadmill,
your doctor
will order a
medication
for you that
is an
alternative
to exercise.
This is
called Persantine,
Adenosine,
Dobutamine
or
Arbutamine.
Persantine
is the most
common
agent. There
are some
risks and
side effects
to using
these
agents. It
will be
described to
you in
detail the
day of the
exam and you
will be
asked to
sign a
consent form
stating that
you
understand
the side
effects and
risks of the
medications.
Side effects
may include
nausea,
vomiting,
headache or
chest pain.
If you
experience
any of these
during the
procedure,
please let
the
cardiologist
know so that
he/she can
administer a
drug that
will reverse
the effect
of the
medication.
What can I
expect from
the test?
Several
small sticky
pads will be
placed on
your chest
and lines
will be
connected to
them to
monitor your
heart rhythm
(EKG). An
intravenous
line will be
placed in
your arm to
provide a
way to
inject the
different
agents used
during the
exam. You
will then
exercise on
the
treadmill or
be given the
medication
as an
alternative.
Then,
imaging will
begin. The
image
portion will
take about
20 minutes.
Your IV line
will be left
in place and
you will
return 3-4
hours later
for another
injection
and scan.
How will I
prepare for
the test?
You will be
asked to not
eat or drink
anything 3-4
hours before
the test.
This is to
prevent
nausea,
which may
accompany
vigorous
exercise.
Your doctor
also may
temporarily
stop certain
heart
medications
prior to the
test. Some
heart
medications
may alter
the accuracy
of the exam.
What
medications
should be
stopped
prior to the
test?
Never
stop a
medication
without
permission
from you
doctor. If
you are able
to exercise
on the
treadmill
during the
test, you
should stop
any antiarrythmic
(irregular
heart beat)
medicine
after
midnight the
night
before. This
includes
Atenylol or
Tenormin.
This
medicine
keeps the
heart from
reaching the
target heart
rate on the
treadmill.
If you are
not able to
exercise on
the
treadmill,
the list of
medications
to stop is
more
extensive:
no food or
beverages
containing
caffeine
after
midnight
should be
taken. No
Anacin,
Excedrin, No
Doz,
Wigraine
(all contain
caffeine).
Don't take
any of these
medicines
after
midnight.
Breathing
medicines
for asthma
or chronic
breathing
problems,
such as
theophylline
or
aminophylline
should not
be taken
36-48 hours
prior to the
test. List
of
theophylline
medications
are:
Aerolate,
Bronkodyl,
Constant T,
Elixophylline
SR Quibron,
Respbid, Slo
Bid, Slo
Phyllin,
Sustaire,
Theo 24,
TheoDur,
Theobid,
Theochron,
Theoclear,
Theolair,
Theospan,
Theovent,
Uniphy.
Please
contact your
doctor if
you are
unable to
discontinue
breathing
medications
for this
amount of
time.
GENERAL
RADIOLOGY
PROCEDURES
GENERAL
INFORMATION
What are
X-ray
studies?
X-ray or
diagnostic
radiology
covers a
wide area of
exams.
Basically,
it consists
of an exam
that uses
small
amounts of
radiation
that pass
through the
body and
strikes a
sheet of
X-ray film.
The
thickness of
the body
part
determines
the
shadowing or
contrast and
density of
the image on
the film.
Since bone
is dense, it
does not let
much
radiation
pass through
to the film.
This causes
it to be
white on the
image.
Lungs, which
are mostly
air, let
almost all
of the
radiation
pass, which
results in a
black area
on the film.
These areas
of varying
shades
produce an
image that
allows
radiologists
(X-ray
doctor) to
interpret
what the
inside of
the body
looks like.
Are X-rays
safe?
While
large
amounts of
radiation
may post a
health risk,
the small
amounts used
in
diagnostic
radiology
clearly
shows the
benefits far
outweigh the
risks. Radiologic
technologists
and
radiologists
are trained
in radiation
physics and
radiation
biology and
strive to
administer
radiation
safety. New
advances in
equipment
and improved
film quality
have
resulted in
less
exposure per
exam.
How is
barium used
and what is
its purpose?
Barium given
orally or
rectally
allows for
visualization
of the
esophagus,
stomach and
bowel. It is
a thick
white liquid
that is
chalky in
appearance.
Sometimes
air is added
to see the
lining of
these
structures.
Any study
utilizing
barium is
called a
fluoroscopic
study. When
barium is
used for any
study, the
patient must
drink extra
liquids and
take a mild
laxative
afterward to
clear it
from the
body system.
What is
X-ray dye?
Iodine
contrast is
sometimes
used to
visualize
certain
blood
vessels or
the urinary
system. It
may be used
to diagnose
a blockage
in a vessel
or a stone
in the
urinary
system.
Iodine
contrast may
be given
intravenously
(in a vein)
or in an
artery.
Iodine
contrast is
not painful
in most
cases, but
may cause a
warm
sensation
upon
injection.
