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FAQ

ULTRASONOGRAPHY 

What is General Ultrasound Imaging?

Conventional ultrasound displays the images in thin, flat sections of the body. Advancements in ultrasound technology include three-dimensional (3-D) ultrasound that formats the sound wave data into 3-D images.

A Doppler ultrasound study may be part of an ultrasound examination.

Doppler ultrasound is a special ultrasound technique that evaluates movement of materials in the body. It allows the doctor to see and evaluate blood flow through arteries and veins in the body.

There are three types of Doppler ultrasound:

  • Color Doppler uses a computer to convert Doppler measurements into an array of colors to show the speed and direction of blood flow through a blood vessel.

  • Power Doppler is a newer technique that is more sensitive than color Doppler and capable of providing greater detail of blood flow, especially when blood flow is little or minimal. Power Doppler, however, does not help the radiologist determine the direction of blood flow, which may be important in some situations.

  • Spectral Doppler displays blood flow measurements graphically, in terms of the distance traveled per unit of time, rather than as a color picture. It can also convert blood flow information into a distinctive sound that can be heard with every heartbeat.

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What are some common uses of the procedure?

Ultrasound exams can help diagnose a variety of conditions and assess organ damage following illness.

Doctors use ultrasound to evaluate:

  • pain

  • swelling

  • infection

Ultrasound is a useful way of examining many of the body's internal organs, including but not limited to the:

Ultrasound is also used to:

  • guide procedures such as needle biopsies, in which needles remove cells from an abnormal area for laboratory testing.

  • image the breasts and guide biopsy of breast cancer 

  • diagnose a variety of heart conditions, including valve problems and congestive heart failure, and to assess damage after a heart attack. Ultrasound of the heart is commonly called an "echocardiogram" or "echo" for short.

Doppler ultrasound helps the doctor to see and evaluate:

  • blockages to blood flow (such as clots)

  • narrowing of vessels

  • tumors and congenital vascular malformations

  • reduced or absent blood flow to various organs, such as the testes or ovary

  • increased blood flow, which may be a sign of infection

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How should I prepare?

Wear comfortable, loose-fitting clothing.

Preparation for the procedure will depend on the type of exam you will have. For some scans, your doctor may tell you not to eat or drink for up to 12 hours before your exam. This timeframe is lower for babies and young children. For others, the doctor may ask you to drink up to six glasses of water two hours prior to your exam and avoid urinating. This will ensure your bladder is full when the scan begins.

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What does the equipment look like?

Ultrasound machines consist of a computer console, video monitor and an attached transducer. The transducer is a small hand-held device that resembles a microphone. Some exams may use different transducers (with different capabilities) during a single exam. The transducer sends out inaudible, high-frequency sound waves into the body and listens for the returning echoes. The same principles apply to sonar used by boats and submarines.

The technologist applies a small amount of gel to the area under examination and places the transducer there. The gel allows sound waves to travel back and forth between the transducer and the area under examination. The ultrasound image is immediately visible on a video monitor. The computer creates the image based on the loudness (amplitude), pitch (frequency), and time it takes for the ultrasound signal to return to the transducer. It also considers what type of body structure and/or tissue the sound is traveling through.

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How does the procedure work?

Ultrasound imaging uses the same principles as the sonar that bats, ships, and fishermen use. When a sound wave strikes an object, it bounces back or echoes. By measuring these echo waves, it is possible to determine how far away the object is as well as its size, shape, and consistency. This includes whether the object is solid or filled with fluid.

Doctors use ultrasound to detect changes in the appearance of organs, tissues, and vessels and to detect abnormal masses, such as tumors.

In an ultrasound exam, a transducer both sends the sound waves and records the echoing (returning) waves. When the transducer is pressed against the skin, it sends small pulses of inaudible, high-frequency sound waves into the body. As the sound waves bounce off internal organs, fluids and tissues, the sensitive receiver in the transducer records tiny changes in the sound's pitch and direction. A computer instantly measures these signature waves and displays them as real-time pictures on a monitor. The technologist typically captures one or more frames of the moving pictures as still images. They may also save short video loops of the images.

