Upper GI Matrix

PA Oblique (RAO): Patient and Part Positioning

• Recumbent, body partially rotated into RAO

• Support head and upper torso

• Flex knees

• Rotated 40-70 degrees depending on body habitus

PA Oblique (RAO): CR, SID, and Respiration Instructions

• CR perpendicular to IR

• Sthenic: CR to duodenal bulb at L1 with 44-55 degree oblique

  • Asthenic: 2 inches below L1 with 40 degree oblique

  • Hypersthenic: 2 inches above L1 with 70 degree oblique

• SID: 40 inches

• Expose on expiration

PA Oblique (RAO): Structures Best Visualized

• Entire stomach and C-loop of duodenum

PA Oblique (RAO): Exposure Factors and Pathology

• kVp: 110-125

  • 90-100 for double contrast

  • 80-90 for water contrast

• Portrait

• Gastric folds

• Demonstrates polyps and ulcers of pylorus, bulb, and C-loop

PA Prone: Patient and Part Position

• Arms raised above

• Support head

• Midsagittal plane aligned to CR and to table

• No rotation

PA Prone: CR, SID, and Respiration Instructions

• CR perpendicular to IR

• Sthenic: CR to duodenal bulb at L1 with 44-55 degree oblique

  • Asthenic: 2 inches below L1 with 40 degree oblique

  • Hypersthenic: 2 inches above L1 with 70 degree oblique

• SID: 40 inches

• Expose on expiration

PA Prone: Structures Best Visualized

• Entire stomach and duodenum

PA Prone: Exposure Factors and Pathology

• kVp: 110-125

  • 90-100 for double contrast

  • 80-90 for water contrast

• Portrait

• Polyps, diverticula, bezors, gastritis in body/pylorus of stomach

Right Lateral: Patient and Part Positioning

• Recumbent right lateral

• Support head

• Shoulders and hip are in true lateral

• IR about iliac crest level

Right Lateral: CR, SID, and Respiration Instructions

• CR perpendicular to IR

• Sthenic: CR to duodenal bulb at L1 with 44-55 degree oblique

  • Asthenic: 2 inches below L1 with 40 degree oblique

  • Hypersthenic: 2 inches above L1 with 70 degree oblique

• SID: 40 inches

• Expose on expiration

Right Lateral: Structures Best Visualized

• Entire stomach and duodenum

• Retrogastric space

• Pylorus stomach

• C-loop of duodenum

Right Lateral: Exposure Factors and Pathology

• kVp: 110-125

  • 90-100 for double contrast

  • 80-90 for water contrast

• Portrait

• Diverticula, tumors, gastric ulcers, and trauma

AP Oblique (LPO): Patient and Part Position

• Recumbent, rotated into LPO

• Rotate from supine with left posterior against IR

• IR about level of iliac crest

AP Oblique (LPO): CR, SID, and Respiration Instructions

• CR perpendicular to IR

• Sthenic: CR to duodenal bulb at L1 with 44-55 degree oblique

  • Asthenic: 2 inches below L1 with 40 degree oblique

  • Hypersthenic: 2 inches above L1 with 70 degree oblique

• SID: 40 inches

• Expose on expiration

AP Oblique (LPO): Structures Best Visualized

• Entire stomach and duodenum

• Full view of duodenum has so superimposition

AP Oblique (LPO): Exposure Factors and Pathology

• kVp: 110-125

  • 90-100 for double contrast

  • 80-90 for water contrast

• Portrait

• Contrast visualizes gastric folds

• Gastritis and ulcers

AP Suipine: Patient and Part Position

• Supine, arms to the side with support for head and knees

• Midsagittal plane aligned to midline of table

• No rotation

• Bottom of IR should be about at level of iliac crest

AP Supine: CR, SID, and Respiration Instructions

• CR perpendicular to IR

• Sthenic: CR to duodenal bulb at L1 with 44-55 degree oblique

  • Asthenic: 2 inches below L1 with 40 degree oblique

  • Hypersthenic: 2 inches above L1 with 70 degree oblique

• SID: 40 inches

• Expose on expiration

AP Supine: Structures Best Visualized

• Entire stomach and duodenum

• Diaphragm and lower lung fields

AP Supine: Exposure Factors and Pathology

• kVp: 110-125

  • 90-100 for double contrast

  • 80-90 for water contrast

• Portrait

• Gastric folds

• Hiatal hernia when trendelenburg