If you have
an allergy
to iodine,
kidney
failure,
sickle cell
disease or
diabetes,
please
inform the
technologist
before
having your
exam.
What is
fluoroscopy?
Fluoroscopy
is a type of
X-ray that
allows the
radiologist
to view the
studied body
part in
"real time."
The image is
displayed
digitally on
a
high-resolution
TV monitor.
EXAM
PREPARATION
How do I
prepare for
my exam?
IVP - extra
fluids and
a light
evening meal
the night
before the
exam. Take
two ounces
of oral
fleets or
one bottle
of magnesium
citrate at 6
p.m. the
night before
your exam.
Drink extra
fluids until
midnight.
Nothing to
eat or drink
afterward.
Upper GI,
SBFT (small
bowel follow
through) -
No food or
drinks after
midnight.
Barium enema
- the
preparation
material can
be bought as
a kit (Fleet
prep kit).
Patient
should have
extra fluids
and a liquid
meal the
night before
exam. Liquid
meals
contain no
milk
products, no
Jell-O and
solid foods.
You may have
strained
soups and
juices. 1.5
ounces of
fleets (or
one bottle
of magnesium
citrate) at
6 p.m. Four
fleet
tablets (or
three
Dulcolax
tablets) at
9 p.m., and
one fleet
suppository
at 6 a.m.
the morning
of the exam.
No food or
drinks after
midnight.
Hysterosalpingogram
- exam
should be
performed
between six
and 11 days
after
menstruation.
Patient must
have a
negative
pregnancy
test less
than two
weeks old.
Patient must
have no
ongoing
pelvic
infection.
Myelogram -
(see section
on
Interventional
Radiology)
Nothing to
eat or drink
after
midnight. No
Compozine or
Thorazine
medications
for 24 hours
prior to
test, or 48
hours
afterward.
Patient will
have bed
rest all
day. No
driving, or
lifting for
one week.
Recovery
time is 3-5
hours.
Anteriogram
- (see
section on
Interventional
Radiology).
Nothing to
eat or drink
after
midnight. No
aspirin
containing
medications
for ten days
prior to
exam. Plan
to stay in
the hospital
for one day
for recovery
time.
Venogram
-Nothing to
eat or drink
for four
hours prior
to exam.
Arthrogram -
Nothing to
eat or drink
for four
hours prior
to exam.
EXAM LENGTH AND
SCHEDULING
What exams
must be
scheduled
and how long
does it
take?
-
Esophagram
- 20
minutes
-
Upper
GI-20
minutes
-
Small
bowel
follow
through
- 1.5 to
2 hours
-
Barium
Enema-one
hour
-
Voiding
cystogram-30
minutes
(30 min.
preparation
time)
-
Intravenous
Pyelogram
(IVP)-one
to two
hours
-
Tomograms-30
minutes
-
Hysterosalpingogram-one
hour
-
Snif
test-15
minutes
-
Venogram-one
hour
-
Myelogram-one
hour
(one
hour
preparation
time and
about
four
hours of
recovery
time)
-
Arthrogram-one
hour
-
Arteriogram-two
or more
hours
(1-2
hour
preparation
time and
8-12
hours of
recovery
time)
EXAM
DESCRIPTIONS
What
can
I
expect
from
my
exam?
- Esophagram, Upper GI - The radiologist will have you drink 1-2 cups of barium while standing. Pictures will be taken while you are drinking. You will then lie down and follow the instructions from the radiologist, while he/she is taking pictures. This exam shows the inside of the esophagus and the stomach. Be sure to drink extra fluids for a couple of days after the exam.
- Small bowel follow through - You will drink two cups of barium and then lie down on the X-ray table. The technologist will take one picture every 15 minutes for up to one or 1.5 hours. The radiologist will take special pictures afterward with the fluoroscope. This test shows small intestinal abnormalities. Be sure to drink extra fluids for a couple of days after the exam.
- Barium Enema - You will be asked to change into an X-ray gown and remove all your underclothes. After you lie down on the X-ray table, a small enema tip will be inserted into you rectum and left there for the exam. This enema tip will allow us to fill your colon with barium and possibly some air. The radiologist will take pictures with the fluoroscope and the technologist will take several more afterward. You will change positions frequently and the exam can be quite uncomfortable for some people, but we move as fast as possible and still provide a quality exam. This exam is used to evaluate the entire colon.
- Voiding Cystogram - you will need to arrive in outpatient surgery one hour prior to the exam time to be catheterized (insert a small tube into the urethra). During the exam, the technologist will fill your bladder with iodine contrast until you are very full and then the catheter will be removed. Several pictures will be taken. A small urinal device will be placed between your legs to empty the contrast. You will be kept covered and pictures will be made while the bladder is emptying. Every effort will be made to protect your privacy during this exam. This exam is usually conducted for recurrent urinary tract infections and will show if there is reflux of urine into the ureters. The bladder's ability to empty effectively will be evaluated. This exam is not painful, but the introduction of the catheter into the bladder may be uncomfortable.
