Diagnostic Imaging

Learn more about our Carter Imaging Center.

Make an appointment for our diagnostic imaging services.

Business hours: Monday – Friday 8:00 a.m. – 4:30 p.m.

The Diagnostic Imaging Department at Canyon Vista Medical Center offers state-of-the-art diagnostic services. Our team includes specially trained and licensed technologists certified in X-ray, CT, MRI, PET/CT, Nuclear Medicine, Ultrasound, and 3D Mammography (click here to hear our 3D Mammography radio podcast). Our expert staff complements the comprehensive imaging technology, ensuring that you are the center of our care and treatment. All areas of diagnostic imaging provide coverage 24 hours per day and seven days per week for emergency services. If the Radiologists are not on site, images can be sent to them via computer called teleradiology.

Our specialized medical equipment and procedures include:

  • Full range of diagnostic radiology (X-ray) services with X-ray technologists on duty 24 hours a day.
  • Multi-Slice CT scanner includes diagnostics, biopsies, trauma, and vascular services. CT (Computed Tomography) is capable of depicting anatomy at different levels within the body because the X-ray source rotates around the patient capturing anatomical detail from many angles. Each rotation creates a single cross-sectional “slice” allowing physicians to view the inside of anatomic structures.
  • MRI (Magnetic Resonance Imaging) offers services in complete diagnostics and vascular studies. Using a technique that includes a magnetic field, radiowaves, and a computer to generate detailed cross-sectional images of human anatomy, MRI produces excellent soft-tissue images.
  • PET/CT – PET is an acronym for Positron Emission Tomography. PET is a test that uses special imaging cameras and a radioactive type of sugar to produce pictures of the function and metabolism of the cells in the body. CT stands for Computerized Tomography. CT is an x-ray test that generates a detailed view of the anatomy or structure of organs and tissues in the body. The CT scan can show the dimension of vessels, lymph nodes and organ systems. A PET/CT scan merges both technologies into a single machine. It provides a picture of function (PET), a picture of anatomy (CT) and a merged picture of both the body’s metabolism and structure.
  • Nuclear Medicine is sometimes described as an “inside-out” X-ray because it records radiation emitting from the patient’s body rather than radiation that is directed through the patient’s body. Involving the injection of a small amount of radioactive medicine, Nuclear Medicine allows physicians to see how an organ functions, not just what it looks like.
  • Ultrasound uses sound waves to produce images of organs, vessels, and tissues in the body. A small hand-held transducer is placed in contact with the patient’s body emitting high-frequency sound waves sending back “echoes”. Specialized computer equipment converts these echoes into an image.
  • PinkRibbonFacilityLogoDigital Mammography/DEXA Scanning is located at our east campus, all mammography screenings are read by a Radiologist and then receive a second reading after they are digitized and read by a computer. This second computerized reading can determine subtle changes in density undetectable by the human eye. Mammography uses an X-ray to create an image of breast tissue and is the best way to find breast cancer early because it can detect breast lumps up to two years before they can be felt.


Frequently Asked Questions:

Do I need a prescription to have an X-ray?

Yes, all X-ray exams require a prescription – a written order from your physician.

What if I am pregnant?

Let your technologist know before you have your exam.

Can my family member be in the examination room when the exam is being done?

Concerns about unnecessary radiation exposure do not allow us to permit anyone other than the patient and technologist in the exam room unless it is deemed necessary by your technologist.

Patient Education:

  • Arthogram
  • Barium Enema
  • Cardiac Stress Test With Treadmill
  • Cardiac Stress Test With Medications
  • CT Enterography
  • Computerized Tomography (CT)
  • Echocardiogram
  • Fluoroscopy
  • Hysterosalpinogram (HSG)
  • IVP
  • Moderate Sedation
  • MRI
  • Myelogram
  • Needle Biopsy
  • Nuclear Adenosine Stress Test
  • Nuclear Dobutamine Stress Test
  • Nuclear Treadmill Stress Test
  • Nuclear Cardiology
  • Nuclear Medicine
  • Paracentesis
  • Radiography
  • Transesophageal Echocardiography (TEE)
  • Upper Gastrointestinal Series (Upper GI)
  • Ultrasound
  • VCUG
  • X-Ray

ARTHROGRAM

What is an Arthrogram?

