Download Radiology Special Procedures Information Packet

Radiology Special Procedures Information Packet
CT SCAN
What is CT scanning? CT scanning uses a specialized X-Ray to produce detailed
pictures of the body. Physicians schedule CT scans to better understand the effects
of trauma and disease.
CT scanning is usually an easy procedure. Patients lie on a table that moves in and
out of an opening in the CT scanner. Abdominal CT patients may have to hold their
breath for a few seconds. Patients who have CT scans of the head may be asked to
remain very still for a few minutes.
What is CT scanning? CT scanning uses a specialized X-Ray to produce detailed
pictures of the body. Physicians schedule CT scans to better understand the effects
of trauma and disease.
Because metal zippers, snaps and buttons interfere with CT, patients must remove
these items before the scan. Patients may wear a sweatsuit without any metal parts
to avoid wearing a hospital gown.
How do patients prepare for the exam?
Patients who have CT scans of the abdomen or pelvis are required to drink four to six
cups of oral contrast before the CT exam. The oral contrast is a mixture of fruit juice
and an iodine-containing liquid. Oral contrast helps the radiologist see the stomach
and intestines and distinguish these organs from any abnormalities that may be
present. Patients are required to prepare for the exam by fasting (no food or drink)
for a period of four hours prior to the CT scan.
When do patients drink the oral contrast?
Patients in the CT waiting area are instructed to begin drinking the oral contrast 90
minutes before the CT appointment. Patients should try to drink the oral contrast
during a 30-minute period.
What is IV contrast?
IV contrast (sometimes called X-ray dye) is a clear fluid that contains iodine. IV
contrast is injected into the veins to highlight the tissues of the body or brain. Most,
but not all, patients who have CT scans have IV contrast injected into a vein during
their CT examination. If patients are allergic to IV contrast or iodine, they should
inform the doctor as soon as possible. Patients who are more than 70 years old,
have kidney problems, or have had chemotherapy need to have a simple blood test
before IV contrast can be administered. Those who meet the former criteria should
inform their physician and the CT technician.
Lab results obtained from other physicians' offices are accepted within 30 days of the
patient's CT appointment. Blood tests drawn and analyzed in another location must
include an evaluation of kidney function.
What about pregnancy?
As with any X-ray procedure, pregnant patients (or those who think they might be
pregnant) should consult a physician to determine if the CT scan can be postponed.
Pregnant patients who must have a CT exam should inform the technologist so that
steps can be taken to protect the unborn child.
What about daily medications?
Patients should always take prescription medicine on schedule before and after CT
scans. Medications requiring food should be discussed with a physician and the CT
technician.
When are results available?
Physicians provide exam results. The radiologist interprets the CT scans the day they
are performed. Some cases may require comparison to other exams, resulting in a
slight delay. CMC provides results directly to physicians as soon as the radiologist
verifies the report accuracy.
ULTRASOUND
What is ultrasound?
Ultrasound uses high frequency sound waves applied with a small probe. When the
sound waves reflect off tissues in the body, they generate a signal that is transmitted
back to the ultrasound machine which generates an image. Ultrasound is used in a
wide variety of injuries and illnesses that may apply to virtually any area of the body.
How do patients prepare for the exam?
There are many procedures in ultrasound that require no preparation at all.
Procedures that involve scanning in the abdomen or pelvis may require patients go
without food prior to the procedure. Patients scheduled for a biopsy will receive
specific exam preparation instructions.
How is the exam performed?
Ultrasound procedures range in time from just 15 minutes to one hour depending on
the procedure. Patients lie on a comfortable table while the technologist places a
small amount of gel on or near the area needing to be scanned. The gel enables the
ultrasound waves to transmit properly. Patients only feel the probe moving gently
against their skin. There are no side effects to ultrasound.
When are results available?
Physicians provide exam results. The radiologist interprets the ultrasound scans the
day they are performed. Some cases may require comparison to other exams,
resulting in a slight delay. CMC provides results directly to physicians as soon as the
radiologist verifies the report accuracy.