- Intravenous Pyelogram (IVP) - You will be asked to lie on an X-ray table and will be given an injection of iodine contrast. Pictures will be taken every few minutes and you may be asked to change positions occasionally. You will need to empty your bladder before and after the exam. This exam is used to study the kidneys, ureters and the bladder. It is not painful, but the needle stick for the injection may be slightly painful.
- Tomograms - This exam is frequently used in conjunction with an IVP or may be performed as a separate exam on certain joints. You will lie still on an X-ray table while pictures are taken. The machine will be moving above you during each picture. If you have tomograms of your kidneys, a band will be placed around your abdomen with a small balloon device in the front. The purpose of this is to compress your ureters in order to highlight your kidneys better. This exam is not painful. Tomograms allow us to see the studied organ in small cross sectional detail.
- Hysterosalpingogram (HSG) - This is much like a pelvic exam in that a speculum will be inserted into your vagina. The radiologist will place a small catheter through the cervix into the uterus. A small amount of iodine contrast will be injected through the catheter to fill the fallopian tubes, then, several pictures will be taken. This exam evaluates the patency of the uterus and fallopian tubes. Exam ranges from slight discomfort to moderate pain. The patient may bleed slightly afterward.
- SNIF Test - The radiologist will fluoroscope you while you make "sniffing" motions. This evaluates the movement of the diaphragm (the muscle between your lungs and abdomen) and is used to rule out paralysis of that muscle.
- Venogram - These are usually performed on the leg or the arm. An IV will be placed on the lowest part of the arm or leg and iodine contrast will be injected and studied fluoroscopically. It evaluates the vein in question to rule out blockage. While the exam is not painful, placement of the IV may be a little uncomfortable.
- Myelogram - You will be placed on your stomach and your lower back will be surgically draped and cleaned with antiseptic solution. A local anesthetic will be given by the radiologist in the lower back to relieve the pain of the spinal needle that will be inserted. Some pressure will be felt during insertion, but usually no pain. Once the contrast is in the spinal canal, images will be taken. This exam shows any stenosis or squeezing of the spinal cord by bulging disks or bone. You will have 3-5 hours of recovery time and will be asked to lie on your back with your head elevated during recovery. You may not drive home, and no lifting for one week. Some myelograms require a CAT scan afterward to confirm the initial diagnosis.
- Anthrogram - This exam is usually done on the shoulder joint. You will lie on your back for the exam. Antiseptic solution will be used to clean the area and an anesthetic will be given to lessen the pain caused by the injection of the contrast in the shoulder joint. The patient may feel some pain or pressure in the joint afterward for several hours after the exam. This test shows if there is a tear of the rotator cuff or if any parts of the shoulder are rubbing together.
- Anteriogram – The patient usually is admitted for 23 hours observation. The patient is sedated and covered with sterile drapes and the groin area is surgically prepared. A catheter will be inserted into an artery in the groin area. This is the area where the hip bends when flexed. The catheter will follow the artery up into the body until it reaches the area of interest. Iodine contrast will be injected while pictures are taken to evaluate patency of the arteries. This exam is uncomfortable, but usually not painful. You will be required to have bed rest for the remainder of the day and will not be able to bend the leg that the catheter was inserted into in order to let the injection site heal and to prevent blood clots.
INTERVENTIONAL RADIOLOGY
GENERAL INFORMATION
What is interventional radiology?
An area of radiology that is frequently called special procedures. The goal is to simplify or improve the treatment of many conditions, previously managed surgically, that decreases length and cost of hospitalization (examples: removal of bile duct stones, abscess drainage, clearing blockages in bowels or vessels).
What is a special procedure?
The special procedures performed at our facility are conducted in a state of the art totally digital fluoroscopy room. Some examples of the procedures that we do are arteriograms, biopsies, abscess drainages, percutaneous nephrostomies, or basically any procedure in which a foreign material is introduced into the body. There are risks involved for all types of invasive procedures. Preparation time and recovery time may vary for each procedure.
What are the risks?
Although the risks are small in most cases, they should be discussed thoroughly by you and your doctor, technologist and/or the radiologist. The risks may include bleeding, infection, allergic reaction, paralysis, lung collapse (lung biopsies only), or even death. Complications are rare. You will be able to consent to the procedure after being informed of the potential risks. This is called "informed consent.” This does not release anyone from liability, but your signature shows that the risks were explained to you. Informed consent is required for all invasive procedures either verbally or in a written communication.
How do I prepare for a special procedure?
You will need to bring your orders to the hospital anywhere from one to seven days prior to your exam to pre-admit. All necessary paperwork and pre-exam lab work will be completed then. The day of the exam you will need to arrive one hour prior to the procedure in outpatient surgery. The nurses will evaluate you; start an IV if needed, give any pre-procedure pre-op medications that have been ordered. Be sure to follow any directions for eating and taking certain medications for your particular exam (See exam preparations).
|