An arthrogram is an X-ray exam to study the anatomical joint. Arthrograms are usually done together with Magnetic Resonance Imaging (MRI).

On the day of your Arthrogram, arrive at Client Services about 30 minutes before your exam is scheduled to begin. DO NOT HAVE ANYTHING TO EAT for four hours before the exam starts.

After you check in, you will change into a gown and talk to the technologist and radiologist about the procedure. The radiologist or nurse will explain the procedure and ask you some questions about your health and any history of allergic reactions. It will be very important to tell the staff if you have ever had an allergic reaction to iodine or other allergies. You will be asked to sign a consent that states you understand the risks and benefits of doing the arthrogram and consent to receive contrast.

The procedure will begin with you lying on your back on the X-ray table. Your skin over the joint will be cleaned with an antiseptic solution and numbed with a small injection of numbing medication. You should feel only mild discomfort or pressure. Then the radiologist will place a needle into the numbed site and into the joint, using direct visualization with fluoroscopy. He will then inject contrast slowly into the joint, several pictures will be taken and then the needle will be removed. The procedure may take 30-45 minutes. After this procedure is completed, you will be taken to MRI. Your MRI may take 30-45 minutes.

AFTER THE EXAM

After your MRI, you are finished and may leave the hospital. You will be encouraged to drink plenty of fluids unless your doctor has instructed you differently.

BARIUM ENEMA

The Barium Enema is a test to examine the large intestines (bowel or colon). The test will help the radiologist find narrowing, blockages, polyps, or diverticula in your rectum or colon.

For the test to be done successfully, your bowels must be completely empty to prepare (prep) you for the test. You will be given a bowel cleansing system by the Diagnostic Imaging Department. This packet contains medications, instructions on how to take them, and a diet to follow before the test.

Follow the instructions unless your doctor tells you to follow different instructions. People respond differently to laxatives that clean out your bowels, so remain close to a bathroom once you start the bowel cleansing system. It is important that you drink water at specific times during this prep. DO NOT DRINK MILK, CREAM, OR NON-DAIRY CREAMER.

Day of Procedure- DO NOT EAT OR DRINK ANYTHING

At least two hours before the test, unwrap the foil wrapper from the bisacodyl suppository and discard the foil. While lying on your side with you thigh raised, insert the suppository into your rectum and gently push in as far as possible. Keep the suppository in your rectum for at least 15 minutes, if possible, before evacuating, even if the urge is strong. Bowel evacuation usually occurs within 15-60 minutes. Patients requiring assistance should have a bedpan, commode or help readily available.

In the Diagnostic Imaging Department

You will be asked to change into a hospital gown. The technologist or nurse will assist you if needed. The technologist will help you onto the table and a small soft tube will gently be placed into your rectum by a technologist or nurse. The radiologist (a doctor) will begin the test by inserting liquid barium into your colon through the tube. Barium is a liquid that will allow the radiologist to see the colon on fluoroscopy. As barium enters the colon, you will feel like you really need to have a bowel movement. Taking slow deep breaths will make you relax and feel better. As the barium is filling your colon, the radiologist will take several pictures using the fluoroscope. Once the barium coats almost all of the colon, the doctor will drain most of the barium out and pass some air through the same tube. The radiologist and technologist will then take more pictures of your colon and allow you to use the bathroom. Most patients tolerate this exam very well.

The exam will last approximately 20-60 minutes. After the exam is completed you may return to a normal diet unless otherwise instructed by your primary doctor. You will be encouraged to increase your fluid intake following the exam. The barium may color your stools slightly whitish for the next day or two but this is normal. If you experience constipation after the examination, tell your doctor.

CARDIAC STRESS TEST WITH TREADMILL

WHAT IS A CARDIAC STRESS TEST WITH TREADMILL?

A cardiac stress test with treadmill is a test that is done in Nuclear Medicine. It is a two-part test that will show if there may be blockage in the blood vessels of your heart muscle. A set of pictures will be taken of your heart at rest and after stress. The stress part of the test is done by having you walk on the treadmill. The cardiologist and a cardiopulmonary technologist will be with you. The amount of time that you walk on the treadmill varies for each patient and may be 30-45 minutes.

