CT Scan
(Q) What is a CT Scan?
(A) CT is generally a relatively quick procedure that uses x-ray beams to create computer-generated image of soft tissue structures, such as tumors and internal organs, and air cavities (sinuses, lungs). It also has advantages in skeletal and neurological imaging. Its radiation doses to the human body are considered minimal due to the speed in which the X-Ray is delivered.
(Q) How is a CT scan performed?
(A) The technologist begins by positioning you on the CT table. Your body may be supported by pillows to help you hold still in the proper position during the scan. As the study proceeds, the table will move slowly into the CT scanner. Depending on the part of the body being examined, the you may slide into the opening of the CT scanner head-first or feet-first. Certain examinations require you to hold your breath during the scan. These instructions will be explained by the technologist and you will be told the exact time in which to hold your breath.
Some CT examinations often require the use of different contrast materials to enhance the visibility of certain tissues or blood vessels. The contrast material may be swallowed or injected through an IV directly into the blood stream. The ordering physician will determine whether your exam requires any type of contrast material.
(Q) What is contrast material?
(A) Contrast material is a substance that is used to highlight certain structures in your body. There are two main type of contrast material: Oral Contrast and Intravenous or IV Contrast. Oral contrast is used to highlight your digestive tract, which includes your stomach and intestines. Certain CT examinations require that you drink this oral contrast at specific times before your exam is performed. The most common type of oral contrast is called barium. Barium looks like a very thin milkshake. It has a bland, slightly chalky taste. Contrary to some beliefs, barium is NOT a radioactive material.
Intravenous or IV contrast is injected into a vein to highlight the blood vessels in the organs of your body. All IV contrast used in CT contains a substance called iodine. If you have a known allergy to iodine in any form, let the technologist know immediately before the exam is performed. When the IV contrast is injected, you may feel a warm, flushed sensation throughout your body for a few seconds.
(Q) What will I experience during the CT Scan?
(A) CT scanning causes no pain. After the technologist has positioned you on the patient table, he or she will have to leave the room since CT scans use radiation. However, you will be constantly monitored through a large glass window. The technologist will be able to see, hear, and speak to you at any time during the scan.
As the scan begins, you may feel the patient table moving back and forth as the scan is taking place. The CT scanner itself may emit a soft whistling noise while the scan is being acquired. You may be required to hold your breath. You will be instructed when to do so. If the exam requires that contrast material be injected into a vein, you may experience a warm flushed sensation as the contrast material is being injected. As soon as the scan is over, the technologist will come back into the room. Typical scans last only a few seconds.
(Q) How do I prepare for a CT Scan?
(A) Some CT Scans require no preparation at all. Other scans may require you to fast for a given period of time. For CT Scans of the abdomen and pelvis, you may be required to drink contrast material a few hours before your exam is scheduled. When you schedule your appointment, you will be given the appropriate prep instructions.
(Q) Do I need to be concerned if I am diabetic?
(A) Being diabetic only becomes a concern if your exam requires that contrast material be injected into a vein to enhance the study. Certain diabetic medications can interact with the contrast material. If you are on Glucophage, Glucovance, Metformin, Avandament, or Avandia, be sure to let your doctor and the technologist know before the exam is performed. You may be required to withhold taking your medication for 48 hours after the CT scan as been performed.
If you are diabetic, and your exam requires that contrast material be injected into a vein, you may be required to have certain blood tests before your CT scan can be performed. These blood tests are done to verify that your kidneys are functioning well enough to filter out the contrast material that will have to be injected. Your physician will order these blood tests. When scheduling your CT scan, be sure to let us know if you are diabetic.
(Q) How long does a CT scan take ?
(A) A CT scan can take from 5 minutes to 30 minutes to be performed, depending on the type of examination ordered and whether contrast material needs to be used. You will be able to drive home after the exam has been performed.
(Q) Who interprets the results and how do I get them?
(A) After your CT scan has been performed, a radiologist, who is a physician experienced in CT and other radiology examinations, will analyze the images and send a signed report with his or her interpretation to the physician who ordered the exam. Once your doctor receives this report, it is his or her responsibility to discuss the findings with you.
