Imaging

Diagnostic Medical Imaging

Diagnostic imaging is a medical imaging technique that is used by physicians to look inside thebody for diagnostic purposes in order to determine proper treatment. It is a non-invasive or minimally invasive methodology to view the internal tissues and organs.

Our doctors' who are specially trained to perform these scans to help diagnose health condition are radiologists. The type of scan depends on the type of health condition that is being analyzed or suspected.

Our doctors may order a diagnostic imaging procedure. Before the imaging, the patient must letthe physician know about all of the medications and medicines he/she takes, any implants they may have or anything foreign that is inside the body,allergies ifany. The doctor will take all things into consideration in determining the type of scan a patient must have to analyze the condition.

Common Diagnostic Medical Imaging Tests

Various types of diagnostic imaging tools allows our doctors to look inside a body for more information about a patient's health.

Some of the most used diagnostic imaging tools include:

USG (Ultrasound) scan

Also called a sonogram, the ultrasound scanning technique uses high-frequency sound waves through the body to produce real-time video images of the organs and tissues. Still photos can also be captured during the scan for future viewing by the doctor.

Preparing for an Ultrasound Scan

The preparation for an ultrasound will depend on the area or organ that is being examined.

• A doctor may demand that a patient should fast for eight to 12 hours before an ultrasound scan, especially before an examination of the abdomen. This is because undigested food could block the sound waves and make it difficult for the technician to get a clear picture.
• Similarly, for examinations of the gall bladder, liver, pancreas, or spleen, a patient may be asked to eat a fat-free meal the evening before the test and then fast until the procedure is completed. Patients however can continue to drink water and take any medications as instructed. For other examinations, the patient may be asked to drink a lot of water and to hold the urine so that your bladder would be full and thus better visualized.
• A doctor will need to know about any prescription drugs, over-the-counter medications, or herbal supplements that you take before the exam.
• It's important to follow the doctor's instructions and ask any questions you may have before the procedure.

Ultrasound imaging carries minimal risks. It is best known for its role in viewing a fetus during pregnancy because it uses no radiation, however, this diagnostic imaging technique is also used for viewing the:

• Thyroid
• Kidneys
• Breasts ( Mammary gland)
• Gallbladder
• Blood vessels
• Pancreas
• Liver
• Prostate
• Scrotum and testicles
• Uterus and ovaries
• Tumor

ECG

An ECG (electrocardiogram) records the electrical activity of the heart when at rest. It provides information about the heart rate and rhythm, and shows if there is enlargement of the heart due to high blood pressure (hypertension) or evidence of a previous heart attack (myocardial infarction). What it does not show however is whether one has asymptomatic blockages in the heart arteries or predict your risk of a future heart attack. The ECG when the heart is at rest is different from a stress or exercise ECG or cardiac imaging test.

A patient may need an ECG test if he has risk factors for heart disease such as high blood pressure, or symptoms such as palpitations or chest pain. Or if he already has aheart disease.

But in other cases, a patient may think twice and deeply about having this test. Here's why:

• Usually, you do not need an ECG if you don't have risk factors for heart disease or symptoms that suggest possible heart disease.
• The test is not useful in routine checkups for people who do not have risk factors for heart disease such as high blood pressure or symptoms of heart disease, like chest pain.
• There are better ways to prevent heart disease than routine ECGs.
• The ECG will not harm you. However, it does show mild nonspecific abnormalities that are not due to underlying heart disease. These would cause worry and lead to follow-up tests and treatments that may not be needed.

When is ECG scan needed?

A patient should have an ECG if he/she has risk factors for an enlarged heart such as high blood pressure or symptoms of heart disease, such as chest pain, shortness of breath, an irregular heartbeat or heavy heartbeats.

A patient may need the test for screening for occupational requirements, or when there is a personal or family history of heart disease, diabetes or other risks.

How should one protect the heart?

Know your risks. Talk to your health care provider. Your risk of heart disease depends on many things, such as your age, sex, ethnicity, cholesterol, blood pressure, and if you smoke or have diabetes.

Lower your risks.