WHAT DO I NEED TO DO TO PREPARE FOR THE TEST?

  • Wear comfortable clothing (shorts, pants with shirt, blouse) and comfortable walking shoes (sneakers).
  • Do not apply powder, lotion, or oil to your chest on the day of your test.
  • If you have neurological problems, severe back problems, or arthritis, please talk to your doctor before your test day. You may not be able to exercise on the treadmill.
  • NOTHING to eat or drink after midnight the night before the test (including the morning of your test). If you are DIABETIC , please talk to your doctor about any changes in your insulin because you will not be eating until your test is completed.
  • For the test to be successful, it is best that you STOP all Beta Blockers and Calcium Channel Blockers for 48-72 hours before the test. Caffeine and chocolate should also be avoided for 24 hours before your test. If you are taking any of the medications on the list, please talk to your doctor about if and when you should stop taking them. Please read the attached list carefully so that your test can be completed successfully on the day it is scheduled. If these instructions are not followed, we will have to reschedule your test.
  • Do Not SMOKE for at least 4 hours before your test.
  • Expect to be at the hospital at least 4 hours.

WHAT HAPPENS DURING THE TEST?

The technologist will start an IV (needle in your vein) in your arm or hand. A radioactive tracer will be injected. There are no side effects. After 15-30 minutes the first set of pictures are taken of your heart at rest. You will be asked to lie quietly on your back under the camera for these pictures. It is very important that you do not move as the pictures are being taken. The pictures will be completed in about 15 minutes. We will then get you ready for the stress part of the test. You will be asked about your medical history. The cardiologist or the technologist will explain the test to you and you will be asked to sign a consent for the stress test. You will be asked to put on a hospital gown. The skin on your chest will be prepared for EKG patches. If you have a lot of chest hair, we may have to shave some areas so that the patches will stick to your skin. The EKG will measure the electrical activity of the heart. The exercise part of the test begins with you slowly walking on the treadmill. The speed and the slope of the treadmill will be increased every three minutes. Your heart rate, rhythm and blood pressure will be monitored during the test. It is important that you walk on the treadmill long enough to show the heart’s reaction to different amounts of work or stress. You will let us know how you feel and the cardiologist will decide the amount of exercise and time needed to complete the test. Once the exercise test is over, you will sit and rest for what is called the recovery period. This could be five minutes or longer. After the recovery period, the EKG patches, and blood pressure cuff will be removed and the test is completed.

CARDIAC STRESS TEST WITH MEDICATION

WHAT IS A CARDIAC STRESS TEST WITH MEDICATION?

A cardiac stress test with medication is a test that is done in Nuclear Medicine. It is a two-part scan that will show if there are areas of the heart muscle that are not receiving enough blood either at rest or during stress. A medication (adenosine or dobutamine) is given to increase the blood flow to the heart and mimics exercise for those patients who are not able to exercise on a treadmill or their doctor prefers to use the medication rather than exercise for certain reasons.

WHAT DO I NEED TO DO TO PREPARE FOR THE TEST?

  • DO NOT apply lotion, powder, or oil to your chest on the day of the test.
  • Do NOT eat or drink anything except water in the 12 hours before your test.
  • Do NOT eat or drink anything with caffeine in the 12 hours before your test.
  • Take any medications your doctor has ordered EXCEPT THE MEDICATIONS LISTED ON THE SHEET GIVEN TO YOU.
  • Please read this list carefully.
  • Bring a book, magazine or something to do while you wait for your scan.
  • If you are diabetic, talk to your doctor about any changes in your insulin since you will not be eating until after the test.
  • If you do not follow these instructions, your test will not be able to be completed successfully.

WHAT TO EXPECT ON THE DAY OF THE TEST.

  • You will be asked your medical history and all medications that you take. You may want to bring a list of medicines to help you remember.
  • You will be told about the test and you will be asked to sign a consent for the test.
  • You will be asked to remove your clothing above your waist, including bra or undershirt, and to put on a hospital gown.
  • There are two parts to this test: Resting and Medication Stress.

