IMAGING AND RADIOLOGY

RADIOLOGY GENERAL ORGAN SYSTEMS

branch of medicine that uses imaging ANGIOGRAPHY

technology to diagnose and treat disease
radiographic test used to evaluate blood vessels
can be divided into diagnostic radiology
and interventional radiology and the circulation
radiopaque is injected through a
DIAGNOSTIC RADIOLOGY catheter inserted to BV

helps health care professionals see structures BIOPSY

inside the body
removal and evaluation of tissue
Diagnostic radiologist is the doctor that
specializes in the interpretation COMPUTED TOMOGRAPHY SCAN (CT SCAN)
Using diagnostic images health care professional
can diagnose the cause of symptoms, monitor computerized x-ray to take pictures or images
how well the body is responding to the in very fine slices which are cross sectionals
through the part of the body
treatment and screen for different illnesses
Example: plain radiography, mammogram,
for dense structure
fluoroscopy and etc. range from 4 to 320 slices and up to 640 slices
for most recent machines and is refer as “multi-
INTERVENTIONAL RADIOLOGY slice” or “multi-detector” technology “MSCT or
MDCT
uses imaging such as CT, Ultrasound, MRI slices are often less than 1 mm thick
and fluoroscopy to help guide procedures like
it may require the patient for a special degree of
inserting catheters, wires and other small
instruments in the body and allows for smaller preparation
may require injection of iodinated contrast
incisions
material to be injected or taken by mouth-
interventional radiologist uses this technology to
sensation of warmth around the groin or buttock
diagnose or treat conditions and in treating
region and strange metallic taste in the mouth,
cancers or tumors, blockages in arteries and
veins, fibroids in the uterus, back pain, liver and while some can be allergic to the contrast media
spiral or helical CT taken continuously to
kidney problems
people need only moderate sedation decrease the time needed to obtain image

example: angiography, needle biopsies, DOPPLER ECHOGRAPHY

uterine artery embolization etc.
uses ultrasound technology
DIAGNOSTIC TEST measures shift in the frequency caused by object
movement
INVASIVE
evaluate blood flow velocity and turbulence
require penetration of the skin or insertion in the heart and peripheral circulation
of instruments or devices into a body orifice
ENDOSCOPY
NON-INVASIVE
examine interior of a hollow viscus or canal
does not require penetration of the skin or Endoscope: flexible or inflexible tube with
insertion of instruments or devices into a body camera and light source, inserted into body
orifice orifice
pose little risk to the patient compared to Biopsy specimen are obtained for
invasive tissue examination

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arthrography, x-ray to view a joints

ENDOSCOPY TYPES
placement of intravenous IV catheters, used to
COLONOSCOPY guide the catheter into a specific location inside
of the body
view inside of the entire colon from rectum hysterosalpingogram, x-ray of the uterus and
to end of small intestine
fallopian tubes
SIGMOIDOSCOPY percutaneous vertebroplasty or kyphoplasty, a
procedure used to treat compression fractures of
view inside of large intestine from the vertebrae (bones) of the spine
rectum through sigmoid colon
also used for lumbar puncture, biopsies, locating
foreign bodies, guided injections into joints or
CHOLANGIOPANCREATOGRAPHY
the spine
view inside of bile duct and pancreas may be used alone or used along with other
diagnostic procedures
ESOPHAGOGASTRODUODENOSCOPY
inside of esophagus, stomach and duodenum MAGNETIC RESONANCE IMAGING

