X rays are generated by an electrical current that passes through an X-ray tube and produces a beam of ionizing radiation that can pass through the body part being examined.  This process creates an image of internal body structures called a radiograph.  

X rays are performed on different parts of the body for various diagnostic purposes.  A chest X ray may be performed to look for evidence of pneumonia, tumors, or fluid or to evaluate the size of the heart.  X rays of the abdomen are usually done to determine the cause of acute abdominal pain.  They also may be helpful for locating a swallowed foreign object, an intestinal obstruction, or a perforation in the digestive tract.  A myelogram is an X ray of the spine that uses a contrast medium injected into the spinal fluid to outline the spinal cord. It is usually done to check for damaged disks in people with lower back pain.  An arthrogram is an X ray of the inside of a joint (usually the knee or hip) that uses contrast
medium injected into the joint to make the image clearer to detect a tear in the cartilage or other joint abnormality.

The person being examined is positioned against a cassette holding the film, or the person may be asked to hold the cassette holding the film against the body part being studied.  A lead shield may be placed over other parts of the body to reduce their exposure to the X rays.   The X-ray unit is aligned over the part of the body to be examined.  The technician moves away from the area to activate the X-ray unit and to avoid exposing himself or herself to unnecessary radiation.  It is important that the person being examined remain as motionless as possible as the X ray is taken to prevent the images from being blurred.  After an X-ray examination, a person can resume normal activities. If a contrast medium was used, it is important that the person consume extra fluids to enhance the prompt excretion of the contrast medium.

Plain radiographs can be taken of many body parts.

Ultrasonography is an imaging method which uses sound waves to produce images of organs and tissues within the body.  It is based on the same principles involved in sonar used by ships and fisherman.  Sound waves are directed at organs and tissues of the body.  When these waves encounter tissues, they bounce back and produce echoes.  These echoes are manipulated by the ultrasound machine to produce images of the body.

An ultrasound exam is performed by a sonographer, a technician trained in ultrasound imaging.  During the procedure, the technician presses a small hand held device, called a transducer, against your skin.  The transducer generates and receives sound waves.  The technologist moves the transducer over the skin overlying the tissues or organs in question.  Sound waves generated by the transducer bounce off tissues and organs within your body and reflected sound waves are recorded by the transducer.  Differing organs and tissues produce unique echoes or sound reflections.  This information is then sent to a computer which produces detailed images of the organ or body part in question based on the unique patterns created by the reflected sound.

Ultrasound is a valuable tool utilized by your doctor.  It is used by physicians in the assessment of symptoms such as pain, swelling and infection.  Ultrasonography is utilized in examining many of the body’s organs including the:  heart, liver, gallbladder, spleen, kidneys, pancreas, uterus, ovaries, bladder, thyroid, parathyroid, scrotum, breasts, and blood vessels.  Additionally, it is vital in the assessment of pregnancy and the unborn fetus.  Other uses include guidance for biopsies, aspirations and drainages.

Ultrasound Procedures

A fluoroscope, a device that is equipped with a fluorescent screen, may be used to produce moving images of the body while the examination is taking place.  The images can be recorded on videotape or as still pictures for evaluation. A fluoroscope may be used to examine the function of the gastrointestinal tract, the respiratory system, and the bladder.

Computed tomography is an X-ray technique that uses computers to manipulate data into 2 and 3-dimensional representations of your body.  This allows radiologists and other doctors to look inside your body and diagnosis disease in a non-invasive manner.  CT scans are very common procedures that a generally very safe.  These studies can be performed with or without contrast, which may be administered intravenously or orally.  The contrast allows better visualization of a patient’s internal organs and other structures.

CT scans are frequently utilized to diagnose and monitor treatment of many disease processes, including cancer, infection, traumatic injuries, congenital deformities and even metabolic disease.  The exquisite ability of this technology to visualize vital structures such as large blood vessels and nerves also allows radiologists to target and safely biopsy concerning lesions throughout the book.

CT scans can be done with our without IV and oral contrast.

Computed tomographic angiography is a technique that utilizes the intravenous injection of iodinated contrast media to optimally enhance blood vessels throughout the body.  These studies are essentially non-invasive and are extremely accurate in the diagnosis of vascular diseases with the utilization of multislice CT scanners.  Commonly performed CTA’s include examinations of the brain arteries (circle of Willis), coronary arteries, thoracic aorta, abominal aorta, lower extremeties (runoff study), carotid arteries and renal arteries.  Physicians can utilize the information to exclude diseases such as aneurysms, dissections and plaques.  These findings can have a significant impact upon medical management and in determining if more invasive procedures or surgery is necessary.

Magnetic Resonance Imaging (MRI) produces very detailed images of bones, joints, soft tissues and organs without the need for exposure to radiation.  It is a valuable tool for detecting everything from heart and vascular disease, stroke, cancer and disorders of the muscles and joints.

MRI uses magnets to produce magnetic fields that allow for determining differences between normal and abnormal anatomy.  The great advantage of MRI for physicians and patients is that it can often help avoid unnecessary surgery and more invasive diagnostic procedures.

Most MRI scans can be completed in less than 45 minutes.  Occasionally, IV contrast is needed to enhance images of certain tissues, organs and joints.

Nuclear Medicine is the division of imaging that uses radioactive isotopes and radioactive drugs to evaluate disease processes.  Studies range from nuclear cardiac scans to bone scans, lung scans, thyroid scans and infection scans.

A small amount of radioactive material is injected into a vein and imaging of the whole body or part of the body is acquired either immediately or at some delayed time point.

Screening mammography is one of the most important parts of Women’s Healthcare.  It decreases the mortality rate from breast cancer by up to 35%.  Breast ultrasound and MRI are excellent supplemental tests which can help determine  benign  from malignant lesions and estimate extent of disease.  Image guided biopsies (ultrasound, stereotactic, and MRI) allow diagnosis of most abnormalities without the need for surgery.

Preparation for ultrasound, stereotactic, or MRI guided breast biopsies:   None needed for most patients.  Because we use only local anesthesia, you can eat and drink as usual.  Withholding blood thinners for a few days prior to a biopsy is suggested but not mandatory;  check with your prescribing physician before stopping any medications.

Pediatric radiologists specialize in imaging babies, children and teenagers.  In additional to becoming a general radiologist, pediatric radiologists obtain one or more years of training in diagnosis of pediatric diseases with imaging.  All of the modalities utilized in imaging adults, such as CT, MRI, ultrasound, plain film radiography, fluoroscopy and nuclear medicine, are are used to image children. 

Not only do pediatric radiologists have detailed knowledge of illnesses and medical conditions of infants, children and teenagers, but their equipment, procedures and staff are oriented to the special needs of children.  Pediatric radiologists are attuned to the safety of their patients not only during the examinations, but protocol examinations in order to limit the doses of harmful x-rays produced by imaging modalities, such as computed tomography or plain film radiographs.  

Interventional procedures include needle aspirations, biopsies and drainages.  By using fluoroscopy, ultrasound, computed tomography and in some cases Magnetic Resonance Imaging the inteventionalist is able to guide needles into the appropriate location without the need for surgery.  The recent advances in minimally invasive procedures allow patients to recover quickly by avoiding surgery.

Bone Mineral Density (DEXA) scans are used to evaluate for low bone mineral density called osteopenia or osteoporosis which can lead to fractures and other bone abnormalities.  It is most commonly used in post-menopausal females, but can be used for patient who have been on chronic steroid therapy as well as for other bone conditions.