Fluoroscopy

Before the examination

-check the 2 patient identifiers and bring them into the exam room

-verify the procedure with the patient

-it is extremely important to assess the patient throughly (allergies, medications, all past medical history)

-inform them if any contrast has been ordered(explain all the positive and negative.) Make sure all consents are signed prior to be exam

-explain what the procedure consists of and what will be expected of them to help with the exam

-ask patient to change into a gown(remove all jewelry and necessary clothing)

Modified barium swallow study (MBSS)

-often confused with a Barium Swallow Study

-done to diagnose a swallowing disorder

-this study is done under fluoroscopy and allows the structure in the mouth, throat, and upper esophagus to be seen. It helps visualize how well a patient chews, drinks and swallows different foods and liquids and therefore determine if patient is a risk of aspiration (when food or liquid enters the trachea, possibly entering the lungs)

-patients are fed various texture foods(mixed with barium), thin barium and thick barium throughout the procedure

Barium swallow study (Esophagram)

-is a study (with the use of a contrast agent) that helps visualize the esophagus and assess the swallowing process

-no different thickness; just regular barium

-exam ends once contrast empties into the stomach

Barium swallow study (Esophagram) *DOUBLE CONTRAST

-is similar to an esophagram, except that effervescent material(crystals) is given to the patient aside from the barium

-these gas producing(carbon dioxide) crystals may be mixed in the barium or given before the barium

-gas produced should not be released so it can provide distension and make it easier to see the mucosal lining of the esophagus

-exam ends once contrast reaches the stomach

Upper gastrointestinal series (UGI)

-is an exam performed to see the pharynx, esophagus, stomach and first part of the small intestine (also known as the duodenum)

-exam ends once contrast empties and passes through the duodenum)

Upper gastrointestinal series (UGI) *DOUBLE CONTRAST

-effervescent material (crystals) is given to the patient aside from the barium

-these gas producing (carbon dioxide) crystals may be mixed in the barium or given before the barium

-gas produced should not be released so it can provide distension and mucosal lining of the esophagus

-exam ends once contrast empties and passes through the duodenum

Small bowls series (SBFT)

-is a single contrast study to check the stomach and entire small bowl (small intestine)

-exam ends once contrast reaches the colon ileocecal valve

Barium enema (BE)

-is done to visualize the large colon (large intestine)

-ends when it makes it way to ileocecal value

Barium enema (BE) *DOUBLE CONTRAST

-for a double contrast study, aside from the colon filling with barium, air is pumped into the intestines (provides a detailed view of inner surface of colon)

-extremely important that you only pump the amount of air that the radiologist instructs (when barium is drained, air will also be released so sometimes the enema bags are opened so air is not accumulated and more released)

-barium enema (BE) *COLOSTOMY helps with the application of a new colostomy bag

Intravenous pyelogram

-a radiologic exam that with the use of iodinated contrast, evaluates abnormalities of your kidneys, ureters, bladder, and how efficiently the patient’s system can handle fluid waste

-the contrast is injected intravenously, travels through blood, and is collected in the kidneys and urinary tract

Voiding cystourethrogram (VCUG)

-is an X-ray study of the bladder and urethra

-a Foley catheter is inserted through the urethra into the bladder, helping contrast flow into it

-images are taken from various angles of the bladder and as the patient is voiding (emptying bladder)

-take a “post void” KUB

Cystourethrogram

-is done exactly as a VCUG, except that no “voiding” images are needed

Retrograde urethrogram (RUG)/Urethrogram

-is a procedure mostly commonly in male patients to diagnose urethral pathology

-urethrography is most commonly performed through the injection of contrast into the urethra

-procedure is less invasive than other diagnostic techniques, such as urethroscopy

Lumbar puncture

-also known as spinal tap

-it is a procedure in which a needle is inserted into the spinal canal (subarachnoid space) and collect cerebrospinal fluid (CSF) for diagnostic testing

-the procedure is typically performed using local anesthesia and a sterile technique is used

Myelograms

-imaging examination that allows visualization and evaluation of the spinal cord, the nerve roots and the meninges

-contrast material is injected into the subarachnoid space and with the help of fluoroscopy, the radiologist views the passage of contrast within the subarachnoid space

-in many of these cases, the myelogram may be followed by a CT or MRI scan to better define the anatomy and any abnormalities

T-Tube Cholangiograms

-is a fluoroscopic procedure in which contrast is injected through T-tube, usually inserted during a cholecystectomy when there is a possibility of residual gall stones within the biliary tree

-some doctors prefer the T-tube to be clamped prior to the procedure to allow the bile duct to fill with bile

-air in the bile duct can give false impression of a gallstone

Hysterosalpingogram (HSG)

-an X-ray test that looks at the inside of the uterus, fallopian tubes and the area around them

-contrast material is put through a thin tube that is put through the vagina and into the uterus and images are taken as the contrast passes through the uterus and fallopian tubes

Arthrograms

-is a series of images (using fluoroscopy, CT or MRI) of a joint after injection of a contrast

-the radiologist places a needle into the joint and with the use of contrast, it allows the radiologist to see the soft tissue structures of your joint, such as tendons, ligaments, muscles, cartilage, and joint capsule

-the injection is normally using a local anesthetic

-this study can be done on a hip, knew, ankle, shoulder, elbow, wrist, or jaw

Venograms

-is an examination that uses an injection of contrast material to show how blood flows through the veins

-performed in the X-ray department or in an interventional radiology suite (special procedures suite)

-the physician will insert a needle or catheter into a vein to inject the contrast agent (placement of needle depends upon area of being examined)

-as contrast material flows through the veins being examined, X-rays are taken, and the area is placed in different positions so veins can be seen at different angles