scanning procedure that uses strong magnets

BRONCHOSCOPY
and radiofrequency pulses to generate signals
view inside of tracheobronchial tree from the body
signals are detected by a radio antenna and
FLUOROSCOPY
processed by a computer to create images of the
study of moving body structures and uses body
radiation (contrast dye)
uses fluoroscope that makes the shadow of x-ray safety is vital and is good for soft structures
visible uses externally applied magnetic field to align
 the axis of nuclear spin of cellular nuclei
swallow creates image
to displace alignment, radiofrequency pulses are
much like an x-ray movie and is often done applied
while a contrast dye moves through the part of energy emitted when the displacement ends is
the body being examined detected
continuous x-ray beam is passed through the uses gadolinium contrast media as a dye and is
body part and sent to a video monitor so that injected to highlight the part of the body being
the body part and its motion can be seen in scanned-may cause allergic reactions, or
detail nephrogenic systemic fibrosis (rare)
as an imaging tool that allows healthcare strong magnetic field can attract and interfere
providers to look at many body systems,
with metal objects and can cause harm or death do
including skeletal, digestive, urinary,
not wear make-up or hairspray since it might
cardiovascular, respiratory, and reproductive
contain tiny metal particles that can interfere
systems with the scan and reduce the quality of the
used in barium x-rays to see the movements of
image
intestines as barium moves through them
cardiac catheterization to see the flow of blood MOLECULAR IMAGING
through coronary arteries to check for arterial
investigational technology that assess biologic
blockage processes at cellular and subcellular level in
electro physiologic procedures to treat
living tissue
patients with arrhythmia biology of cancer, CVD

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PARACENTESIS SINGLE PHOTON EMISSION COMPUTED

TOMOGRAPHY
removal and analysis of fluid from body
cavity thoracentesis fluid from pleural space similar to PET but involves administration of
radionuclides that emit gamma rays
PLETHYSMOGRAPHY
less expensive but limited image resolution
changes in the size of vessels and hollow organs assess coronary arteries, bone, brain, prostate
by measuring displacement of air or fluid from and thyroid
containment system
STANDARD RADIOGRAPHY (PLAIN FILMS/ X-RAY
POSITRON EMISSION TOMOGRAPHY (PET SCAN) FILMS)

uses a radioactive substance called a “tracer” to imaging of body structures or parts of the
look for disease in the body body using x-radiation similar to visible light,
shows how organs and tissues are working; radiowaves and microwaves
shows the structure of, and blood flow to and x-ray is a very high energy level that allows x-
from organs ray beam to penetrate through the body
uses a small amount of radioactive tracer which Plain x-ray: simplest medical images created by
is given through a vein (IV) x-radiation
needle is often inserted inside of elbow and the dense structure such as bone = absorbs high
tracer travels through blood and collects in percentage of x-ray beam which appear light
organs and tissues grey on the image
radiotracers are molecules linked to or “labeled” low-density structures such as soft tissues =
with a small amount of radioactive material that absorb a small percentage which appears as
can be detected on the PETS and are designated to dark grey
accumulate in cancerous tumors or regions of images are produced on photographic plate by
inflammation and can also bind to specific passing x-rays through body (roentgen rays)
proteins in body
ULTRASONOGRAPHY (ECHOGRAPHY)
F-18 fluorodeoxyglucose: most commonly used
radiotracer and similar to glucose term used for high frequency soundwaves
Can be swallowed, inhaled, injected and that produces a picture or an image
accumulates
MAMMOGRAPHY
Radioactive emission from radiotracer are
detected by a special camera or imaging devices x-ray picture of breasts
that produces pictures and provided molecular used to find breast tumor and cancer
information a compressor will be pressed firmly against the
Absorption usually takes about 1 hour breast and flattens breast tissue
Lie during test and prevent too much movement 3D mammography a type of
to prevent blur digital mammography
images 3D
PET and CT Images = PET/CT commonly used CARDIOVASCULAR SYSTEM

CARDIAC CATHETERIZATION
RADIONUCLIDE STUDIES
evaluate cardiac function
administration of oral, parenteral or inhaled
catheter is passed into the right or left side of
radioactive chemical or pharmaceuticals the heart
Ex: Ventilation- perfusion scan of lungs

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transducers on tip of the catheter record

ECHOCARDIOGRAPHY
pressures in vessels and chambers of the heart
ports obtain blood samples for determination of size, shape and motion of valves, septum and
oxygen content and cardiac output walls as well as changes in chamber size during
cardiac cycle
RIGHT SIDED CATHETRIZATION
transthoracic approach
used to measure right atrial pressures, transesophageal approach
right ventricular pressures, pulmonary
artery pressure and pulmonary artery CONTRAST ECHOCARDIOGRAPHY
occlusion pressure right side chambers of heart visualized