The best ways to lower your risk of heart disease are to:

• Be aware of your risk factors.
• Be smoke-free.
• Be physically active.
• Know and control your blood pressure.
• Eat a healthy diet that is high in fiber, lower in fat, especially saturated and trans fats, lower in sodium, includes lots of fruit and vegetables, and includes portions of food that are in line with your level of physical activity.
• Achieve and maintain a healthy weight.
• Manage diabetes.
• Limit useof alcohol.
• Reduce stress.
• Visit us at Diamed regularly and follow our doctors' advice.
• Know and control your blood cholesterol.
• Have your blood pressure, blood cholesterol, and blood sugar tested according to doctor's recommendations.

The following tests are proven to help measure the risk of having heart disease:

Blood pressure: One should be tested at least once a year using a blood-pressure cuff. If the patient have been diagnosed with high blood pressure (or other related conditions), Diamed will recommend that your blood pressure be checked more often.

Cholesterol: A patient should have a blood test for cholesterol if he is a male and over 40, female and over 50 or post-menopausal, you have heart disease, stroke, diabetes or high blood pressure, your waist measures more than 102 cm (40 in) for men or 88 cm (35 in) for women, you have a family history of heart disease or stroke. Your health care provider can advise how often you should have your cholesterol tested.

Blood sugar: If you're over 40, you should have a blood test once every three years to measure your blood sugar (glucose). Too much glucose can harm your blood vessels. If you have risk factors for diabetes or are pregnant, your blood sugar levels should be tested. Speak to your health care provider about whether you need a blood sugar test.

X-rays

This type of scan is performed using electromagnetic radiation.

• X-rays are often used to determine broken bones, pneumonia, and tumors.
• Mammography is a type of X-ray scan of the breast.
• An X-ray is one of the fastest types of medical scans that can be performed.

An X-ray is a quick, painless test that produces images of the structures inside the body (particularly the bones). X-ray beams pass through the body, and are absorbed in different amounts depending on the density of the material they pass through.

X-rays of your joints can reveal evidence of arthritis. X-rays taken over the years can help the doctor determine if the arthritis is worsening.

Densitometry:- Special types of X-ray tests can measure bone density and detect presents of Osteoporosis.

Preparation for an X-Ray

• Most X-rays, especially with bones require no special preparation.
• Patients must wear lightweight and comfortable clothes. Where clothing interferes with the images, a patient may be asked to change into a hospital gown.
• Inform the physician or X-ray technologist if there is any possibility ofa pregnancy.Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation.
• If an X-ray is necessary, precautions will be taken to minimize radiation exposure to the baby.

Different types of X-rays require different preparations. Patients must ask the doctor or a nurse to provide specific instructions.

What to wear

In general, patient will have to undress whatever part of the body that needs the examination. Depending on which area is being X-rayed, a patient may wear a gown during the exam.Jewelry, eyeglasses and any metal objects will have to be removed because they can show up on an X-ray.

Contrast material

Before certain types of X-rays, patients are given a liquid called contrast medium. Such as barium and iodine, these help outline a specific area of the body on the X-ray image. The contrast medium may be swallowedor received as an injection or an enema.

What to Expect During the X-Ray

• X-rays are performed at wherever an X-ray machine is available (e.g. in doctors' offices, dentists' offices, emergency rooms and hospitals). The machine produces a safe level of radiation that passes through the human body and records an image on a specialized plate.AnX-raycan't be felt.
• A technologist will position the body to obtain the necessary views. He or she may use pillows or sandbags to help the patient hold his position. During the X-ray exposure, a patient is expected to remain still and sometimes hold the breath to avoid moving so that the image doesn't blur.
• An X-ray procedure ordinarily may take just a few minutes for a simple X-ray or a little longer for more-involved procedures, such as those that may use contrast mediums.
• Restraints or other techniques may be used to keep a child who is having an X-raystill. These won't harm the child and will prevent the need for a repeat procedure. Procedures may necessarily be repeated if the child moves during the X-ray exposure.
• A parent or an adult may be allowed to remain with the child during the test. If it becomes necessary that he remains in the room during the X-ray exposure, such a parent will most likely be asked to wear a lead apron to shield from unnecessary exposure.