Dexa Scan
(Q) What is a DEXA bone densitometry exam?
(A) DEXA (dual energy x-ray absorptiometry) is the gold standard for osteoporosis detection. Bone densitometry is a safe, painless study that measures the amount of bone mineral content in specific areas of the body. The exam uses small amounts of x-ray radiation to produce images of the spine, hip or wrist, where most osteoporotic fractures occur. The x-ray is composed of two energy levels that are absorbed differently by bones. A computer determines from these differences how much bone mineral is present.
(Q) How is a DEXA scan done?
(A) You lie on your back on a padded table and are asked to keep still while an x-ray detector (the ‘scanner’) moves over the area to be tested. An x-ray machine under the table fires x-rays towards the detector. The bones commonly scanned are the vertebra (back bones), hip and wrist. (These are the bones most commonly affected by osteoporosis.) The scan is painless and takes 10-15 minutes.
(Q) What are the reasons for having a DEXA scan?
(A) By measuring bone mineral density, a DEXA scan provides information on bone health that is used to:
- Detect the presence of osteoporosis in men and women with particular risk factors
- Screen for osteoporosis, particularly in women making decisions about hormone replacement therapy at menopause
- Predict future fracture risk so prevention therapy can be started.
- Monitor bone density in those with low normal levels and in those with osteoporosis undergoing treatment
(Q) What is osteoporosis?
(A) Osteoporosis is a disease characterized by low bone mass and structural deterioration of bone tissue which leads to reduced bone strength, poor bone quality and an increased risk of fractures, especially of the hip, spine and wrist. Often called the “quiet disease,” osteoporosis symptoms are rarely evident until significant bone loss has occurred. The disease, however, is treatable and preventable. Early diagnosis and monitoring through bone density testing allows for therapeutic intervention and has improved the prognosis for patients.
(Q) When should you have a Dexa Scan?
(A) It is recommended that patients have a base line Dexa scan at 45-50 years of age. Then all following exams can be compared to the first scan to monitor the changes in the bone density.
(Q) Is a Dexa Scan safe?
(A) The amount of radiation a DEXA scan emits is only a fraction of that received during a standard chest x-ray. Although exposure is very low, be sure to inform the technologist if there is a chance of pregnancy.
(Q) What should I do to prepare for a Bone Density (Dexa) Scan Exam?
(A) Do not take calcium supplements the day of the exam. Wear any kind of clothing you like, but please avoid metal buttons or buckles. NO fasting is required.
Digital Mammography
(Q) Will it hurt?
(A) Every woman has a different level of sensitivity to their mammogram. Emery Medical Solutions, Inc. uses the Siemens Flex Paddles for performing your mammogram. These special paddles allow the machine to detect when the compression is sufficient for the best exam. Our experienced technologists will guide you through every step of the experience with the utmost of care.
(Q) When should I start having Mammograms?
(A) The guidelines established by the American College of Radiology and the American College of Surgeons suggest having your first mammogram between 35 and 40 years of age, depending on the patient risk factors. From 40 to 50 years of age, patients should have a mammogram every 1 to 2 years, depending on the patient risk factors. After the age of 50, it is recommended to have one mammogram per year. Risk factors include, but not limited to, family history of cancer, personal history of cancer, age, hormone therapy and medical history.
(Q) What is the difference between a Screening and Diagnostic Mammogram?
(A) A screening mammogram is performed for a patient with no breast complaints such as a palpable lump or other breast symptoms. A diagnostic mammogram is performed for a patient with a known breast symptom or abnormality. These exams are only performed with a physician on-site.
(Q) Can I have a breast Ultrasound instead of a Mammogram?
(A) Tiny calcifications or pieces of calcium are a common indication of breast cancer seen on a Mammogram. Ultrasound CANNOT detect these calcifications, therefore the Mammogram is necessary for accurate breast cancer screening.
(Q) Why is it so important for me to get my Mammogram films from last year to bring to the appointment this year?