LEFT SIDED CATHETRIZATION DOPPLER ECHOCARDIOGRAPHY

used to measure left ventricular pressures doppler imaging + echocardiography
cardiac blood flow patterns
CENTRAL LINE PLACEMENT WITH
HEMODYNAMIC MONITORING EXERCISE ECHOCARDIOGRAPHY
central line is used and catheter is placed into before and during exercise
central venous system and advanced into right
M-MODE ECHOCARDIOGRAPHY
side of the heart
cardiac output is measures records motion of the heart
pulmonary artery and occlusion, right ventricular evaluate structures of the heart
and arterial pressures are measured
2D-ECHOCARDIOGRAPHY
CHEST RADIOGRAPHY
2D image of the heart
diagnose cardiac disease and monitor patient
ELECTROCARDIOGRAPHY
response to drug and non-drug therapy
determine the size and shape of atria and cardiac electrical activity
ventricles
calculate cardiothoracic ratio detect ELECTROCARDIOGRAM WITH STRESS
abnormalities in lung fields and pleural spaces
done during standardized exercise
CRONARY ANGIOGRAPHY patient at test after the administration of
dobutamine or dipyridamole
cardiac vessels are visualized by
injecting vessels with a contrast agent HOLTER MONITORING

DIGITAL SUBTRACTION ANGIOGRAPHY aka ambulatory electrocardiography

ECG continuously throughout the patient
background images are obtained before contrast usual activities
agent is injected
background images are subtracted from images THALLIUM STRESS TEST
obtained after the injection of contrast thallium T1 201 taken up by healthy myocardial
agent improves image resolution
tissue
gamma camera is used to record serial images of
myocardium

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INTRACARDIAC ELECTROPHYSIOLOGIC STUDIES CAPSULE ENDOSCOPY

special catheters with electrodes are used to Visualize GI tract
stimulate cardiac tissue Disposable capsule with camera, light source,
nature and origin of cardiac arrhythmias and battery, antenna, miniature transmitter
response to anti-arrhythmic drug therapy Capsule is excreted rectally

LYMPHOSCINTIGRAPHY CHOLECYSTOGRAPHY

patency and anatomy of peripheral lymph Gallbladder function and

vessels anatomy Orally administered
assess lymphedema and tumor involvement or Opanoic acid
regional lymph nodes
CHOLECYSTOSONOGRAPHY
MULTILE GATED ACQUISITION SCAN
Gallstone, gallbladder, biliary system
aka Radionuclide angiocardiography
D-XYLOSE TEST
injection of albumin or RBC labeled with a
radionuclide Screen for CHO malabsorption
25g d-xylose with water (5 hours period urine)
TECHNETIUM Tc 99m PYROPHOSPHATE UPTAKE
Normal: more than 3 g excreted in the urine
increase uptake of Tc 99m for patient with a
myocardial infarction ENDOSCOPIC RETROGRADE
CHOLANGIOPANCREATOGRAPHY
GASTROINTESTINAL SYSTEM
Combines endoscopy and radiography to
ABDOMINAL RADIOGRAPHY visualize pancreas and biliary system
Contrast dye is injected into ducts
include kidney, ureter and bladder
(KUB) patient lying supine ENDOSCOPY
identify intestinal obstruction and organ-
Inserted orally into esophagus
specific structure abnormalities
Visualize the lining of upper and lower GIT
ASCITIC FLUID ANALYSIS
ESOPHAGOGASTRODUODENOSCOPY
abdominal paracentesis 
Color: yellow= cirrhosis EGD esophagus to visualize the lining of
esophagus, stomach and duodenum
Color: cloudy= infection
Color: brown= hyperbilirubinemia or bloody in INTRAGASTRIC PH
malignancy pH of gastric secretions
Cell count: polymorphonuclear cell count of 250
presence and severity of acid reflux
mm3 = infection
monitor effectiveness of acid-suppressive
Serum or Ascites Albumin gradient: 1.1 g/dL, drug therapy
increase= portal hypertension
MANOMETRY
BARIUM STUDIES
evaluate esophageal contractions and
Uses barium sulfate= esophagus, and stomach sphincter pressures
Barium enemas= large intestine

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Cell count: no cells, inflammation= WBC,