After the X-ray

One can generallyresume normal activities after an X-ray, as routine X-rays usually have no side effects. However, if contrast medium was used, before the X-rays, it would be necessary for the patient to drink plenty of fluids to help rid the body of it and ask the doctor about other signs and symptoms to watch out for.

MRI

Magnetic resonance imaging (MRI) does not use radiation of any kind. Ituses magnets and computerized equipment to take pictures inside of a patient's body. This makes it preferable for many people.What a lot of patients don't like is that the patient may have to go headfirst into the MRI machine for the scan.This makes patients feel claustrophobic (the fear of confined spaces). It is best to keep the eyes closed the entire time to prevent the feeling of claustrophobia.For some MRI scans, the doctor will request for a gadolinium dye injection. This will help to provide contrast in the MRI scans.

PREPARING FOR THE MRI SCAN

• On the day of the MRI scan, a patient should be able to eat, drink and take any medication as usual, unless advised otherwise.
• In some cases, patients may be asked not to eat or drink anything for up to 4 hours before the scan. Sometimes a patient may be asked to drink a fairly large amount of water beforehand. This however, will depend on the area to be scanned.
• Upon arrival at the hospital, a patient usually will be asked to fill in a questionnaire about health and medical history. This helps the medical staff to ensure you have the scan safely.
• With the questionnaire completed, you'll usually be asked to give your signed consent for the scan to go ahead.
• As the MRI scanner produces strong magnetic fields, it's important to remove any metal objects from your body. These may include: Watches, earrings and necklaces, ear, nipple and nose rings, dentures (false teeth), hearing aids, wigs (some wigs contain traces of metal).
• Depending on which part of the body that is to be scanned, one may need to wear a hospital gown during the procedure. Otherwise a patient should wear clothes without metal zips, fasteners, buttons, underwire (bras), belts or buckles.
• Patients with a history of kidney disease, may be given a blood test to determine how well the kidneys are functioning and whether it's safe to proceed with the scan.
• Patients should let the staff be aware if there is a history of allergic reactions or any blood clotting problems before having the contrast dye injection if it becomes necessary.

ANAESTHESIA AND SEDATIVES FOR MRI SCAN

• Anesthesia is rarely needed as the MRI scan is a painless procedure.
• A claustrophobic patient can ask for a mild sedative to help him relax. This must be suggested to the doctor or consultant well in advance of having the scan.
• If a patient is sedatedfor the scan, arrangement will have to be made for a friend or family member to drive him/her home afterwards.
• Babies and young children may be given a general anaesthetic before having an MRI scan.
• This is because it's very important to stay still during the scan, which babies and young children are often unable to do when they're awake.

CT Scans

Also called CAT scans, computed tomography (CT) scans take X-rays and filter them through computerized technology to create a 3-D view of the patient's organs.

A CT scan combines a series of X-ray images taken from different angles and uses computer processing to create images of organs or structures inside the body. CT scan images provide more detail than plain X-rays do.

We may recommend a CT scan to help:

• Diagnose muscle and bone disorders, such as fractures
• Guide procedures, such as surgery
• Detect internal injuries and internal bleeding
• CT scans are painless and typically only take a few minutes.

ARE THERE ANY RISKS WITH CT SCAN?

• CT scans use X-rays, which produce ionizing radiation. Research shows that this kind of radiation may damage your DNA which can lead to cancer. However, the risk is still very small. A patient's chances of developing a fatal cancer because of a CT scan is very minimal.
• The effect of radiation adds up over a lifetime. Therefore a patient's risk increases with every CT scan.Before a CT scan patients must necessarily enquire about the procedure's potential dangers and benefits, and ask why the CT scan is necessary.
• Ionizing radiation may be more harmful in children because they're still growing. Again, they also have more years to get exposed to more radiation. Before the procedure, patients must ask the doctor or technician if the CT machine's settings have been adjusted for a child.
• Patient must tell the physician if she is pregnant. If a pregnant woman needs imaging for the stomach area, the doctor may recommend an exam that doesn't use radiation, such as an ultrasound.