RESTING:

  • An IV (needle into your vein) will be placed in your arm or hand.
  • A radioactive tracer will be injected into the IV and the technologist will take pictures of your heart with a special computerized camera about 30-40 minutes after the injection.
  • Pictures may take 20-30 minutes to complete. IT IS VERY IMPORTANT THAT YOU HOLD VERY STILL WHILE THESE PICTURES ARE BEING TAKEN.

MEDICATION STRESS:

  • After the pictures are taken, we will begin the medication stress test. This test will take 6-12 minutes depending on the medication ordered by your doctor.
  • The medication is given in your IV and a radioactive tracer is also injected into your IV during this part of the test.
  • Pictures of your heart are taken about 1 hour after this medication stress test. It may take 20-30 minutes to take these pictures. IT IS VERY IMPORTANT THAT YOU HOLD VERY STILL WHILE THESE PICTURES ARE BEING TAKEN.
  • Your doctor will read your test and give you the results.
  • Sometimes, your doctor may want you to come in one day for the pictures and another day for the medication stress test.

CT ENTEROGRAPHY

WHAT IS CT ENTEROGRAPHY?

CT Enterography is a procedure to help the doctor diagnose bowel problems. The examination is done in CT scan. The preparation for this procedure takes 1 hour and 20 minutes and consists of taking one pill and drinking 8 cups (64 ounces) of water over this time period.

WHAT TO EXPECT

You will be asked not to drink or eat anything after midnight or at least 4 hours before your exam.

You will be required to arrive at the hospital 2 hours before your scheduled exam in order to prepare you for the procedure.

75 minutes before your scheduled exam, a nurse will give you a pill called Reglan (Metoclopramide). This pill is given to stimulate the motion and activity of your intestines. At this time you will also be asked to drink 2 cups (16 ounces) of water. The water helps to inflate the intestines before the images are taken in CT. 25 minutes later you will be asked to drink another 2 cups (16 ounces) of water. 25 minutes later you will be asked to drink another 2 cups (16 ounces) of water. 15 minutes later you will be asked to drink your last 2 cups (16 ounces) of water.

If you are not diabetic, the radiologist may order an injection of another drug called Glucagon to slow down the motion of the intestines right before the CT scan images are taken. If ordered, the injection is given through an IV, a needle placed in your vein.

The CT scan images are taken. The radiologist interprets the images and a report will be sent to your primary physician. Your primary physician will discuss those results with you.

COMPUTERIZED TOMOGRAPHY (CT)

What is CT?

A CT scan is a method of taking pictures of the inside of your body. The scanner looks like a large doughnut, and it houses a rotating x-ray beam that encircles your body to produce cross-sections, or slices of pictures of the inside of your body. The pictures are sent to a computer, printed onto x-ray film and the radiologist will look at the film and let your physician know the results.

If you are a woman of childbearing age (12-55 years old), the staff in the Diagnostic Imaging Department will ask you if there is a possibility you are pregnant, because an unborn child (fetus) is sensitive to radiation exposure. You will be asked to sign a consent that states you are not pregnant, and if you think you could be, a pregnancy test will be done in the lab before your X-ray test may be done.

Depending on the type of CT scan ordered, you may need contrast to help the insides of your body show up better. For example, you may have to drink a contrast agent to coat you intestines if that is the area you doctor wants scanned. And for another type of scan, you may need a contrast agent injected into your vein so that other parts of your body will show up better. For some types of scans, you may need both types of contrast. You will be asked about any allergies that you may have or if you are diabetic. It will be important to tell the technologist if you have any allergies or if you take diabetic medications.

You may be asked to change into a hospital gown depending on what kind of CT scan was ordered. You will be asked to lie on the CT table. The table will slide into the scanner. (The scanner is not a deep tunnel). The technologist will leave the room but will be able to see you through a window, speak to you and hear you through a microphone system. You will hear a whirring sound as the scanner is working, you may be asked to hold your breath for a moment.

The CT scan may take 10 minutes to 1 hour, depending on the type of CT scan ordered. You will be encouraged to increase your fluid intake following the exam if you received contrast for your CT scan.