Doppler ultrasound, a special ultrasound technique, measures the direction and speed of blood cells as they move through vessels. The movement of blood cells causes a change in pitch of the reflected sound waves (called the Doppler effect). A computer collects and processes the sounds and creates graphs or color pictures that represent the flow of blood through the blood vessels.

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How is the procedure performed?

For most ultrasound exams, you will lie face-up on an exam table that can be tilted or moved. Patients may turn to either side to improve the quality of the images.

A nursing assistant will position you on the exam table. They will apply a water-based gel to the area of the body under examination. The gel will help the transducer make secure contact with the body. It also eliminates air pockets between the transducer and the skin that can block the sound waves from passing into your body. The radiologist places the transducer on the body and moves it back and forth over the area of interest until it captures the desired images.

There is usually no discomfort from pressure as they press the transducer against the area being examined. 

Doctors perform Doppler sonography with the same transducer.

Very rarely, young children may need sedation to hold still for the procedure. Parents should ask about this beforehand and be made aware of prior food and drink restrictions that sedation requires. The ultrasound gel does not usually stain or discolor clothing.

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What will I experience during and after the procedure?

Ultrasound exams are painless, fast, and easily tolerated.

If the doctor performs a Doppler ultrasound exam, you may hear pulse-like sounds that change in pitch as they monitor and measure the blood flow.

Most ultrasound exams take about 15 minutes. More extensive exams may take up to 30 minutes

When the exam is complete, the radiologist may ask you to wait while the doctor reviews the ultrasound images.

After an ultrasound exam, you should be able to resume your normal activities immediately.

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Who interprets the results and how do I get them?

A radiologist, a doctor trained to supervise and interpret the exams, will analyze the images. The radiologist will send a signed report to the doctor who requested the exam. Your doctor will then share the results with you. In some cases, the radiologist may discuss results with you after the exam.

You may need a follow-up exam. If so, your doctor will explain why. Sometimes a follow-up exam further evaluates a potential issue with more views or a special imaging technique. It may also see if there has been any change in an issue over time. Follow-up exams are often the best way to see if treatment is working or if a problem needs attention.

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What are the benefits vs. risks?

Benefits

  • Most ultrasound scanning is noninvasive (no needles or injections).

  • Occasionally, an ultrasound exam may be temporarily uncomfortable, but it should not be painful.

  • Ultrasound is widely available, easy to use, and less expensive than most other imaging methods.

  • Ultrasound imaging is extremely safe .

  • Ultrasound scanning gives a clear picture of soft tissues that do not show up well on x-ray images.

  • Ultrasound is the preferred imaging modality for the diagnosis and monitoring of pregnant women and their unborn babies.

  • Ultrasound provides real-time imaging. This makes it a good tool for guiding minimally invasive procedures such as needle biopsies and fluid aspiration.

Risks

What are the limitations of General Ultrasound Imaging?

Ultrasound waves are disrupted by air or gas. Therefore, ultrasound is not an ideal imaging technique for the air-filled bowel or organs obscured by the bowel. Ultrasound is not as useful for imaging air-filled lungs, but it may be used to detect fluid around or within the lungs. Similarly, ultrasound cannot penetrate bone, but may be used for imaging bone fractures or for infection surrounding a bone.

Large patients are more difficult to image by ultrasound because greater amounts of tissue weaken the sound waves as they pass deeper into the body and need to return to the transducer for analysis.CT/ MRI  scan is useful for this patients.

Ultrasound has difficulty penetrating bone and, therefore, can only see the outer surface of bony structures and not what lies within (except in infants who have more cartilage in their skeletons than older children or adults).

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Computed tomography (CT) of the body uses sophisticated x-ray technology to help detect a variety of diseases and conditions. CT scanning is fast, painless, noninvasive and accurate. In emergency cases, it can reveal internal injuries and bleeding quickly enough to help save lives.Tell your doctor if there's a possibility you are pregnant and discuss any recent illnesses, medical conditions, medications you're taking, and allergies.  If you have a known allergy to contrast material, your doctor may prescribe medications to reduce the risk of an allergic reaction. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

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What is CT Scanning ?