MRI
What is MRI?
Magnetic resonance imaging uses radio wave energy in a magnetic field. The signal
generated by the radio waves produce very detailed images of the human body. The
advantage of MRI is its precise image detail that enables physicians to locate
extremely small defects or disease processes. MRI is considered a very common
procedure for virtually every area of medicine.
How do patients prepare for the exam?
Unless a patient receives a sedative or anesthesia, there is no preparation for the
exam. Patients should wear comfortable clothing and take precautions for entering a
magnetic field. Removing all metal items prior to entering the procedure room (like
jewelry, keys, and wallets) is standard. Patients with pacemakers, implants, cardiac
stents or other metal devices within the body may still qualify for MRI scanning. It is
important for patients to discuss implanted devices with their physician and the MRI
staff.
How is the exam performed?
An MRI scan is a very easy exam. Patients complete a questionnaire regarding
medical history as well as MRI safety issues. Most exams last 30 to 60 minutes
depending on the type of exam ordered by the physician. Normal dress is acceptable
provided ALL metal objects are removed. The staff provides a hospital gown if
clothing is a concern.
Once all safety information is obtained, patients lie on the imaging table. If a
physician has requested a contrast agent, the staff will insert an IV. Ear plugs are
also provided.
Loud knocking or clicking noises are normal for MRI units. Once scanning begins,
patients should be as still as possible. Side affects or allergic reactions to MRI
contrast materials are rare. CMC staff is fully prepared to assist in these unusual
circumstances.
When are results available?
Physicians provide exam results. The radiologist interprets the MRI scans the day
they are performed. Some cases may require comparison to other exams, resulting
in a slight delay. CMC provides results directly to physicians as soon as the
radiologist verifies the report accuracy.
NUCLEAR MEDICINE
What is nuclear medicine?
Nuclear medicine scanners produce images by detecting a radioactive tracer in the
patient. The process uses radioactive pharmaceuticals which are injected into the vein.
After injection, the isotope circulates through the body and concentrates in a specific
area. There are different isotopes designed to concentrate in different areas of the body
(i.e., lungs, heart, kidneys, skeleton and brain). Physicians may order one or more
different types of nuclear medicine procedures.
Both nuclear medicine and PET (positron emission tomography) are considered
functional or metabolic imaging tools, meaning that they provide information on how
organs or cells work.
How do patients prepare for the exam?
Different preparations depend on the type of exam ordered. Some nuclear medicine
procedures require no preparation, but others may require medication or food
modifications. Either a physician's office or the Radiology Imaging Services scheduling
staff will provide instructions.
A nuclear medicine exam can last as little as 30 minutes or could extend over the course
of several days.
Some scans require the isotope injection in the scan room so the technical staff can take
immediate images while the isotope is circulating. With other exams, patients may
receive the isotope injection followed by a delay while the isotope circulates. Again,
depending on the exam, patients may be requested to return for pictures within an hour or
even the next day. The technical staff will discuss these issues on the day of the exam.
When are results available?
Physicians provide exam results. The radiologist interprets the nuclear medicine scans the
day they are performed. Some cases may require comparison to other exams, resulting in
a slight delay. CMC provides results directly to physicians as soon as the radiologist
verifies the report accuracy.
PET IMAGING
What is Positron Emission Tomography (or PET)?
PET scanning uses radioactive isotopes (radiopharmaceuticals) to create a powerful
diagnostic tool for cancer, heart disease and a variety of neurological disorders like
Alzheimer's disease. Similar to conventional nuclear medicine, the exam requires the
injection of a radiopharmaceutical, which circulates throughout the body and
localizes in cancer sites or other disease processes. The primary
radiopharmaceutical, or tracer, used in PET is a radioactive sugar called FDG. Cancer
cells use this sugar at an aggressive rate. PET uses a scanner to detect radioactivity
and generate a whole body image demonstrating cancer sites, heart disease or
neurological disorders.
What is the advantage of combined PET and CT?