ECHOCARDIOGRAM (ECHO)

WHAT IS AN ECHOCARDIOGRAM?

An echo uses sound waves to form a picture of the heart valve and heart muscle. The echo machine sends sound waves to a transducer (a plastic sound sensitive instrument) that is touching your chest. The sound waves are reflected by the heart walls (muscles) and heart valves, back to the transducer, and the sound waves are changed into a picture. An echo will be able to give your doctor information about the size of the heart chambers, wall motion, valve movements, and changes in the structure around or in the heart.

You do not need to complete any special preparation (prep) for this exam. The exam is done in the echo lab in the Diagnostic Imaging Department (Radiology).

You will be asked to remove your clothing above your waist, including any bra or undershirt. The technologist will keep most of your chest covered and only expose the center of your chest area from your lower neck to about 4 inches above your navel. You will lie on your back or left side on a bed. EKG patches will be placed on your chest. A technologist will apply gel and then the transducer into the gel over the heart area. The structures of the heart will be examined by moving the transducer over different areas of the heart. The sound waves cause no discomfort. You may hear a “whooshing” sound. This is your heart beat. An EKG will record the electrical activity of your heart during the exam. This will help your doctor read the results of your exam.

When the exam is finished, the odorless, colorless gel is wiped off and you may get dressed. An echo may take 20-45 minutes.

FLUOROSCOPIC EXAMINATION

WHAT IS FLUOROSCOPY?

Fluoroscopy is a special type of X-ray that allows a radiologist (Doctor specializing in X-ray), to examine different parts of your body. Fluoroscopy is done in a special suite in the Diagnostic Imaging Department with equipment that allows a radiologist to see the organs and tissues in your body in motion.

Most fluoroscopic exams require the use of X-ray contrast to better see the organs in your body. It will be important to tell the technologist if you have any allergies. If you are allergic to shell fish or iodine, you may be allergic to the contrast. You will be asked to sign a consent to receive the contrast. The images of your body will appear on a monitor like a TV screen.

You will be asked to remove any clothing that has metal snaps, clips, tabs or zippers because metal can interfere with the accuracy of the images. We will provide you with a hospital gown to wear during the exam.

If you are a woman of childbearing age (12-55 years old), the staff in the Diagnostic Imaging Department will ask you if there is a possibility you are pregnant, because an unborn child (fetus) is sensitive to radiation exposure. You will be asked to sign a consent that states you are not pregnant, and if you think you could be, a pregnancy test will be done in the lab before your X-ray test may be done.

WHERE IS FLUOROSCOPY DONE?

Fluoroscopy exams are done in a room in the x-Ray section of the Diagnostic Imaging Department. The radiation that you are exposed to during X-rays, passes through you immediately. You are not “radioactive,” and it is not necessary to take any special precautions following your exam.

HYSTEROSALPINGOGRAM (HSG)

WHAT IS A HYSTEROSALPINGOGRAM?

A Hysterosalpingogram is an x-ray of the uterus and fallopian tubes following the injection of contrast. This exam can help find problems in your tubes and uterus that may have prevented you from becoming pregnant. The exam may also identify possible problems in the uterus or tubes of women not seeking to become pregnant, but who have other concerns. The most common reason for the exam is to see if the fallopian tubes, that pass the egg from the ovary to the uterus, are open.

You must have a pregnancy test before the exam, as the exam may not be done if you are pregnant. You will be asked have a pregnancy test drawn in the lab before the hysterosalpingogram. It will take 20 minutes to get the results of the blood test. If the results are negative, the exam will proceed.

You will be asked to change into a hospital gown. You will lie on an x-ray table on your back. A regular x-ray will be taken of your pelvis first. Then you will be asked to bend your knees and scoot down towards the end of the table. This is the same position you are in during a pelvic examination. The physician will place a speculum (metal or plastic tube) into your vagina to hold it open, just like when you have a PAP smear at the Gynecologist’s office. A small plastic catheter (tube) will be placed gently into the uterus so that contrast can be injected. You may experience moderate to strong cramps while a balloon at the end of the catheter is inflated in order to keep it in place. You may feel pressure or cramps as the contrast is injected into your uterus and fallopian tubes. Most women take slow deep breaths and relax and the cramps go away. Let the physician, nurse or technologist know how you are feeling during the test. While the contrast is flowing, the physician will take pictures with the fluoroscope. After these pictures are taken, the catheter and speculum are removed and the exam is completed. You may use the bathroom and wash after the exam.