Computed tomography, more commonly known as a CT or CAT scan, is a diagnostic medical imaging test. Like traditional x-rays, it produces multiple images or pictures of the inside of the body.

A CT scan generates images that can be reformatted in multiple planes. It can even generate three-dimensional images. Your doctor can review these images on a computer monitor, print them on film or via a 3D printer, or transfer them to a CD or DVD.

CT images of internal organs, bones, soft tissue, and blood vessels provide greater detail than traditional x-rays. This is especially true for soft tissues and blood vessels.

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What are some common uses of the procedure?

CT imaging OF BODY is:

  • one of the fastest and most accurate tools for examining the chest, abdomen and pelvis because it provides detailed, cross-sectional views of all types of tissue.

  • used to examine patients with injuries from trauma such as a motor vehicle accident.

  • performed on patients with acute symptoms such as chest or abdominal pain or difficulty breathing.

  • often the best method for detecting cancers in the chest, abdomen and pelvis, such as lymphoma and cancers of the lung, liver, kidney, ovary and pancreas. It's considered the best method since the image allows a physician to confirm the presence of a tumor, measure its size, identify its precise location and determine the extent of its involvement with other nearby tissue.

  • an examination that plays a significant role in the detection, diagnosis and treatment of vascular diseases that can lead to stroke, kidney failure or even death. CT is commonly used to assess for pulmonary embolism (a blood clot in the lung vessels) as well as for aortic aneurysms.Using specialized equipment and expertise to create and interpret CT scans of the body, radiologists can more easily diagnose problems such as cancer, cardiovascular disease, infectious disease, appendicitis, trauma and musculoskeletal disorders.

In pediatric patients, CT imaging is often used to evaluate:

  • lymphoma

  • neuroblastoma

  • kidney tumors

  • congenital malformations of the heart, kidneys and blood vessels

  • cystic fibrosis

  • complications of acute appendicitis

  • complications of pneumonia

  • inflammatory bowel disease

  • severe injuries

Radiologists and radiation oncologists often use the CT examination to:

  • quickly identify injuries to the lungs, heart and vessels, liver, spleen, kidneys, bowel or other internal organs in cases of trauma.

  • guide biopsies and other procedures such as abscess drainages and minimally invasive tumor treatments.

  • plan for and assess the results of surgery, such as organ transplants or gastric bypass.

  • stage, plan and properly administer radiation treatments for tumors as well as monitor response to chemotherapy.

  • measure bone mineral density for the detection of osteoporosis.

Chest CT SCAN can demonstrate various lung disorders, such as:

Doctors typically use head CT to detect:

  • bleeding, brain injury and skull fractures in patients with head injuries.

  • bleeding caused by a ruptured or leaking aneurysm in a patient with a sudden severe headache.

  • a blood clot or bleeding within the brain in a patient with symptoms of a stroke.

  • a stroke, especially with a technique called CT Perfusion of the Head.

  • brain tumors.

  • enlarged brain cavities (ventricles) in patients with hydrocephalus.

  • diseases or malformations of the skull.

  • assess aneurysms, arteriovenous malformations, and blood vessels through a technique called CT angiography.

  CT of the sinuses is primarily used to:

  • help diagnose sinusitis.

  • evaluate sinuses that are filled with fluid or thickened sinus membranes.

  • detect the presence of inflammatory diseases.

  • provide additional information about tumors of the nasal cavity and sinuses.

  • plan for surgery by defining anatomy.

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Perhaps, the most frequent use of spinal CT is to detect—or to rule out—spinal column damage in patients who have been injured.

CT scanning of the spine is also performed to:

  • assess spine fractures due to injury.

  • evaluate the spine before and after surgery.

  • help diagnose spinal pain. One of the most common causes of spinal pain that may be diagnosed by CT is a herniated intervertebral disk. Occasionally, this diagnosis is made using CT myelography.

