Diagnostics (X-Ray)

 

Learn what an X-ray is and what to expect when getting one.

 

A general X-ray is of course the most common type of X-ray. The exams can vary from a common chest X-ray to evaluate whether you have pneumonia, to an X-ray of a bone to determine whether you have a fracture.

Radiation is utilized for these types of X-rays and the diagnostic information is very valuable in determining the type of treatment your physician will choose for you.

If you are scheduled to have an X-ray and are uncomfortable about it, contact your physician for questions about how this will help in your treatment.

Cerebral Angiography and Myelogram

A cerebral angiogram is an X-ray that shows the blood vessels in the head. In order to see these blood vessels, doctors must inject a dye that provides contrast. They deliver the dye through a thin tube, called a catheter into a vein in the arm, leg or the neck.

The purpose of a cerebral angiogram is to detect problems with the blood vessels. These include:

  • Aneurysms which is a sac in the vessel wall that could burst
  • Malformations
  • Blood clots
  • Unusual narrowing or blockage
  • Follow-up on surgery
  • Changes due to a tumor, internal bleeding or swelling

The person must not eat for 8 to 10 hours before the test. Most people are awake during the procedure. Some people (especially children) receive a general anesthetic. Others may need a mild sedative to relax.

The test can last from 30 minutes to a few hours. Some people are sensitive to the dye. The dye may cause warm feelings, flushed face, temporary headache, salty taste, or nausea and vomiting.

The patient lies on an X-ray table while a device holds his head still. The most common site to inject the dye is the leg. A local anesthetic numbs this site. The healthcare provider then inserts a needle into an artery. The catheter is then moved toward the head. The dye is injected and moves through the vessels that supply the brain. At the same time, X-rays are taken. Images are viewed on a TV monitor or transferred to a series of still films.

After the test, the person is typically on bed rest for 12 to 24 hours. Providers closely watch for signs of a blood clot, stroke or neurological problems. These include numbness, tingling, weakness in limbs, vision problems, confusion and dizziness. Signs of delayed reaction to the contrast dye include itching, rash, sweating, or difficulty breathing. The puncture site is treated with ice and firm pressure. If the site was in the leg, it should be kept straight for at least 12 hours. The person should drink plenty of fluids to rid the body of dye. Doctors do not recommend cerebral angiograms for persons with liver, kidney, or thyroid disease.

A detailed exam of the spine is a myelogram. The procedure evaluates abnormalities in the spine such as a ruptured disk.

After a local anesthetic is applied to the area, a needle is inserted between the bones of the spine, where spinal fluid is withdrawn and sent to the laboratory for evaluation. Contrast, also called x-ray dye, is injected through the needle. The patient might be tilted in order to move the contrast up the spine.

X-rays are taken of the area of interest. A CT scan of the spine is completed after the needle is removed and the x-rays are taken.

You will be required to remain at the hospital after the procedure for observation for at least 2 hours and possibly up to 8 hours.

If you have been advised to have a myelogram, ask your physician to help you understand what the test will show and how this can benefit you.

IVP and PTHC

An intravenous pyelogram is an exam that looks at your kidneys, ureters and bladder. Multiple things can be evaluated in performing this procedure. Your physician might be questioning a stone, a stricture, or needs to determine how well the kidney itself is functioning.

Contrast, also called X-ray dye, is injected into a vein in your arm. Most people feel a warm, flushed sensation with this. Multiple X-rays are taken of the kidneys at set intervals. You might be required to use the restroom before taking a final X-ray to determine how well your bladder empties.

Should you have additional questions or concerns, call your physician to help you understand the need for you to have this particular procedure.

Percutaneous (purr-cue-taney-us) transhepatic (trans-hep-pat-tick) cholangiography (co-lan-geography), or PTHC is one of the tests physicians use to study the bile duct. In this test, a contrast material that shows up on X-ray film is injected by needle into the bile duct.

