IMAGING AND RADIOLOGY

PATIENT INFO:

 

FAQ:

 

1. What is radiology?

Radiology is the study of images of the human body. Although Radiology began with the use of X-Rays and large flat sheets of photographic films, the modern Radiologist now has a variety of tools for "taking pictures" of living patients. Many of these newer tools create an image with a computer (CT - computed tomography) and some do not use any X-Rays, nor radiation of any kind - such as MR and Ultrasound.

2.What is ultrasound?

Ultrasound imaging, also called ultrasound scanning or sonography involves exposing part of the body to high-frequency sound waves to produce pictures of the inside of the body. Ultrasound exams do not use ionizing radiation (x-ray). Because ultrasound images are captured in real-time, they can show the structure and movement of the body's internal organs, as well as blood flowing through blood vessels.

3. How should I prepare for abdominal ultrasound?

You should wear comfortable, loose-fitting clothing to your exam. You may be given a gown to wear during the procedure. 3-4 hours fasting is mandatory so as to visualize the abdominal organs optimally. In case of pelvic scan you need to come with full bladder for optimal visualization of the urinary bladder, prostate, uterus and ovaries.

4. How should I prepare for obstetric scan?

For a first trimester scan, you need to come on full bladder. For second and trimester scan no particular preparation is required.

5. What is computed tomography (CT)?

A CT (computerized tomography) scanner is a special kind of X-ray machine. Instead of sending out a single X-ray through your body as with ordinary X-rays, several beams are sent simultaneously from different angles. The X-rays from the beams are detected after they have passed through the body and their strength is measured. Beams that have passed through less dense tissue such as the lungs will be stronger, whereas beams that have passed through denser tissue such as bone will be weaker. A computer can use this information to work out the relative density of the tissues examined. Each set of measurements made by the scanner is, in effect, a cross-section through the body. The computer processes the results, displaying them as a two-dimensional picture shown on a monitor.

6. How should I prepare for the CT exam?

Metal objects including jewelry, eyeglasses, dentures and hairpins may affect the CT images and should be left at home or removed prior to your exam. You may also be asked to remove hearing aids and removable dental work. You may be asked not to eat or drink anything for at least 3-4 hours beforehand, especially if a contrast material will be used in your exam. You should inform your physician of any medications you are taking and if you have any allergies, especially to contrast materials. Also inform your doctor of any recent illnesses or other medical conditions, and if you have a history of heart disease, asthma, diabetes, kidney disease or thyroid problems. Any of these conditions may increase the risk of an unusual adverse effect. Women should always inform their physician or technologist if there is any possibility that they are pregnant.

7. What is 64-slice CT? Does it have any advantages over other CTs?

The 64-slice CT acquires 64 slices of the body in one single rotation. So it can operate 4-64 times faster than other standard CT scanners. The unprecedented coverage speed of this system allows clinicians to capture a high resolution image of the heart in 5 beats, or go head to toe in under 10 seconds – faster than any other CT scanner on the market today. This pain-free procedure offers exceptional image quality, which can mean better physician diagnosis, faster recovery time and increased patient comfort and convenience.

8. What is angiogram?

Angiogram refers to study of blood vessels. CT angiogram refers to study of blood vessels using CT technology.

9. How should I prepare for CT angiogram studies?

You will be required to come in a fasting state of at least 3 hours. A blood test called serum creatine should be done prior to all CT angiogram studies. If you are diabetic please inform the physician before hand so as to modify the medications and the waiting period.

10. What are the advantages of 64-slice CT angiogram versus catheter angiogram?

The advantage to using a 64-slice CT scan versus catheter angiography is that the physician does not need to insert a catheter directly into a vein or artery to inject dye. Instead of inserting a catheter into a large vein or artery and advancing the catheter to the area being studied, the physician will administer a contrast agent into a peripheral vein (usually in the arm) using a small needle. This contrast agent highlights blood flow in comparison to other organs and structures, and allows the physician to visualize arteries and veins on a CT scan. Compared to a catheter angiogram, this is a much less invasive procedure and is more "patient-friendly," with a decreased chance of infection or other adverse outcome.

11. Do I need to do any tests prior to CT coronary angiogram?

Yes. You have to get your serum creatine done prior to the study. This is done to ensure that your kidneys are functioning properly and there will be no problems of contrast administration. Ejection fraction detection using ECHO is also recommended prior to scanning.

12. How much time does it take for a CT coronary angiogram study?

The scanning time is just ten seconds. But you may have a waiting period of 15minutes to one hour to stabilise the heart rate.

13. What does the procedure involve?

Once your heart rate is stabilized with medications, a peripheral vein will be cannulated. An initial plain scan (without contrast injection) is performed to detect the calcium in the coronary arteries. The angiogram scanning is then performed following injection of contrast using an automatic power injector. You will be asked to hold your breath during the scanning for 8-10seconds.

14. Do I have any restrictions after the study?

No special instructions are given after the scanning. You may have to take plenty of water (make sure that you don’t have any fluid restrictions advise by your doctor) orally to reduce contrast toxicity.

15. How much time will it take to get the report following CT coronary angiogram study?

In cases of findings requiring immediate medical attention, the radiologist will inform the concerned physician orally. In all other cases, a typed report will be given to the patient in 2-3 hours following the study.

