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Fluoroscopy

Fluoroscopy is a study of moving body structures where a continuous X-ray beam is passed through the body part being examined. The beam is transmitted to a monitor so that the body part and its motion can be seen in greater detail. Studies that are done under fluoroscopy are:


Barium Enema

A lower GI or barium enema, is an x-ray examination of the large intestine, also known as the colon. This includes the right or ascending colon, the transverse colon, the left or descending colon, sigmoid colon and the rectum. The appendix and a portion of the distal small intestine may also be included.

A barium enema uses a special form of x-ray called fluoroscopy and a contrast material called barium or a water soluble iodinated contrast.

Fluoroscopy makes it possible to see internal organs in motion. When the lower gastrointestinal tract is filled with barium, the radiologist is able to view and assess the anatomy and function of the rectum, colon and sometimes part of the lower small intestine.

What are some common uses of the procedure?

A physician may order a lower GI examination to detect:

  • benign tumors (such as polyps)
  • cancer
  • causes of other intestinal illnesses

The procedure is frequently performed to help diagnose symptoms such as:

  • chronic diarrhea
  • blood in stools
  • constipation
  • irritable bowel syndrome
  • unexplained weight loss
  • a change in bowel habits
  • suspected blood loss
  • abdominal pain

Images of the small bowel and colon are also used to diagnose inflammatory bowel disease, a group of disorders that includes Crohn's disease and ulcerative colitis.

Intravenous Pyelogram (IVP)

An intravenous pyelogram (IVP) is an x-ray examination of the kidneys, ureters and urinary bladder that uses iodinated contrast material injected into veins.

When contrast material is injected into a vein in the patient's arm, it travels through the blood stream and collects in the kidneys and urinary tract, turning these areas bright white. An IVP allows the radiologist to view and assess the anatomy and function of the kidneys, ureters and the bladder.

What are some common uses of the procedure?

An intravenous pyelogram examination helps the physician assess abnormalities in the urinary system. The exam is used to help diagnose symptoms such as blood in the urine or pain in the side or lower back.

The IVP exam can enable the radiologist to detect problems within the urinary tract resulting from:

  • kidney stones
  • enlarged prostate
  • tumors in the kidney, ureters or urinary bladder


Myelography

Myelography is an imaging examination that involves the introduction of a spinal needle into the spinal canal and the injection of contrast material in the space around the spinal cord (the subarachnoid space) and nerve roots using a real-time form of x-ray called fluoroscopy.

When the contrast material is injected into the subarachnoid space, the radiologist is able to view and evaluate the status of the spinal cord, nerve roots, and meninges, which are the membranes which surround and cover the spinal cord and nerve roots. Myelography provides a very detailed picture of the spinal cord and spinal column. The radiologist views the passage of contrast material in real-time within the subarachnoid space as it is flowing using fluoroscopy but also may take permanent images, called x-rays or radiographs, of the contrast material around the spinal cord and nerve roots in order to document abnormalities involving or affecting these structures. In most cases, the myelogram is followed by a computed tomography (CT) scan to better define the anatomy and any abnormalities.

What are some common uses of the procedure?

Magnetic resonance imaging (MRI) is often the first imaging exam done to evaluate the spinal cord and nerve roots. However, on occasion, a patient has medical devices, such as a cardiac pacemaker, that may prevent him or her from undergoing MRI. Sometimes, myelography and/or a CT scan is performed in conjunction with MRI to better define abnormalities.

Myelography is most commonly used to detect abnormalities affecting the spinal cord, the spinal canal, the spinal nerve roots and the blood vessels that supply the spinal cord, including:

  • to show whether herniations of the material between the vertebral bodies, termed the intervertebral disks, are pushing on nerve roots or the spinal cord.
  • to depict a condition that often accompanies degeneration of the bones and soft tissues surrounding the spinal canal, termed spinal stenosis. In this condition, the spinal canal narrows as the surrounding tissues enlarge due to the development of bony spurs (osteophytes) and the adjacent ligaments.

Myelography can also be used to assess the following conditions when MR imaging cannot be performed, or in addition to MRI:

  • tumors
  • infection
  • inflammation of the arachnoid membrane that covers the spinal cord
  • spinal lesions caused by disease or trauma

A myelogram can show whether surgical treatment is promising in a given case and, if it is, can help in planning surgery.


Upper GI Series

Upper gastrointestinal tract radiography, also called an upper GI, is an x-ray examination of the pharynx, esophagus, stomach and first part of the small intestine (also known as the duodenum) that uses a special form of x-ray called fluoroscopy and an orally ingested contrast material called barium.

Fluoroscopy makes it possible to see internal organs in motion. When the upper GI tract is coated with barium, the radiologist is able to view and assess the anatomy and function of the esophagus, stomach and duodenum.

An x-ray examination that evaluates only the pharynx and esophagus is called a barium swallow. In addition to drinking barium, some patients are also given baking-soda crystals (similar to Alka-Seltzer) to further improve the images. This procedure is called an air-contrast or double-contrast upper GI.

What are some common uses of the procedure?

An upper GI examination helps evaluate digestive function and to detect:

  • ulcers
  • tumors
  • inflammation of the esophagus, stomach and duodenum
  • hiatal hernias
  • scarring
  • blockages
  • abnormalities of the muscular wall of GI tissues

The procedure is also used to help diagnose symptoms such as:

  • difficulty swallowing
  • chest and abdominal pain
  • reflux (a backward flow of partially digested food and digestive juices)
  • unexplained vomiting
  • severe indigestion
  • blood in the stool (indicating internal GI bleeding)