With a combination PET/CT scanner, the concept is similar to weather radar. PET
provides the radar that identifies a tumor, while the CT scan provides the anatomic
map that helps identify the precise location of the disease.
Most cancer patients will have CT and PET scans ordered at the same time. CMC
provides these services in one visit and on one scanner, all in about 30 minutes.
How do patients prepare for the exam?
The standard preparation is to have no food for four hours prior to the exam.
Drinking at least two glasses of water two hours prior to the exam is also requested.
Diabetic patients and those needing a cardiac exam will have additional instructions.
To obtain accurate results on a PET scan, diabetic patients will need to work closely
with the PET staff to regulate blood sugar levels.
How is the exam performed?
A PET/CT scan takes 30 to 45 minutes. The total time in the department is about two
hours considering there is a one-hour wait after the isotope injection. After the
injection, patients relax for a 60-minute uptake period. Physicians frequently order a
mild sedative or diuretic (aids to empty bladder) for this period. Both of these
medications can improve the quality of the scan.
After the uptake period, patients lie on the scanner table in a comfortable position
and move as little as possible for 30 to 45 minutes. There are no side affects from
the isotope injection or the scan itself. The affects of the diuretic or sedative will be
explained prior to the procedure.
When are results available?
Physicians provide exam results. The radiologist interprets the PET scans the day
they are performed. Some cases may require comparison to other exams, resulting
in a slight delay. CMC provides results directly to physicians as soon as the
radiologist verifies the report accuracy.
DIGITAL IMAGING NETWORK
Carolinas HealthCare System has developed the most extensive digital
communication system in the region for imaging procedures. Carolinas Medical
Center is an integral part of this system, allowing physicians and technicians to
access patient records for quicker, more accurate diagnosis and treatment.
The advantages of the Digital Imaging Network:
Images are recorded in a personal image folder. Because the network extends
through Mecklenburg County, physicians can enter their secure password to review
patient images in an office or hospital setting.
The computer network extends to the Emergency Room and the Operating Rooms.
Patients experiencing an emergency event or requiring surgery have all images
immediately available. Radiologists can review scans from any location in Carolinas
HealthCare System, which means a specialist at another facility can be contacted to
assist in diagnosis.
CMC also provides copies of exams via computer disc so images can be reviewed at
other healthcare facilities.
INTERVENTIONAL RADIOLOGY
What is interventional radiology?
Interventional radiology is a rapidly growing area that provides minimally invasive,
targeted treatments using imaging guidance. Interventional radiology services are
preferred over some surgical procedures because they involve smaller incisions, less
risk, less pain and shorter recovery times for patients.
Interventional radiologists use their expertise in reading X-rays, ultrasound and
other medical images to guide small instruments such as catheters (tiny tubes)
through the blood vessels or other pathways to treat disease. These procedures are
typically much less invasive and much less costly than traditional surgery.
How do patients prepare for the exam?
The exam often requires sedation. Because of this, patients should limit anything by
mouth, except for medications. Patients should check with a physician about
medications, especially those that require food.
Some procedures do not require sedation, but will require the injection of X-ray dye.
Physicians should be consulted about medications and eating limitations.
Most procedures require a hospital gown, but comfortable clothing is recommended
for all. Following the exam, patients rest in recovery rooms where family members
may join them. Patients may be asked to arrive one to two hours prior to procedures
for laboratory analysis.
Patients answer specific questions about their medications and symptoms and may
have a short physical exam. This allows the interventional radiologist to become
aware of conditions that may affect the procedure.
How is the exam performed?
During an interventional procedure patients may be asked to hold their breath from
time to time. This insures clear images. All procedures are explained in great detail
prior to the exam's start.
Some procedures require patients to lie flat for extended periods. A mild sedative
can be prescribed for this.
When are results available?
Physicians provide exam results. The radiologist interprets the interventional
procedures the day they are performed. Some cases may require comparison to
other exams, resulting in a slight delay. CMC provides results directly to physicians
as soon as the radiologist verifies the report accuracy.