Fluoroscopy

Fluoroscopy is a technique for obtaining “live action” X-rays, similar to an X-ray movie. Barium or iodine is used as a contrast material that shows up on x-rays and is either injected or swallowed during fluoroscopy to outline blood vessels or organs. The continuous beam of x-rays is used to evaluate structures and movement within the body, such as blood traveling through a blood vessel, the diaphragm moving up and down, or food moving through the urinary and digestive tract. It can also be used to help a radiologist locate a foreign object in the body, position a catheter or needle for a procedure, or to re-align a broken bone.

It is very important for women to inform their physician and Radiologic Technologist if there is any possibility that they are pregnant.

Common Fluoroscopy Exams:

Arthrogram
An arthrogram is the radiographic exam of a joint after the injection of a contrast agent and/or air to outline the soft tissue and joint structures on the image. An arthrogram is performed to identify abnormalities associated with the shoulder, wrist, hip, knee and ankle. Besides identifying abnormalities an arthrogram can also be performed to alleviate joint pain.

The skin around the joint to be examined will be cleansed with an antiseptic and a local anesthetic will be injected into the area around the joint. The fluoroscopic exam will show correct needle placement, and a contrast agent and/or air will then be injected into the joint space. This examination is usually completed within 30 minutes.

Hysterosalpingogram
Hysterosalpingogram is a test that examines the inside of the uterus, fallopian tubes and the surrounding area. It is often done for women who are unable to become pregnant (infertile).

During a hysterosalpingogram a contrast agent is injected through a thin tube that is inserted through the vagina into the uterus. Because the uterus and fallopian tubes are connected, the contrast agent will flow into the fallopian tubes. “Live” x-ray pictures are being taken as the contrast agent is being administered.

This test should be performed 10 days from the onset of your menses. This examination is completed in approximately 30 minutes.

Lower GI tract/Barium Enema
A barium enema is an x-ray evaluation of the large intestine, also known as the colon. Your doctor will give you detailed instructions on how to prepare for your barium enema. The day before the procedure, you will likely be asked not to eat, and to drink only clear liquids (juice with no pulp, tea, black coffee, cola, or broth). After midnight you should have nothing to eat or drink. You may also be instructed to take a bowel preparation kit the day before the procedure. Oral medications may be taken with small amounts of water.

During the barium enema exam liquid barium, a dense non-absorbable metallic solution, is introduced into the colon through a rectal tube. The barium coats the inside of the rectum, colon, and part of the lower small intestine. As the barium is being administered “live” x-ray pictures are being taken. The patient may be repositioned numerous times to enable the radiologist to capture views of their colon from several angles. Once the x-ray images are completed most of the barium is drained back into a bag and the patient is directed into the restroom to expel the remaining barium. This test usually takes approximately 45 minutes to 1 hour.

Myelogram
A myelogram is an x-ray examination of the spinal cord and the space surrounding it, called the subarachnoid space. The x-ray film is taken after the injection of the contrast material through a needle placed in this space. This exam is done about 350,000 times a year in the United States and is relatively safe and painless.

For patients who cannot have an MRI exam for any reason, a myelogram may be performed, followed by a CT scan. A myelogram is done to provide a very detailed picture of the spinal cord and spinal column, and of any abnormalities that may be present. A myelogram is performed with the patient lying face down on the x-ray table. After locating the best placement for the needle, your skin will be cleaned and numbed with a local anesthetic. The contrast agent is then injected and the x-ray table is slowly tilted. During this time, the flow of contrast is monitored by the radiologist.

After the myelogram, patients will stay in a recovery room from 1 to 4 hours, resting with your head elevated at a 30 to 45 degree angle. You will be encouraged to take fluids at this time to help eliminate contrast material from your body and prevent headaches. This examination usually takes approximately 45 minutes. Our nurses will contact you to instruct you on the preparation for this exam.

Upper GI tract
Upper GI series (upper gastrointestinal) is an x-ray examination of the esophagus, stomach and first part of the small intestine (duodenum). A barium swallow/esophagus examination is used to evaluate the pharynx and esophagus only.

In order to visualize these organs, patients will be given barium to drink. The radiologist will monitor the flow of barium through your upper gastrointestinal tract by “live” x-ray as the patient is drinking the barium. First you will be standing up, then lying down, as the radiologist obtains pictures of your esophagus and stomach. You will be asked to hold your breath to prevent blurring of the still images. Also, periodically you will be asked to move into different positions while standing, and to roll into different positions while lying down on the table.

The preparation for this examination is to have nothing to eat or drink after midnight or 8 hours before the exam. This includes no gum chewing or smoking. This examination usually takes about 30 minutes.

Small Bowel Series
A small bowel series is generally done to evaluate the small bowel symptoms of malabsorption, GI bleeding or indications of bowel obstruction. This exam is performed after drinking12 to 24 oz of barium liquid. The procedure can take up to several hours, with images taken at different, timed intervals. The radiologist monitors the progression of the barium through the small bowel. The amount of time varies with each individual. The preparation for this exam is to have nothing to eat or drink after midnight or 8 hours before your examination. This includes no gum chewing or smoking.
Voiding Cystourethrogram (VCUG)
This is an x-ray examination of the bladder and lower urinary tract. A catheter is inserted into the bladder and filled with a contrast material. Several x-rays images of the bladder and urethra are captured as the patient empties the bladder. This examination usually takes about 45 minutes. There is no preparation for this test.
Intravenous Pyelography (IVP)
Intravenous Pyelography is an x-ray examination of the kidneys, ureters, and urinary bladder. IVP studies are used to detect problems within the urinary tract. Some indications for an IVP include, frequent urination, blood in the urine seen or unseen by the patient, or pain in the side or lower back, kidney stones, enlarged prostate or other changes.

IVP’s have widely been replaced by CT Urograms where CT images are collected for this purpose.