PERCUTANEOUS TRANSHEPATIC
hemorrhage= RBC
CHOLANGIOGRAPHY
Color: no color
biliary radicle with in liver and fluoroscopy Glucose: 0.6 if there is an increase=meningitis etc
is used to visualize intra and extra hepatic Opening pressure: 60 to 200mmHg
bile ducts Protein: low concentration

PH STIMULATION TEST COLD CALORIC TEST

response of gastric acid secretion Brainstem function in comatose

betazole or pentagastrin patient Ice-cold water
Eyes move to cold ear then back to center
SCHILLING TEST = normal
absorption of Vitamin B12
EDROPHONIUM (TENSILON) TETS
SIGMOIDOSCOPY Diagnose myasthenia gravis
GI from rectum to sigmoid colon Muscle strength is evaluated

HEMATOLOIC SYSTEM ELECTROENCEPHALOGRAPHY

BONE MARROW ASPIRATION Electrical activity of the brain from electrodes

Diagnose seizures, assess patient response to
Iliac crest. Sternum withdrawing sample of bone
drug
marrow
Slide: cell-line precursor and iron stores ELECTROMYOGRAPHY
Diagnose anemia and leukemia
Evaluates muscle action potential
Diagnose muscle diseases
IMMUNOLOGIC SYSTEM

ANERGY PANEL PERIPHERAL NERVE STIMULATION

Asses depth neuromuscular blockade

Patient’s reactivity to a variety of antigens
Intradermal: redness and swelling
NERVE CONDUCTION STUDIES
Reaction= antigen= antibodies
Rate of nerve conduction
PATCH TESTING stimulate the nerve and recording the velocity of
Delayed hypersensitivity reaction to allergens conduction to electrodes placed over muscle
Applied directly to skin = 72 hrs erythema and diagnose nerve injuries and neuromuscular
blistering disease

SKIN-PRICK TESTING NUTRITION

Immediate hypersensitivity ANTHROPOMETRICS

reactions 1mm; 30 mins = wheal (+) comparative body measurement assesses

NEUROLOGIC SYSTEM nutritional status

skinfold thickness of upper portion of non-
CEREBROSPINAL FLUID ANALYSIS
dominant arm, middle upper arm circumference
Lumbar puncture obtaining CSF increase than 40% decrease = malnutrition

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RENAL SYSTEMS FORCED EXPIRATORY VOLUME IN 1 SEC

IV PYELOGRAPHY Volume of air exhaled in first second during

forced exhalation after maximal inspiration
visualize entire urinary tract
FORCED VITAL CAPACITY
RETROGRADE PYELOGRAPHY
Total volume of air (in L) blown out of the
visualize urine-collecting systems
lungs during forced exhalation after maximal
independent of renal function
inspiration
RESPIRATORY SYSTEM
PEAK EXPIRATORY FLOW RATE
BRONCHOSCOPY Measures the forced expiratory flow in
visualize tracheobronchial tree liters/min
introduce to nose, mouth, endotracheal, or Diagnose asthma
tracheotomy tube
RESIDUAL VOLUME
for gram staining, culture, cytologic exam
Volume of air remaining in the lungs after
CHEST RADIOGRAPHY
forced expiration
diagnosis of pulmonary and cardiac diseases Increase in asthma

PLEURAL FLUID ANALYSIS TIDAL VOLUME

thoracocentesis Volume of air inspired or expired in normal

blood: trauma breathing
straw yellow color: transudate
PULSE OXIMETRY
black color: Aspergillus niger infection
pus: emphysema Assess oxygen saturation
ammonia odor: urinothorax
transudate: increase vascular hydrostatic QUANTITATIVE PILOCARPINE IONTOPHORESIS

pressure Aka sweat test

exudate: high molecular weight proteins Measures concentration of Na in sweat after
stimulation of sweat glands with topical
PULMONARY FUNCTION TESTING
pilocarpine
diagnose pulmonary disease Cystic fibrosis diagnosis
Spirometer: detects and records change sin
lung volume and flow VENTILATION OR PERFUSION SCANNING

Used to compare ventilation and perfusion

CARBON MONOXIDE DIFFUSING CAPACITY
Pulmonary emboli diagnosis
DLCU
Non-invasive
Index of surface area available for gas exchange
Decrease: emphysema, alveolar inflammation,
and pulmonary fibrosis

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