Nuclear scans

Also called radioisotope scans or radionuclide scans.This uses a radioactive substance and a gamma ray camera to make a picture of the inside of the body. The radioactive substance is administered in a very small, harmless dosage either orally or intravenously. Time is allowed to elapse for the substance to travel through the body. When the substance reaches the part of the body needing to be examined, the patient is made to lie down in a machine for twenty to thirty minutes. The two dimensional pictures taken by the machine will show whether the tissue is functioning properly or not.

Our doctors may order a bone scan in the case of unexplained skeletal pain, bone infection or a bone injury that can't be seen on a standard X-ray. A bone scan is a nuclear imaging test that helps diagnose and track several types of bone diseases.

The ability to scan the entire skeleton makes a bone scan very helpful in diagnosing a wide range of bone disorders, including:

• Fractures
• Arthritis
• Paget's disease of bone
• Infection of the joints, joint replacements or bones (osteomyelitis)
• Fibrous dysplasia
• Impaired blood supply to bones or death of bone tissue (avascular necrosis)

Mammogram

There are two types of mammogramsscreening and diagnostic mammograms that are employed in the battle against breast cancer. Screening mammograms are used to detect any abnormalities whilediagnostic mammograms check for malignancy after lumps or thickening in the breast may have been detected. Technologists will use best practices depending on which examination is being performed. With screening exams, only a couple of images of each breastis needed. Diagnostic exams are more extensive, and will involve the takingof more images from multiple angles. Magnified images are also taken so that physicians can examine suspicious areas.

Fluoroscopy

While other tests can be compared to still photography, a fluoroscopy is more like a motion picture of bodily functions.A fluoroscopy shows moving body parts and organs. The procedure is often done with contrast dye, which will show how it flows through the human body. Blood flow exams often done with fluoroscopy.Fluoroscopies are used to evaluate both hard and soft tissue, including bones, joints, organs and vessels.

Unlike many other exams in which the patient is asked to be motionless, the technologist may ask the person to move during the fluoroscopy in order to get an idea how the body is reacting to motion. Fluoroscopy is not painful, however, the process of injecting contrast dyes into the body can be.

PET scans

Also known as Positron Emission Tomography scan, this is like disease detection in the body, revealing problems happening at the level of cells. This scan involves introducing radioactive tracers into the patient's body. The use of a PET scanner, will allow the tracers uncover problems that otherwise could go undetected until they worsen.

Depending on which procedure is adopted, tracers can be introduced in three different ways:

• Injection in a vein,
• Inhalation of a gas or
• Drinking a special mixture.

It takes a while for tracers to travel within the body, so the technician will allow about an hour's wait before the scan proper. Patient will be made to lie down on a table that moves through an O-shaped machine. The technologist will instruct the patient as to when to be motionless and when to hold one's breathe.

Benefits of Diagnostic Imaging

Medical Imaging offers numerous benefits to both the healthcare providers and the patients. The benefits may include;

Better Diagnosis

Literally, imaging in medical practice aids the physician to understand the complications in a human body and enables them to take better informed decisions. These procedures are completely painless, non-invasive and most of them do not require any special preparation, except when contrast media is used. In cases such as breast cancer, medical imaging can be life-saving.

Imaging technologies like Ultrasound allows a medical examiner to examine the internal body structures such as tendons, muscles, joints, vessels and internal organs. Also known as Sonogram, these Ultrasound tests are conducted as prenatal tests for pregnant women. Most of them are suggested to get an ultrasound in their second trimester of pregnancy to get a picture of the baby in the womb. It helps the doctor to check on the baby's health and development.

Affordable Health Care Costs

When a doctor is able to identify what/where the issue is, better informed decisions on the way forward towards treatment would have been made easier. Post medical imaging and in most cases, invasive diagnostic procedures such as exploratory surgery or angiography or cardiac catheterization may become unnecessary as the issue can be treated with normal medicines. In the long run, this drastically reduces treatment cost and also paves way for healing in a better way.

Safe and effective

Radiation can be used for great benefit to humanity with minimal risk, a risk comparable to or lower than those commonly accepted as an ordinary part of daily life.In the recent past, manufacturers have been trying to bring innovations that will reduce the radiation dose, even as the accuracy and the ability of physicians to diagnose their patients is improved. With these inventions, the exposure to medical radiation can be effectively managed and minimized.