(A) All changes in your mammogram from year to year must be carefully evaluated. Some changes in the breast can indicate breast cancer formation. The radiologist uses the previous films to provide a more thorough evaluation.
(Q) How do I get my Screening Mammogram results?
(A) The doctor that referred you to Emery Medical Solutions, Inc. will receive a type written report of your results. The report should arrive within several days of having your mammogram performed at our office. Your physician’s office should contact you to review any results, as needed.
Digital Ultrasound
(Q) What is an ultrasound?
(A) High frequency sound waves are focused on the organ of interest. These sound waves are reflected back to the camera and a picture is created.
(Q) How is an ultrasound performed?
(A) A gel substance is placed on the end of a hand held camera and lightly placed on the organ being evaluated.
(Q) Is there any discomfort during an ultrasound exam?
(A) The exam should be very painless. Some patients may experience minor discomfort if the technologist scans a previously tender area.
(Q) Are there any preparations for the test?
(A) Abdominal ultrasound patients must fast for at least 6 hours prior to the appointment. Kidney ultrasound patients must fast AND drink 24oz water 1 hour before the appointment without voiding until after the exam. Pelvic ultrasound patients must drink 32oz water 1 hour before the appointment without voiding until after the exam. All other ultrasound testing does not require any prep.
(Q) How long will the exam take?
A) Each exam will last for 20 – 30 minutes.
(Q) Does a physician review the images?
(A) Yes, a board certified radiologist and/or cardiologist will review each exam and a report will be generated for your doctor.
(Q) When will my doctor get the results?
(A) A typewritten report will be sent directly to the ordering physician within 48 hours of your exam. Your doctor will inform you of any necessary information.
(Q) I need to have a fetal ultrasound. Will I get any pictures to take home?
(A) Yes, we will provide you with paper images along with a CD Rom containing digital images. VHS taping is available, if you do not have access to a PC to view the CD Rom.
(Q) Does my insurance cover these tests?
(A) Our staff will verify all insurances prior to your appointment date. We will confirm your active status and any necessary co-pay fees that may apply. Our office will contact you the date prior to your appointment to inform you of any fees due at the time of the exam.
MRI
(Q) What is MRI?
(A) Magnetic resonance imaging (MRI) uses radio frequency waves and a strong magnetic field rather than x-rays to provide remarkably clear and detailed pictures of internal organs and tissues. The technique has proven very valuable for the diagnosis of a broad range of pathologic conditions in all parts of the body including cancer, heart and vascular disease, stroke, and joint. MRI requires specialized equipment and expertise and allows evaluation of some body structures that may not be as visible with other imaging methods.
(Q) What body parts can be scanned by MRI?
(A) Because MRI can give such clear pictures of soft-tissue structures near and around bones, it is the most sensitive exam for spinal and joint problems. MRI is widely used to diagnose sports-related injuries, especially those affecting the knee, shoulder, hip, elbow and wrist. The images allow the physician to see even very small tears and injuries to ligaments and muscles. In addition, MRI of the heart, aorta, coronary arteries and blood vessels is a fast, noninvasive tool for diagnosing coronary artery disease and heart problems.
MRI can also be used to image the organs of the chest and abdomen. MRI is also used to scan the breast. Because no radiation exposure is involved, MRI is often the preferred diagnostic tool for examination of the male and female reproductive systems, pelvis and hips and the bladder.
(Q) Can I have a Breast MRI instead of a Mammogram?
(A) No. MRI of the breast is not a replacement for mammography or ultrasound imaging but rather is a supplemental tool for detecting and staging breast cancer and other breast abnormalities.
(Q) How do I prepare for an MRI?
(A) Because the strong magnetic field used for MRI will pull on any ferromagnetic metal object implanted in the body, MRI staff will ask whether you have any metallic implants inside your body, such as a pacemaker, surgical staples, or joint replacements. If in fact you do have a pacemaker, you will be unable to have an MRI scan. In most cases surgical staples, plates, pins and screws pose no risk during MRI if they have been in place for more than four to six weeks.