AFTER THE EXAMINATION

You may notice a slight discharge of contrast after the exam. Contrast is colorless and odorless. It is slightly thick. You may have slight spotting of blood. Use sanitary napkins or pads, not tampons, until the discharge is gone. You may continue to have mild cramping after the exam. If the cramps increase, the pain becomes stronger, or if you notice heavy bleeding, call your obstetrician or gynecologist.

INTRAVENOUS PYELOGRAM (IVP)

What is an IVP?

IVP stands for “Intravenous Pyelogram.” This is a test to study how the urinary system (kidneys, ureters, bladder) looks and works. The exam can detect blockage caused by kidney stones, problems causing kidney pain, blood in the urine, injuries or tumors.

For the test to produce the best pictures and results for your doctor, your bowels should be completely empty. You will be given a bowel cleansing system by the Diagnostic Imaging Department. This packet contains medications, instructions on how to take them, and a diet to follow before the test.

Follow the instructions unless your doctor tells you to follow different instructions. People respond differently to laxatives that clean out your bowels, so remain close to a bathroom once you start the bowel cleansing system.

It is important that you drink water at specific times during this prep. DO NOT DRINK MILK, CREAM, OR NON-DAIRY CREAMER.

Day of Procedure- DO NOT EAT OR DRINK ANYTHING

At least two hours before the test, unwrap the foil wrapper from the bisacodyl suppository and discard the foil. While lying on your side with your thigh raised, insert the suppository into your rectum and gently push in as far as possible. Keep the suppository in your rectum for at least 15 minutes, if possible, before evacuating, even if the urge is strong. Bowel evacuation usually occurs within 15-60 minutes. Patients requiring assistance should have a bedpan, commode or help readily available.

In the Diagnostic Imaging Department

You will be asked to change into a hospital gown. The technologist or nurse will assist you if needed. The technologist will assist you onto the table. X-rays will be taken of your abdomen to make sure that your intestines are clean. Next, the technologist will inject contrast into a vein in your arm. If you are allergic to shell fish or iodine, you may be allergic to the contrast. Let the technologist know of any allergies you have. The contrast makes your urinary system visible on Xray. As the contrast passes through your bloodstream into your urinary system, you may begin to feel the need to urinate. You may also experience a warm feeling, or feeling flushed, or you may notice a slight metallic taste in your mouth. These are normal reactions.

You may be asked to turn side to side, and to hold your breath at times as the xrays are being taken. Next, you will be asked to go to the bathroom and urinate to empty your bladder. Then a final Xray may be taken. The examination takes about one hour.

The contrast you received is passed through your system when you urinate. It will not discolor your urine or stool. You will be encouraged to increase your fluid intake following the IVP, unless otherwise instructed by your doctor. You may also resume your routine diet and activity, unless otherwise instructed by your doctor.

MAGNETIC RESONANCE IMAGING (MRI)

What is MRI?

MRI uses a combination of powerful magnetic fields, radio waves and a computer to create images or pictures of your body- mainly the soft tissue. Because it produces better soft tissue pictures than x-rays can, it is most commonly used to look at the brain, spine, chest, abdomen, vascular system, and musculoskeletal system (especially the shoulder and knee).

During the exam, you will lie on the MRI bed and you will be placed inside a scanner that looks like a long tube.

If you are a woman of childbearing age (12-55 years old), the staff in the Diagnostic Imaging Department will ask you if there is a possibility you are pregnant. You will be asked to sign a consent that states you are not pregnant, and if you think you could be, a pregnancy test will be done in the lab before your MRI test may be done.

Because of the strong magnetic field, you will be asked to fill out a questionnaire. Most of these questions are to determine if you have any form of metal in your body. It is very important that you answer these questions carefully. Metal in your body could distort the MRI pictures or may be very dangerous to you in the scanner.