  • accurately measure bone density in the spine and predict whether vertebral fractures are likely to occur in patients who are at risk of osteoporosis.

  • assess for congenital anomalies of the spine or scoliosis.

  • detect various types of tumors in the vertebral column, including those that have spread there from another area of the body. Some tumors that arise elsewhere are first identified by finding deposits of malignant cells (metastases) in the vertebrae; prostate cancer is an example.

  • guide diagnostic procedures such as the biopsy of a suspicious area to detect cancer, or the removal of fluid from a localized infection (abscess).

In patients with narrowing (stenosis) of the spine canal, vertebral fracture, infection or degenerative disease such as arthritis, CT of the spine may provide important information when performed alone or in addition to magnetic resonance imaging (MRI).

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CT angiography is helpful in examining blood vessels and the organs supplied by them in various body parts, including:

  • brain

  • neck

  • heart

  • chest

  • abdomen (such as the kidneys and liver)

  • pelvis

  • legs and feet

  • arms and hands

 

Physicians use CT angiography to diagnose and evaluate many diseases of blood vessels and related conditions such as:

  • aneurysms

  • blockages

  • blood clots

  • congenital (birth-related) abnormalities of the cardiovascular system, including the heart

  • disorganized blood vessels, such as vascular malformations

  • injury

  • tumors

  • vessel rupture or tears

Also, physicians use CT angiography to check blood vessels following surgery, such as:

  • identify abnormalities, such as aneurysms, in the aorta, both in the chest and abdomen, or in other arteries.

  • detect atherosclerotic (plaque) disease in the carotid artery of the neck, which may limit blood flow to the brain and cause a stroke.

  • identify a arteriovenous malformation inside the brain or elsewhere.

  • detect plaque disease that has narrowed the arteries to the legs and help prepare for angioplasty/stent placement or surgery.

  • detect disease in the arteries to the kidneys or visualize blood flow to help prepare for a kidney transplant or stent placement.

  • guide interventional radiologists and surgeons making repairs to diseased blood vessels, such as implanting stents or evaluating a stent after implantation.

  • detect injury to one or more arteries in the neck, chest, abdomen, pelvis, or limbs following trauma.

  • evaluate arteries feeding a tumor prior to surgery or other procedures such as chemoembolization or selective internal radiation therapy.

  • identify dissection or splitting in the aorta in the chest or abdomen or its major branches.

  • show the extent and severity of coronary artery disease and its effects and plan for an intervention, such as a coronary bypass and stenting.

  • examine pulmonary arteries in the lungs to detect pulmonary embolism (blood clots, such as those traveling from leg veins) or pulmonary AVMs.

  • look at congenital abnormalities in blood vessels, especially arteries in children (e.g., malformations in the heart or other blood vessels due to congenital heart disease).

  • evaluate stenosis and obstructions of vessels.

PAEDIATRIC CT

In children, CT is typically used to diagnose causes of abdominal pain, evaluate for injury after trauma, diagnose and stage cancer, monitor response to treatment for cancer, and diagnose and monitor infectious or inflammatory disorders.

CT may also be performed to evaluate blood vessels throughout the body. With CT, it is possible to obtain very detailed pictures of the heart and blood vessels in children, even newborn infants.

Except for the chest x-ray, CT is the most commonly used imaging procedure for evaluating the chest. CT of the chest is used to evaluate:

  • complications from infections such as pneumonia

  • a tumor that arises in the lung or has spread there from a distant site

  • airway disease such as inflammation of the bronchi (breathing passages)

  • birth defects

  • trauma to blood vessels or lung

CT is well-suited for visualizing diseases or injury of important organs in the abdomen including the liver, kidney and spleen. CT is sometimes used to:

  • diagnose appendicitis

  • detect abdominal tumors or birth defects

In the pelvic region, CT scans can help:

  • detect cysts or tumors in the pelvis

  • evaluate for stones in the urinary tract

  • assess disease of the pelvic bones

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  • CT SCAN  during pregnancy

  • Your doctor may order a computed tomography (CT) exam if you have symptoms that require treatment or exam results that need clarification but cannot wait until after the delivery of your baby.