Try to wear non-metallic clothing, such as wearing elastic instead of zippers. If possible, leave all removable metal at home, such as your watch, rings, and earrings. When you arrive for your MRI exam, you may be asked to place your purse or wallet in a secured location outside the exam room, since the magnetic field can erase items such as credit cards. You may also be asked to remove such items as hearing aids, hairpins, and all removable dental work, such as partials. It is safe to perform an MRI scan if you have braces, although the metal in the braces may distort the images taken in that area.
(Q) How is an MRI scan performed?
(A) The patient is placed on a sliding table and positioned comfortably for the MRI examination. Then the radiologist and technologist leave the room and the individual MRI sequences are performed. The patient is able to communicate with the radiologist or technologist at any time using an intercom. Depending on how many images are needed, the exam will generally take 15 to 45 minutes, although a very detailed study may take longer. You will be asked not to move during the actual imaging process, but between sequences some movement is allowed. Patients are generally required to remain still for only a few seconds to a few minutes at a time.
Depending on the part of the body being examined, a contrast material (usually gadolinium) may be used to enhance the visibility of certain tissues or blood vessels. A small needle connected to an intravenous line is placed in an arm or hand vein.
(Q) What will I experience during the MRI scan?
(A) MRI causes no pain but some patients can find it uncomfortable to remain still during the examination. Some patients feel a sense of being “closed in.” If you are claustrophobic, be sure to let the technologist know. Listening to music or having someone in the room can help. If you suffer from severe claustrophobia, your doctor may prescribe you medication that may help you relax. A technologist will be watching you through a special glass window during the exam. At any time, the technologist can enter the room and pull you out of the scanner if necessary.
If a contrast injection is needed, there may be discomfort at the injection site and you may have a cool sensation at the site during the injection. Most bothersome to many patients are the loud tapping or knocking noises heard at certain phases of imaging. Ear plugs may help.
X Ray
(Q) What is an x-ray?
(A) X-ray is the oldest and most frequently used form of medical imaging. Discovered more than a century ago, x-rays can produce diagnostic images of the human body on film or digitally on a computer screen. X-rays are a form of radiation, like light or radio waves that can be focused into a beam. X-rays pass through most objects, including the body. Once it is carefully aimed at the part of the body being examined, an x-ray machine produces a small burst of radiation that passes through the body, recording an image on photographic film or a special image recording plate.
(Q) How should I prepare for the procedure?
(A) There is no special preparation required for most x-rays. Once you arrive, you may be asked to change into a gown before your examination. You will also be asked to remove jewelry, eyeglasses and any metal objects that could show up on the images and overlap important findings. Women should always inform their doctor or x-ray technologist if there is any possibility that they are pregnant.
(Q) How is the procedure performed?
(A) The technologist positions the patient on the examination table, places a film holder (cassette) under the table in the area of the body to be imaged. Then the technologist steps behind a radiation barrier and asks the patient to hold very still without breathing for a few seconds. The x-ray equipment is activated, sending a beam of x-rays through the body to expose the film. The technologist then repositions the patient for another view, and the process is repeated.
(Q) How long does an x-ray exam take?
(A) An x-ray exam usually consists of multiple images. A typical x-ray exam usually takes 5 to 10 minutes to perform, including the time it takes for you to change into a gown if necessary. When your x-rays are completed you will be asked to wait until the technologist checks the images for adequate exposure and motion. This only takes a minute or two.
(Q) What is an IVP?
(A) An intravenous pyelogram (IVP) is an x-ray examination of the kidneys, ureters and urinary bladder that uses contrast material. When a contrast material is injected into 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 and lower urinary tract.
Your doctor will give you detailed instructions on how to prepare for your IVP study. You should inform your physician of any medications you are taking and if you have any allergies, especially to contrast material. Also inform your doctor about recent illnesses or other medical conditions. Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant.
(Q) How do I protect myself from the x-ray radiation?
(A) The technologist will provide you with lead shielding, usually in the form of a lead apron. The lead shielding will be placed according to the body part being imaged. For example, if you are getting an abdominal x-ray, the technologist will not cover your abdominal area since that is the body part being imaged.