Guide Lower Genitourinary Radiology: Imaging and Intervention

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Lower Genitourinary Radiology. Imaging and Intervention. Editors: Jafri, Syed Z.H., Amendola, Marco A., Diokno, Ananias C. (Eds.) Free Preview.
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Admissions and Tuition Section Overview Residencies and fellowships. About Section Overview College profile. Patient Care College Research. Search Search Mayo Clinic Search. Goals and objectives The goals and objectives of the fellowship include: Hands-on experience with a large group of patients whose diagnosis and treatment requires advanced abdominal imaging and interventional techniques currently being developed and refined Clinical instruction by fellowship-trained radiologists, many of whom have extensive publications and are recognized experts in their fields Experience with state-of-the-art MRI, CT and ultrasound equipment Intensive training and experience with the most cutting-edge developments, including the application and interpretation of MRI at 3.

BMD is not recommended for pregnant patients as the X-rays may cause harm to the unborn baby. No special preparations are required for BMD scan. However, patients who had undergone recent imaging study involving oral contrast are required to wait 2 weeks before going for the BMD examination. CT scan uses X-rays to produce cross sectional images of your body with the aid of computer allowing radiologists to visualise internal structures of the body to make appropriate diagnosis of the medical condition. The X-rays that passes through the body will be captured and analysed by the computer which will then create clear and detailed images of internal organs and structures.

For certain types of scans, contrast special dye is injected into the body to allow major blood vessels as well as organs to be seen more clearly.

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As the scan time is shorter and uses a doughnut-like gantry, claustrophobic patients are generally able to tolerate CT scan well. CT scans can produce detailed cross sectional and 3D images which are used to look for abnormalities and diagnose various conditions.

Lower Genitourinary Radiology Imaging and Intervention

Depending on the type of diseases or medical conditions, CT may be used in conjunction with other imaging techniques like ultrasound US and Magnetic Resonance Imaging MRI to help doctors to evaluate a medical condition. Advances in technology allow the x-ray dose used to be kept as low as possible. The use of contrast injection is often not recommended for patients who are allergic to contrast media, iodine or have kidney problems. Pregnant patients are not advised to go for CT scans due to the radiation, which may be risky to the unborn baby. However, it will be recommended for life-threatening cases by the doctor where benefits outweigh the risks involved in the scan.

No preparation required if there is no contrast injection involved in the scan. CT scans with contrast injection, require patients to fast no food to go through the injection with greater ease without vomiting or nausea. For asthma or for drug allergies, medication would be prescribed to be taken prior to scan in order to reduce the risk of reaction during the contrast injection. Patients need to inform doctor of these medical conditions prior to arranging for a scan. At times water may be given before the scan to produce clearer images during the scan.

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Fluoroscopy is a dynamic study of human body function in which contrast is introduced to outline body structures and a continuous stream of X-rays is used to produce images through which the doctors will be able to see the body part and its motion in detail. The use of contrast to outline body structures allows the doctors to see the movement of the internal body structures in real time as the contrast travels through thus providing dynamic and functional information which helps doctors in diagnoses and treatment of patients.

Advancement in technology allows fluoroscopy to minimize the dose given to patients. Due to radiation involved, pregnant patients must inform the doctor and the radiographer before any fluoroscopic examination to avoid risks to the unborn baby. However, fluoroscopic examination is only recommended for pregnant patients when their condition is life-threatening. If patients are allergic to the contrast dye used, they must notify the doctor to avoid allergic reaction to the dye.

Depending on the nature of examinations, some exams may require patients to fast before the procedure or in some circumstances, refrain from smoking before fluoroscopy. Mammography is an X-ray examination of the breast to screen for breast abnormalities.

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Low dose X-rays passes through the breast which will be detected by the detectors in the machine and converted signals to images of the breast. The use of digital mammography produces high resolution 3D images of the breast which is more sensitive than conventional film-screen mammography for early breast cancer detection. Mammography produces sharp images of the breast tissue and is highly sensitive in picking up small abnormalities. Mammography is often used as a complementary when breast abnormality is detected in other imaging techniques like ultrasound and MRI Magnetic resonance imaging , to allow doctors to make a more accurate diagnosis.

Although radiation is used in mammography, low doses of X-rays that remains within safe levels are used to produce the images.

Normal Anatomy

Doctors will only request for mammography for diagnosis and treatment when the benefits outweigh the risks of the examination. Since radiation is involved, pregnant patients are required to inform the radiographer before the mammogram as it poses some risks to the unborn baby. It is safe for female patients who are breast feeding to go for mammogram.

They will be advised to express out milk prior to the scan in order to obtain better images. Mammography examination must be scheduled at least one week after the start of the menstrual period when breasts are least tender. On the day of the examination, patients should not use powder, lotion or deodorant under arms or on breasts as this may mimic micro calcifications.

MRI is a medical imaging technique that uses strong magnetic field and magnetic waves to produce detailed images in different planes of any part of the human body. MRI is very useful to diagnose diseases and assess internal damage to soft tissues in our body. It also monitors organ abnormalities such as lesions which reduces the need for biopsy or exploratory procedures that are more invasive. Some MRI scans may require contrast special dye to be injected into the body to highlight certain structures. The use of contrast injection is often not recommended for patients with poor kidney function as the contrast could not be effectively excreted and may pose health problems.

The strong magnetic field used in MRI will attract any ferromagnetic objects objects that contain iron and may cause them to move inside the body.

The clinical benefit of a medically appropriate X-ray imaging exam outweighs the small radiation risk. The FDA encourages patients and parents of pediatric patients to engage in a discussion with their health care provider about the benefits and risks of fluoroscopy procedures see the Medical X-ray Imaging webpage for advice on questions to ask your health care provider. Extensive information is available on fluoroscopy, diseases and conditions where fluoroscopy is used for diagnosis or treatment, and on the risks and benefits of fluoroscopy.

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In addition to the patient information links on the Medical X-ray Imaging webpage , more specific information on procedures conducted using fluoroscopy is provided below:. Concerns about radiation-related injuries to patients have increased since the mids due to the increasing complexity and radiation dose of some fluoroscopically-guided interventions. In , the FDA revised the radiation safety performance standard for diagnostic X-ray systems, including fluoroscopy to improve the display of dose information to the physicians 21 CFR As part of this initiative, the FDA held a public meeting on ways to improve devices to reduce unnecessary radiation exposure to help the agency decide on any new targeted requirements for manufacturers of CT and fluoroscopic devices.

The new requirements that could be built into fluoroscopy equipment could facilitate implementation of the principles of justification and optimization in the protection of patients undergoing radiological examinations. More information about the principles of justification and optimization can be found on the Medical X-ray Imaging webpage.

The sections below include supplemental information that can be used to reduce radiation exposure for fluoroscopy equipment currently available on the market. The imaging team, which includes the physician, radiologic technologist, physicist, and other medical personnel should be responsible for developing optimized protocols, implementing regular equipment quality control tests, and monitoring radiation doses to patients as part of quality assurance program emphasizing radiation management.

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Health care providers who use fluoroscopy should be properly trained in its use. In a report issued in , the National Council on Radiation Protection and Measurements NCRP made specific recommendations for facilities that perform fluoroscopic procedures. These recommendations can be applied to all fluoroscopy procedures.