Then a series of X-ray pictures are taken of the contrast material in the bile duct. The information from the X-ray is used to diagnose the cause of upper abdominal pain after gallbladder surgery or unexplained jaundice when a bile duct is obstructed.

To do this test, the patient is given a sedative and placed on an X-ray table that can be tilted at several angles. A long flexible needle is inserted through the skin and liver until it reaches the bile duct, while the physician monitors the progress through X-ray images. The contrast material is injected and a series of X-rays are taken at different angles. Then the needle is removed and a dressing applied.

The procedure itself takes about an hour, but usually the patient must lie down for six hours after the test, which is done in the hospital.

If you are scheduled for PTHC your health care Provider will give you instructions for preparation. You will be asked not to eat for eight hours before the test. You will be given sedatives, antibiotics and a local anesthetic where the needle enters the skin. After the test, call your health care provider if you experience bleeding, swelling or tenderness at the injection site.

Upper GI and Small Bowel Series

An upper gastrointestinal or (GI) series is an X-ray test of the esophagus, stomach. The person swallows a barium mixture. Barium is a white, chalky substance that shows the digestive tract in clear contrast on X-ray. As the barium moves down, fluoroscopy shows the outlines of the organs and their movements. Fluoroscopy uses X-rays, to show movement. Examiners also take still X-rays to record findings.

This test evaluates the following signs and symptoms:

  • Difficulty swallowing
  • Spitting up food
  • Heart burn or gnawing pain
  • Diarrhea
  • Unexplained weight loss
  • Gastrointestinal (GI) bleeding

It helps diagnose hiatal hernia, abnormal pouches, enlarged blood vessels, ulcers, tumors and inflammatory disease. It can also aid the diagnosis of absorption and digestive movement disorders.

The patient receiving the test must not eat, drink or smoke after midnight before the test. The person must also stop many types of oral drugs and antacids. The patient lies on an X-ray table that tilts in various positions. The barium is in a flavored drink similar to a milkshake. Sometimes a small amount of air is also pumped into the stomach to clarify the image. The patients stool will be lightly colored as the barium passes for the nest 24 to 72 hours.

An Upper GI series is a relatively safe test. There is a slight chance of retention of barium. This may lead to obstruction or hardened stools. Individuals who already have obstruction or a puncture in the digestive tract should not have this test.

A small bowel series is a test of the small intestine. Two cups of barium, a white liquid substance, is ingested and still X-rays are taken at irregular intervals lasting from 15 minutes to 2 hours. This can be a long procedure due to the fact that the barium must go completely through the small intestine until it reaches the large intestine. When the barium reaches the large intestine, a few more X-rays are taken and the test is finished.

Mammography

Breast cancer is the most common cancer in women. It is considered a disease of menopausal women, but there are younger women with this problem as well. This is especially true in women with a positive family history.

Mammography is a form of X-ray used to find breast cancers. It is used in two ways, one as a screening test and the other to examine and identified breast lump. A mammogram is a widely available screening tool used to find small breast cancers that can't be felt by exam. The smaller the cancer, the less likely it is to have spread and the better the outcome.

The combination of your monthly self-exam, your health care worker's yearly exam and the mammogram gives the best chance of finding a breast cancer. It is recommended that women between the aged 50 and older have a mammogram every year. Women aged 40 to 44 who are at an increased risk for breast cancer may also require an annual exam.

These include women who have a history of:

  • Smoking
  • Family or personal history of breast cancer
  • Previous pre-cancer of the breast
  • No children, or children at an older age

Getting a mammogram is easy. Many mammography centers have health education videos, and exam models to explain what will be done. You will usually tell your personal health history to a nurse or technician, be brought to a changing room, and from there go to the nearby test room. The machine is large with a platform for your breast. The helper will place your breast here and apply another tray on the breast to press it gently out for a flatter X-ray. It may be uncomfortable, but it allows the X-ray to see more of the tissue deep within your breast. Two or three different views of each breast are taken to check the whole breast. The X-rays are read by a radiologist, and the results are reported to your provider.



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