If you are claustrophobic or experience pain when lying on your back for more than 30 minutes, let your doctor know. Your doctor may order medication to relax you, but you will need to make arrangements to have someone drive you home from the hospital after the exam.

Depending upon the test that was ordered, you may be given an injection of contrast into your vein to make the images of your body show up better. There are usually no side effects from the contrast. The exam takes 45 minutes to one hour depending on what is ordered. One particular test called an MRI lower extremities will take up to 2 hours.

It would be preferred if you could wear loose-fitting clothes with no metal. If this is not possible, we may ask you to change into a hospital gown that has no metal.

You may also want to leave your jewelry at home. If this is not possible we do have a secured cabinet to store your items.

We will provide you with headphones and music for your listening pleasure during the exam. You may bring your own Music selection CD if you prefer.

NEEDLE BIOPSY

WHAT IS A NEEDLE BIOPSY?

A needle biopsy is performed in the Diagnostic Imaging (Radiology) Department, by an experienced radiologist. A radiologist is a doctor specializing in reading and interpreting the images we get from x-ray procedures. The radiologist will use x-ray, CT scan or ultrasound to guide the needle to the exact location needed to get a sample of tissue, fluid, or cells. Another doctor, a pathologist, will examine this sample under a microscope.

Your doctor may have ordered a needle biopsy after finding a lump or mass, and the biopsy will help your doctor give you a diagnosis. Sometimes a biopsy is done to determine the type and severity of kidney or liver disease. Some of the common biopsy areas are lung, liver, breast, and thyroid. Your doctor will discuss why you need a biopsy as well as the risks and benefits of this procedure.

HOW SHOULD I PREPARE FOR THE BIOPSY?

You may be asked not to take certain medications that can thin your blood (such as Coumadin or Aspirin). Your doctor will let you know which medications to stop and when to stop them. You will be asked not to eat or drink for a certain amount of time before the procedure.

You will need to have blood tests drawn before the procedure, unless your doctor has blood test results in your chart that are recent. Then we will have your doctor fax them to us. If you need to have the blood drawn, we will ask you to arrive about one hour before your scheduled biopsy.

WHAT HAPPENS DURING THE BIOPSY?

You will be asked to change into a hospital gown. You will meet the radiologist who will perform the procedure and answer any questions that you may have. You will be asked to sign a consent for the procedure. The nurse will ask you questions about your medical history, medications that you take, and about possible allergies. The nurse will take your vital signs, and for some biopsies an IV (needle in your vein), will be placed. For some procedures, the radiologist has the nurse give you IV medication to help reduce anxiety, fear or pain.

If you do receive IV medication, you must have someone available to drive you home.

You will be awake and aware during the biopsy. The nurse will stay with you and ask you how you are feeling during the procedure. You will probably be lying on your back or side. The skin in the biopsy area will be cleaned with cool antiseptic swabs and covered with sterile drapes. The radiologist will then numb your skin with a local anesthetic. Once the skin is numb, the radiologist will pass a special needle into the lump or mass to be sampled. The small sample will be given to the pathologist to examine under the microscope. The results from the pathologist may take a few days to be completed, and those results will then be sent to your doctor. Your doctor will discuss the results with you.

WHAT HAPPENS AFTER THE BIOPSY?

If you received IV medication during the procedure, the nurse will monitor you for another hour or more. The nurse will monitor your vital signs and check for signs of possible bleeding. You may have a small band-aid over the biopsy site (liver and lung biopsy). If you did not receive IV medication, you will probably be free to leave after the procedure. For some biopsies (breast and thyroid), you will have a gauze dressing over the biopsy site and you will be given an ice pack to place over the dressing for a few hours. This cold pack helps to minimize swelling and bleeding. Before you leave you will be given discharge instructions to take home with you.

WHAT ARE THE POSSIBLE COMPLICATIONS?

Bleeding is the most common possible complication of this procedure. A slight bruise may also appear. If a lung biopsy is done, a small amount of blood may sometimes be seen in your sputum after the procedure. If a kidney biopsy is done, a small amount of blood may be noticed in the urine after the procedure. This small amount of bleeding should decrease over time.