16. Who all are ideal candidates for 64-slice cardiac CT scan?

1. Long standing history of hypertension / diabetes. 2. Family history of heart attacks. 3. Smokers 4. Type A personality 5. Obese individuals 6. Inconclusive treadmill test 7. Post CABG / Stent patients

17. How accurate is CT coronary angiogram?

The negative predictive value is greater than 95%. That means that when the study is normal, it is almost definite that there will be no coronary artery disease. In an abnormal study, coronary CT sometimes has a tendency to overestimate or underestimate stenoses and lesions, especially when there is calcium as well as in vessels less than 1.5 mm in size.

18. Are there any dangers of CT scanning?

Though X-rays involve radiation, there are no dangers, in practice. In women who are pregnant, however, CT scanning should be done after weighing all the risks and benefits.

19. What is the injection that I will receive?

The majority of patients will be injected with a “dye” which enhances the ability of CT scans to pick up abnormalities. This is routine. Only a non-ionic dye (the safest) is used.

20. Are there any complications of the “DYE”?

0.5% percent of patients may get nausea and redness of the skin. Though severe reactions are known, these are very rare and uncommon.

21. What is MRI?

It is a computerized imaging technique, capable of obtaining images of the body in any plane. MRI utilizes strong magnetic fields and radio frequency pulses to generate images, which demonstrates more clearly than other methods, the possible differences between normal and abnormal tissues. The procedure is painless, has no known side effects, circumvents the harmful effects of radiation, and provides the radiologist with high-resolution images that offer additional information when compared to the CT scan. With newer technology, it is also possible to obtain functional and biochemical information of body tissue. Imaging of the heart and arteries is also possible, through a non invasive procedure.

22. How should I prepare for MRI?

Unless you are told otherwise, you may follow your regular daily routine and take medications as usual. Women should always inform their physician or technologist if there is any possibility that they are pregnant. Because the risks of an MRI exam to the baby are unknown, pregnant women should not have this exam unless the potential benefit from the MRI is assumed to outweigh the potential risks. If you have claustrophobia (fear of enclosed spaces) or anxiety, you may want to ask your physician for a prescription for a mild sedative. Because metal and electronic objects can interfere with the magnetic field of the MRI unit, they are not allowed in the exam room.

These items include:

• 1.Jewelry, watches, credit cards and hearing aids, all of which can be damaged.
• 2.Pins, hairpins, metal zippers and similar metallic items, which can distort MRI images.
• 3.Removable dental work.
• 4.Pens, pocketknives and eye glasses.
• 5.In most cases, an MRI exam is safe for patients with metal implants, except for a few types. People with the following implants cannot be scanned and should not enter the MRI area:
• 6.Internal (implanted) defibrillator
• 7.Cochlear (ear) implant
• 8.Clips used on brain aneurysms
• 9.You should tell the technologist if you have medical or electronic devices in your body, because they may interfere with the exam or potentially pose a risk. Examples include:
• a.Artificial heart valves
• b.Implanted drug infusion ports
• c.Infusion catheter
• d.Intrauterine device (IUD)
• e.Implanted electronic device, including a cardiac pacemaker
• f.Artificial limbs or metallic joint prostheses
• g.Implanted nerve stimulators
• h.Metal pins, screws, plates or surgical staples

In general, metal objects used in orthopedic surgery pose no risk during MRI. However, a recently placed artificial joint may require the use of another imaging procedure.

ACADEMIC:

Our department is one of the recognized centers for radiology training to post-graduate students by the National Board of examinations. The aim is to impart high-quality radiology education through meticulous training to post-graduate residents.

Every year four students including two post DMRD candidates are enrolled for the course. The selection is made following a common entrance test and interview. The entrance test is usually conducted in the month of January - February and selection is purely on merit basis.

Diploma in x-ray technology:

This is a three-year diploma course authorized by the paramedical board of examinations of Government of Karnataka. Selection is by interview and is purely on merit basis. The students are taught subjects related to medicine, including physics, chemistry, biology, anatomy, physiology, pathology, general physics, radiography and radiology.

RESEARCH FOCUS:

• 1. CT evaluation of post-operative shunts in congenital heart disease – Dr. Srikanth
• 2. CT evaluation of MAPCAS in patients with tetralogy of fallot / pulmonary atresia – Dr. Vikas
• 3. Spiral CT in the evaluation of pulmonary embolism – Dr. Kaliaperumal
• 4. Coronary artery calcium detection using CT and its relevance to coronary artery disease – Dr. Saleem Ahmad
• 5. CT in the evaluation of aortic stenting – Dr. Zarina Aziz
• 6. 64-slice CT evaluation of coronary stents – Dr. Tanuj Gupta
• 7. Role of CT in the evaluation of anomalous pulmonary venous drainage – Dr. Roopa Tantri
• 8. Extra-cardiac anomalies in patients with congenital heart diseases – Dr. Jayadeepa
• 9. 64-slice CT evaluation of coronary artery bypass grafts – Dr. Muruganv 10. Role of CT-perfusion in stroke – Dr. Shivkumar Swamy
• 10. 64-slice CT in the evaluation of thoracic aortic disease – Dr. Santosh
• 11.64-slice CT in the evaluation of abdominal aortic disease – Dr. Yameen
• 12.64-slice hepatic angiogram in the evaluation of pre-transplant voluntary hepatic donors – Dr. Pallavi
• 13.64-slice CT renal angiogram in the evaluation of pre-transplant voluntary renal donors – Dr. Vandana Gupta
• 14.Incidence of aortic arch anomalies in patients with congenital heart disease – Dr. Monali
• 15.Carotid intima-media thickness as a predictor of coronary artery disease – Dr. Naveen