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Fluoroscopy

Fluoroscopy

Fluoroscopy is used to study moving body structures. An x ray beam is continuously passed into the body part to be examined it is transmitted to a TV-like monitor so that the body part in motion is studied in detail. As an imaging technique, fluoroscopy is commonly employed by physicians to obtain real-time images of the internal structures of a patient during minimally invasive and microscopic surgical procedures, as well as many types of diagnostic tests like discography.

Fluoroscope: In its simplest form, fluoroscopy consists of an x ray source and a fluorescent screen between which a patient is placed. Modern fluoroscopes couple the screen to an X ray image intensifier and a video camera allowing the images to be played and recorded on a monitor. Traditional fluoroscopes consisted of an x ray source and fluorescent screen between which the patient was placed. Modern fluoroscopes have shown several improvements in screen phosphors, image intensifiers and even flat panel detectors. These allow for increase quality while minimizing the radiation dosage to the patient. Modern fluoroscopes also use the CSI screens and produce noise-limited images. This ensures minimal radiation dosage results while still obtaining images of acceptable quality.

Fluoroscopy can be adopted on an inpatient or outpatient basis. Depending upon the specific type of procedure or examination, it is determined whether any preparation prior to the procedure is required. All fluoroscopic procedures pose potential health risk to the patient. Fluoroscopy uses more radiation than standard x rays. Radiation doses depend upon the size of the patient as well as the length of the procedure. Fluoroscopy is widely used in orthopedic surgery to guide fracture reduction and the placement of metal work. Fluoroscopy is used in many diagnostic and therapeutic radiological procedures to observe the action of instruments being used either to diagnose or to treat the patient. Fluoroscopy is also used to help find a foreign object in the body, position a needle for a medical procedure or re align a broken bone. Different types of fluoroscopy procedures:

Esophogram: x ray study of the throat.

Upper G I series: is a study of the esophagus, stomach and duodenum.

Small bowel series: is a study of the stomach and entire small intestine.

Barium enema: is a study of colon.

Hystersalpingogram: is a study of the uterus and fallopian tubes.

Intravenous Pyelography: is a study of the kidneys, ureters, and the urinary bladder.

Voiding cystourethrogram: is the study of the bladder and urethra.

Arthrogram: is a study of the shoulder and knee joint showing ligament and tears.

Lung biopsy

Lung biopsy involves removal of small piece of lung tissue to check for any conditions such as sarcoidosis, pulmonary fibrosis and lung cancer. It is essential to keep the physician informed if the patient is pregnant or taking medications such as warfarin or anticoagulants. Do not eat or drink for 8 to 10 hours before the lung biopsy. The secretions in the mouth and airways is dried up with some medications.

Needle lung biopsy is done with a long needle that is inserted through the chest wall. Ultrasound, fluoroscopy or CT scan are used to aid locating the abnormal lung tissue.

Open lung biopsy may need hospitalization for a couple of days. This procedure involves making an incision between the ribs to take a sample of lung tissue. This is preferred when a larger sample is required and is done under anesthesia. An endotracheal tube is passed through the airways to take a sample of lung tissue.

Bronchoscope lung biopsy is done in cases of suspected infection. The bronchoscope is inserted through the nose or mouth into the airways. This type of lung biopsy is used when abnormal tissue is near the breathing tubes.

VATS Video assisted thorascopic surgery involves use of thorasope to remove a sample of lung tissue.

Mediastinoscopy is conducted under general anesthesia. The mediastinoscope is inserted through an incision made between the lungs. Any abnormal tissues or lymph nodes are examined.

Cardiac Catheterization

Cardiac catheterization is a test which is performed to obtain certain diagnostic information about the heart. Patients may require this medical therapy rather than undergo angioplasty or bypass surgery when they suffer from rare or easily controlled episodes of angina. Alternatively, cardiac catheterization is not performed in patients who have infrequent episodes of angina and in whom angina can be easily controlled. When a patient has heart failure due to suspected coronary artery disease or there is suspected coronary artery disease, cardiac catheterization is conducted. Cardiac catheterization can help:

Measure blood pressure within heart.

Know the amount of oxygen in the blood.

Check the pumping ability of the heart muscle.

Check blood flow through the heart after surgery.

Collect blood samples from the heart.

Inject dye into the coronary arteries.

To provide treatment in certain types of heart conditions like congenital heart defects and how severe it is.

To find out a coronary artery disease and if found to pinpoint the size and location of fat and calcium deposits that have built up in coronary artery from atherosclerosis.

To determine whether the patient needs bypass surgery or angioplasty.

Examine the arteries of the heart with an x-ray technique called fluoroscopy.

The patient is asked not to drink or eat anything, except a small amount of water, for atleast 6 to 12 hours before the test. The patient is tested for allergy to iodine or other medications. Patients suffering from kidney disease or diabetes or bleeding disorders must keep the cardiologist informed. The cardiac catheterization test is performed in a cath lab by a cardiologist. The actual catheterization procedure takes about 15 - 30 minutes. The patient's electrocardiogram that continuously records the electrical activity of the heart is taken. A pulse oximeter device that measures the oxygen levels of the patients' blood is monitored. An intravenous needle is inserted into the patients' vein to give fluids or medicine during the catheterization procedure. A sedative is also given through this IV line which helps the patient to relax.

Cardiac catheterization procedure involves passing a catheter, a thin flexible tube, into the right or left side of the heart. The doctor inserts this thin plastic tube into the groin - femoral artery. Other places where in the catheter may be inserted are the elbow- brachial artery or the wrist - radial artery. From there it is slowly advanced into the chambers of the heart or into the coronary arteries. The doctor watches the progress of the catheter into the heart's vessels and chambers on the imaging screen. Pressures within the heart chambers are measured and the blood and tissue samples are also removed through the catheter. A small amount of dye is also injected through the catheter into the heart chamber or into one of the coronary arteries.

Therapeutic catheterization: Certain types of heart defects can be repaired using catheterization. For instance, if the coronary arteries are blocked, the cardiologist can use a catheter, guide wire and balloon to open and improve blood flow to the heart. This is termed as percutaneous coronary intervention (PCI).

Normal result indicate that there is no significant narrowing or blockage in the coronary arteries. Abnormal results may suggest that the heart does not pump blood normally or the valves in the heart may be weak. There may be leakage between heart chambers. There is a possibility of aortic aneurysm. Some complications with cardiac catheterization include heart attack or stroke, hematoma, puncture of the heart or arrhthmias.