Diagnostic Imaging Continued

X-Ray Views

·       AP (Anteroposterior) = x-ray passes from front to back of patient. Machine is placed at the front of the patient when standing or lying supine (laying on back)

·       PA (Posteroanterior) = x-ray passed from the back to the front of the patient. Machine is placed at the back of the patient when they are in an upright position

·       Lat (lateral) = x-ray view taken from patients left or right side

·       Decubitus = x-ray beam is placed horizontally when patient lays on their side

·       Prosthesis = x-ray view ordered pre-op for patient going to the OR to have hip/knee prosthesis. Tech will x-ray larger portion of bone on either side of the joint as opposed to normal hip/knee x-rays

·       ES (erect & supine) = two different views by having patient standing and laying on their back

The following procedures use contrast mediums;

1)    Angiogram/Arteriogram = examines artery after injection of contrast medium using a catheter into a peripheral vessel such as femoral, carotid, brachial.

2)   Arthrogram = examines joints after a contrast medium is injected into the joint space

3)   Ba Enema = examines lower bowel after barium (a contrast medium) is introduced into the rectum via rectal tube. The tube is left in during the procedure and air is sometimes introduced as a radiolucent so the x-ray can pass through easily

4)   Ba Swallow/U.G.I series = examines the esophagus, stomach and duodenum after the patients swallows barium. S.B.F.T (small bowel follow-through) is frequently ordered with this procedure

5)   Percutaneous Transhepatic Cholangiogram = examines biliary ducts after injecting a contrast medium through a needle into the skin

6)   T-tube Cholangiogram = patient undergoing an open cholecystectomy in OR sometimes has a t-tube inserted for post-op drainage of bile. Biliary ducts are examined post-op after contrast medium is introduced through the tube

7)   Oral Cholecystogram/Gallbladder Series = examines the biliary ducts/gallbladder after an oral contrast medium is ingested the evening before the procedure

8)   Voiding Cystourethrogram = examines the bladder/urethra after a contrast medium is inserted into the bladder via catheter a

9)   Stress Cystourethrogram =  SAME AS ABOVE

10)                   Intravenous Pyelogram = examines the kidneys, ureters, and bladder (KUB) after a contrast medium is injected intravenously

11)  Myelogram = examines the spinal canal (the cavity that runs through each vertebrae which contains the spinal cord) after a contrast medium is injected into the subarachnoid space via lumbar puncture

12)                    Sialogram = examines the salivary ducts after injection of a contrast medium into a duct

13)                    Sinogram = examines the nasal sinuses after filling it with a contrast medium. This is not ordered often as a CAT scan of the sinuses show more details

14)                    Venogram = examines the veins after a contrast medium is injected into the veins

The following radiology procedures need a consent form to be signed;

·       Angiogram/Arteriogram = contrast medium is injected into artery

·       Arthrogram = contrast medium is injected into the joint space

·       IVP (Intravenous Pyelogram) = contrast medium is injected intravenously to exam the KUB (kidney, ureters, bladder)

·       Myelogram = contrast medium is injected via lumbar puncture to exam the spinal column

·       Percutaneous Transhepatic Cholangiogram = contrast medium is injected through a needle into the skin to examine the biliary duct/gallbladder

·       Sialogram = contrast medium is injected into a duct to examine the salivary ducts

·       Venogram = contrast medium is injected into the veins

The following require patient prep;

Angiogram/Arteriogram

a)  Nothing to eat or drink from midnight before exam

b)  Start normal saline I.V. in right arm

c)   Bloodwork to be done in the A.M: INR, PTT, bleeding time

d)  Pulmonary function: vitalograph to be done

e)   Discontinue blood thinners 24 hours prior to exam

Ba Enema

a)  Patient to drink clear fluids for 2 days before exam (clear fluids = tea, coffee, juice, chicken broth, jello, water)

b)  At lunch time the day before exam drink 1 bottle of MAGNESIUM CITRATE

c)   At bedtime the day before exam take 3 DULCOLAX tabs (do not crush/chew)

d)  Morning of exam insert 1 DULCOLAX SUPP into rectum

Barium Series or Stomach or Upper G.I Tract

a)  Light supper

b)  Nothing to eat/drink after midnight before exam

 Oral Cholecystogram (Gallbladder series)

a)            Day before procedure high-fat lunch

b)            Evening meal light & fat-fre

c)             Two hrs after evening meal 8-12 oragrafin depending on weight & sips of water

d)            No other food/drink until after exam (sips of water permitted)

Cystourethrogram

a)  Catheter to be inserted into bladder prior to exam

Intravenous Pyelogram (IVP or drip infusion)

a)  Laxative preceding day (x-prep @1000hrs and 1400hrs) drink several glasses of water after completing x-prep dosage

b)  Light supper

c)   NPO after midnight

Myelogram: non-ionic

a)  Antipsychotics (including phenothiazines) discontinue for at least two days before procedure

b)  Patient should be well hydrated up to 3 hours prior to exam with clear fluids

c)   No solid food for 8 hours prior to exam

Venogram

a)  Fasting 4 hours prior to exam

Booking Times for Radiology

Radiology procedures that require a contrast medium or take longer to perform require a booking time

·      Angiogram/arteriogram

·      Arthrogram

·      Ba Enema

·      Ba Swallow/UGI series

·      Cholangiogram

·      Cholecystogram

·      Cystourethrogram

·      IVP

·      Mammogram

·      Myelogram

·      Sialogram

·      Sinogram

·      Venogram

 The only procedures in radiology that don’t require booking times are routine x-rays