  • There are many reasons why you may need a CT exam, but your doctor can explain the type of information he/she is seeking from the exam. You should ask about your doctor's concerns and the need for this medical imaging exam

  • If the abdomen or pelvis is not being imaged, such as in chest or head CT, there is no risk to the baby from radiation.

  • The amount of radiation used in normal CT imaging has never been shown to cause harm to an unborn child. However, if the CT scan examines the abdomen or pelvis area, then there may be a very slight risk to the baby. An unborn baby exposed to CT during pregnancy may have about a one in 1,000 greater chance of developing a cancer as a child. The level of risk is not proven though, and may be nonexistent. The radiologist (a doctor with expertise in medical imaging) and the CT technologist will adjust the CT exam techniques to lower the radiation dose to your baby if they know you are pregnant.

  • You should not refuse a CT exam necessary for diagnosing your potentially serious or urgent illness because of fear of radiation. The most important factor in having a healthy baby is ensuring a healthy mother, because the baby depends on the mother to stay well and carry her pregnancy to term.

  • The goal is to take care of the mother, who has a much greater chance of developing a serious illness.

  • Contrast material- some CT exams, contrast material may need to be injected intravenously into an arm vein.

  • Contrast material does cross the placenta to your baby. It has been used in pregnancy for decades without harm. Use of contrast material has not been shown to harm.

  • An illness is not pleasant, and a significant illness during pregnancy can be especially serious. However, the baby depends on the mother to stay healthy and to carry her pregnancy to term. If helping the mother become better means performing a CT exam, then it will benefit the baby's health as well.

How should I prepare?

Wear comfortable, loose-fitting clothing to your exam. You may need to change into a gown for the procedure.

Metal objects, including jewelry, eyeglasses, dentures, and hairpins, may affect the CT images. Leave them at home or remove them prior to your exam. Some CT exams will require you to remove hearing aids and removable dental work. Women will need to remove bras containing metal underwire. You may need to remove any piercings, if possible.

Your doctor may instruct you to not eat or drink anything for a few hours before your exam if it will use contrast material. Tell your doctor about all medications you are taking and if you have any allergies. If you have a known allergy to contrast material, your doctor may prescribe medications (usually a steroid) to reduce the risk of an allergic reaction. To avoid unnecessary delays, contact your doctor well before the date of your exam.

Also tell your doctor about any recent illnesses or other medical conditions and whether you have a history of heart disease, asthma, diabetes, kidney disease, or thyroid problems. Any of these conditions may increase the risk of an adverse effect.

Women should always inform their physician and the CT technologist if there is any possibility that they may be pregnant. 

BRING ALL THE PREVIOUS INVESTIFATION REPORTS WITHOUT FAIL

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What does the CT equipment look like?

The CT scanner is typically a large, donut-shaped machine with a short tunnel in the center. You will lie on a narrow table that slides in and out of this short tunnel. Rotating around you, the x-ray tube and electronic x-ray detectors are located opposite each other in a ring, called a gantry. The computer workstation that processes the imaging information is in a separate control room. This is where the technologist operates the scanner and monitors your exam in direct visual contact. The technologist will be able to hear and talk to you using a speaker and microphone.

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How does it work

In many ways, a CT scan works like other x-ray exams. Different body parts absorb x-rays in different amounts. This difference allows the doctor to distinguish body parts from one another on an x-ray or CT image.

A conventional x-ray exam directs a small amount of radiation through the body part under examination. A special electronic image recording plate captures the image. Bones appear white on the x-ray. Soft tissue, such as the heart or liver, shows up in shades of gray. Air appears black.

With CT scanning, several x-ray beams and electronic x-ray detectors rotate around you. These measure the amount of radiation being absorbed throughout your body. Sometimes, the exam table will move during the scan. A special computer program processes this large volume of data to create two-dimensional cross-sectional images of your body. The system displays the images on a computer monitor. CT imaging is sometimes compared to looking into a loaf of bread by cutting the loaf into thin slices. When the computer software reassembles the image slices, the result is a very detailed multidimensional view of the body's interior.

Nearly all CT scanners can obtain multiple slices in a single rotation. These multi-slice (multidetector) CT scanners obtain thinner slices in less time. This results in more detail.

Modern CT scanners can image large sections of the body in just a few seconds, and even faster in small children. Such speed is beneficial for all patients. Speed is especially beneficial for children, the elderly, and critically ill – anyone who finds it difficult to stay still, even for the brief time necessary to obtain images.*For reliable diagnosis, the anwar scans offer state-of-the-art multislice CT scanning for all body parts with high-resolution images. Our center has been upgraded with a brand new Siemens 32 slice machine with the most up-to-date global technology. The referring doctors benefit from this technology since it delivers 3D information, HR pictures with higher diagnostic certainty, and speedier diagnosis.  It also delivers the following benefits to patients: same dose as X-rays in some studies, peace of mind, and improved quality of care.

For children, the radiologist will adjust the CT scanner technique to their size and the area of interest to reduce the radiation dose.

Some CT exams use a contrast material to enhance visibility in the body area under examination.

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How is the procedure performed?

The technologist begins by positioning you on the CT exam table, usually lying flat on your back. They may use straps and pillows to help you maintain the correct position and remain still during the exam.

Many scanners are fast enough to scan children without sedation. In special cases, children who cannot hold still may need sedation. Motion may cause blurring of the images and degrade image quality the same way that it affects photographs.

The exam may use contrast material, depending on the type of exam. If so, it will be swallowed, injected through an intravenous line (IV) or, rarely, administered by enema.

Next, the table will move quickly through the scanner to determine the correct starting position for the scans. Then, the table will move slowly through the machine for the actual CT scan. Depending on the type of CT scan, the machine may make several passes.

The technologist may ask you to hold your breath during the scanning. Any motion, including breathing and body movements, can lead to artifacts on the images. This loss of image quality can resemble the blurring seen on a photograph taken of a moving object.

When the exam is complete, the technologist will ask you to wait until they verify that the images are of high enough quality for accurate interpretation by the radiologist.

The CT examination is usually completed within 30 minutes. The portion requiring intravenous contrast injection usually lasts only 10 to 30 seconds.

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What will I experience during and after the procedure?

CT exams are generally painless, fast, and easy. Multidetector CT reduces the amount of time that the patient needs to lie still.

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The doctor may administer contrast material intravenously (by vein) if needed,  You may feel warm or flushed as the contrast is injected.  This will pass. You may feel a need to urinate. However, these are only side effects of the contrast injection, and they subside quickly.

If you swallow oral contrast material, you may find the taste mildly unpleasant. However, most patients can easily tolerate it. If you receive an enema, you can expect to experience a sense of abdominal fullness.  If so, be patient; the mild discomfort will not last long.

When you enter the CT scanner, you may see special light lines projected onto your body. These lines help ensure that you are in the correct position on the exam table. With modern CT scanners, you may hear slight buzzing, clicking and whirring sounds. These occur as the CT scanner's internal parts, not usually visible to you, revolve around you during the imaging process.

You will be alone in the exam room during the CT scan, unless there are special circumstances. For example, sometimes a parent wearing a lead shield may stay in the room with their child. However, the technologist will always be able to see, hear and speak with you through a built-in intercom system.

With pediatric patients, a parent may be allowed in the room but may need to wear a lead apron to minimize radiation exposure.

After a CT exam, the technologist will remove your intravenous line.  You can return to your normal activities immediately.

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Who interprets the results and how do I get them?

A radiologist, a doctor specially trained to supervise and interpret radiology exams, will analyze the images. The radiologist will send an official report to the doctor who ordered the exam.You may need a follow-up exam. If so, your doctor will explain why. Sometimes a follow-up exam further evaluates a potential issue with more views or a special imaging technique. It may also see if there has been any change in an issue over time. Follow-up exams are often the best way to see if treatment is working or if a problem needs attention.

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What are the benefits vs. risks?

Benefits

  • CT scanning is painless, noninvasive, and accurate.

  • A major advantage of CT is its ability to image bone, soft tissue, and blood vessels all at the same time.

  • Unlike conventional x-rays, CT scanning provides very detailed images of many types of tissue as well as the lungs, bones, and blood vessels.

  • CT exams are fast and simple. In emergency cases, they can reveal internal injuries and bleeding quickly enough to help save lives.

  • CT has been shown to be a cost-effective imaging tool for a wide range of clinical problems.

  • CT is less sensitive to patient movement than MRI.

  • Unlike MRI, an implanted medical device of any kind will not prevent you from having a CT scan.

  • CT imaging provides real-time imaging, making it a good tool for guiding needle biopsies and needle aspirations. This is particularly true of procedures involving the lungs, abdomen, pelvis, and bones.

  • A diagnosis via CT scan may eliminate the need for exploratory surgery and surgical biopsy.

  • No radiation remains in a patient's body after a CT exam.

  • The x-rays used for CT scanning should have no immediate side effects.

Risks

There is no conclusive evidence that radiation at small amounts delivered by a CT scan causes cancer. When a CT scan is recommended by your doctor, the expected benefit of this test outweighs the potential risk from radiation. 

  • The radiation dose for this procedure varies. For your safety, anwar scans  provide  multislice CT scanning on a brand new Siemens 32 slice machine outfitted with cutting-edge global technology. It only emits ultra-low dose radiation which is well under the safety level [for example, it causes the same dose as X-rays in some studies].

  • Women should always tell their doctor and x-ray or CT technologist if there is any chance they are pregnant. 

  • Doctors do not generally recommend CT scanning for pregnant women unless medically necessary because of potential risk to the unborn baby.

  • The risk of serious allergic reaction to contrast materials that contain iodine is extremely rare, and radiology departments are well-equipped to deal with them.

  • CT scans in children should always be done with low-dose technique.

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What are the limitations of CT Scanning of the Body?

Soft-tissue details in areas such as the brain, gallbladder, internal pelvic organs, and joints (such as knees and shoulders) can often be better evaluated with magnetic resonance imaging (MRI). In pregnant women, while CT can be performed safely, other imaging exams not involving radiation, such as ultrasound or MRI, are preferred but only if they are likely to be as good as CT in diagnosing your condition.

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X-ray (Radiography)

X-ray or radiography uses a very small dose of ionizing radiation to produce pictures of the body's internal structures. X-rays are the oldest and most frequently used form of medical imaging. They are often used to help diagnosed fractured bones, look for injury or infection and to locate foreign objects in soft tissue. Some x-ray exams may use an iodine-based contrast material or barium to help improve the visibility of specific organs, blood vessels, tissues or bone.

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What is Hysterosalpingography?

HSG is an x-ray exam of the uterus and fallopian tubes. It uses a special form of x-ray called fluoroscopy and a contrast material.

An x-ray exam helps doctors diagnose and treat medical conditions. It exposes you to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most often used form of medical imaging.

Your doctor uses fluoroscopy to see your internal organs in motion. Your doctor or technologist will fill your uterus and fallopian tubes with a water-soluble contrast material. Your radiologist will then use fluoroscopy to view and assess them.

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What are some common uses of the procedure?

Doctors primarily use this exam to examine why you might be having difficulty becoming pregnant. The doctor looks at the openness of the fallopian tubes, the shape and structure of the uterus, and any scarring within the uterine or nearby peritoneal (abdominal) cavity.

The exam also evaluates the openness of the fallopian tubes and checks the effects of tubal surgery. These effects include:

  • Blockage of the fallopian tubes due to infection or scarring

  • Tubal ligation

  • Closure of the fallopian tubes in a sterilization procedure and a sterilization reversal

  • Re-opening of the fallopian tubes following a sterilization or disease-related blockage

The exam can investigate repeated miscarriages resulting from congenital or acquired uterine problems such as:

  • Uterine fibroids

  • Endometrial(uterine) polyps

  • Adhesions

  • Congenital problems (uterine anomalies)

  • Tumors

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How should I prepare?

Schedule your exam for seven to 10 days after the first day of your menstrual period, but before ovulation. This is the best time for the exam.Do not have this procedure if you have an active pelvic infection. Tell your doctor and technologist if you have any signs of pelvic infection, or an untreated STD. Tell your doctor if you are allergic to iodinated contrast.

Tell your doctor about all the medications you take. List any allergies, especially to iodine contrast materials. Tell your doctor about recent illnesses or other medical conditions.You will need to remove some clothing and wear a gown for the exam. Remove any metal objects or clothing in the pelvis that might interfere with the x-ray images.

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What does the equipment look like?

This exam typically uses a radiographic table, one or two x-ray tubes, and a video monitor. Fluoroscopy converts x-rays into video images. Doctors use it to watch and guide procedures. The x-ray machine and a detector suspended over the exam table produce the video.

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How does the procedure work?

X-rays are a form of radiation like light or radio waves. X-rays pass through most objects, including the body. The technologist carefully aims the x-ray beam at the area of interest. The machine produces a small burst of radiation that passes through your body. The radiation records an image on photographic film or a special detector.

Fluoroscopy uses a continuous or pulsed x-ray beam to create images and project them onto a video monitor. Your exam may use a contrast material to clearly define the area of interest. Fluoroscopy allows your doctor to view joints or internal organs in motion. The exam also captures still images or movies and stores them electronically on a computer.

Most x-ray images are electronically stored digital files. Your doctor can easily access these stored images to diagnose and manage your condition.

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How is the procedure performed?

Your doctor will likely do this exam on an outpatient basis.

The procedure is like a gynecological exam. You will lie on your back on the exam table with your knees bent, or your feet will be held up with stirrups. Your doctor will insert a speculum into your vagina, clean the cervix and insert a catheter. The doctor will remove the speculum and carefully position you underneath the fluoroscopy camera. The doctor will fill the uterine cavity, fallopian tubes and peritoneal cavity with contrast material through the catheter and capture the fluoroscopic images. The doctor may ask you to shift position underneath the fluoroscopy camera.

When the procedure is complete, the doctor will remove the catheter and allow you to sit up.

When the examination is complete, the technologist may ask you to wait until the radiologist confirms they have all the necessary images.

The exam usually takes about 30 minutes.

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What will I experience during and after the procedure?

This exam should cause only minor discomfort.

This may cause lower abdominal pain. This should be minimal and brief. Most women experience vaginal spotting for a few days after the exam. This is normal.

Who interprets the results and how do I get them?

A radiologist, a doctor trained to supervise and interpret radiology examinations, will analyze the images. The radiologist will send a signed report to your primary care or referring physician who will discuss the results with you.

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What are the benefits vs. risks?

Benefits

  • This exam is minimally invasive; complications are rare.

  • It can offer valuable information on problems getting pregnant or carrying a fetus to term.

  • It can potentially open blocked fallopian tubes to allow you to become pregnant in the future.

  • No radiation stays in your body after an x-ray exam.

  • X-rays usually have no side effects in the typical diagnostic range for this exam.

Risks​

  • The radiation dose for this procedure varies, but within safetylimits.

  • Tell the doctor and technologist if you have a pelvic infection, inflammatory condition, or untreated STD. This will help you avoid making any such infection worse.

  • Women should always tell their doctor and x-ray technologist if they are pregnant. 

What are the limitations of Hysterosalpingography?

This exam only sees the inside of the uterus and fallopian tubes. Your doctor may use MRI or ultrasound to look at problems in the ovaries, uterine wall, and other pelvic structures. This exam cannot evaluate infertility problems due to low or abnormal sperm count or the inability of a fertilized egg to implant in the uterus.

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CT SCAN

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