Occasionally after a lung biopsy, it is possible to develop a pneumothorax (collapsed lung). This collapse is usually small and may be unnoticed by the patient. The radiologist will examine you closely after the biopsy to determine whether or not a pneumothorax has developed. We will continue to monitor you and do a chest x-ray. Occasionally, you may need to be hospitalized for a pneumothorax. In most cases the pneumothorax resolves on its own without treatment.

NUCLEAR ADENOSINE STRESS TEST

• Nothing to eat or drink after midnight the night before your test. Your cardiologist will tell you not to take blood pressure medicines that morning. Most of your other medications may be taken with a sip of water. The following medications cannot be taken for 48 hours before the test: Theophylline, Theodur, Aminophylline, and Uniphyl. Nitroglycerine patches should be taken off one hour before the test. PLEASE DISCUSS YOUR MEDICATIONS WITH YOUR CARDIOLOGIST.

• Diabetics should not take insulin that morning because you will be fasting. PLEASE DISCUSS THIS WITH YOUR CARDIOLOGIST .

• NO CAFFEINE FOR 24 HOURS BEFORE THE TEST , TO INCLUDE CHOCOLATE, SODA, COFFEE, OR COLD MEDICINE CONTAINING CAFFEINE.

• A nuclear imaging agent will be injected into an IV (a needle placed into a vein in your arm or hand), about 30 minutes before pictures are taken in Nuclear Medicine.

• You will then be asked to lie on a bed and a nurse will start an infusion of adenosine into your IV line. The infusion takes 6 minutes. Halfway through the adenosine infusion, the imaging agent is re-injected. Your blood pressure and heart will be monitored throughout the procedure. After the infusion you will wait about one hour to have more pictures taken in Nuclear Medicine.

• Typical time from start to finish is four to six hours; most of this time is just waiting to have more pictures taken after the imaging agent circulates.

• Common side effects from adenosine include, but are not limited to, a feeling of pressure in your head, throat, chest or abdomen, and feeling flushed in your face. These symptoms will stop about 1-2 minutes after the infusion is stopped.

NUCLEAR DOBUTAMINE STRESS TEST

• Nothing to eat or drink after midnight the night before your test. Your cardiologist will tell you not to take Beta-Blockers if you are on these medications. If your wear a Nitroglycerin patch, it should be removed one hour before the stress part of your test. Your other medications may be taken with a sip of water. PLEASE DISCUSS THIS WITH YOUR CARDIOLOGIST.

• Diabetics should not take insulin that morning because you will be fasting. PLEASE DISCUSS THIS WITH YOUR CARDIOLOGIST .

• NO CAFFEINE FOR 24 HOURS BEFORE THE TEST , TO INCLUDE CHOCOLATE, SODA, COFFEE, OR COLD MEDICINE CONTAINING CAFFEINE.

• A nuclear imaging agent will be injected into an IV (a needle placed into a vein in your arm or hand), about 30 minutes before pictures are taken in Nuclear Medicine.

You will then be asked to lie on a bed and a nurse will start an infusion of dobutamine into your IV line. The dose of the medication is increased every 3 minutes until your heart reaches its peak level. The imaging agent is re-injected when your heart rate reaches its peak. Your blood pressure and heart will be monitored throughout the procedure. After the infusion you will wait about one hour to one and a half hours to have more pictures taken in Nuclear Medicine.

• Dobutamine stress testing is recommended for patients with a history of asthma, COPD, or for patients who regularly use inhalers.

• Typical time from start to finish is four to six hours; most of this time is just waiting to have more pictures taken after the imaging agent circulates.

• Common side effects you may have from Dobutamine include, but are not limited to, shortness of breath and palpitations.

NUCLEAR TREADMILL STRESS TEST

• Nothing to eat or drink after midnight the night before your test. Your cardiologist will tell you not to take blood pressure medicines that morning. Your other medications may be taken with a sip of water. PLEASE DISCUSS THIS WITH YOUR CARDIOLOGIST.

• Diabetics should not take insulin that morning because you will be fasting. PLEASE DISCUSS THIS WITH YOUR CARDIOLOGIST .

• NO CAFFEINE FOR 24 HOURS BEFORE THE TEST , TO INCLUDE CHOCOLATE, SODA, COFFEE, OR COLD MEDICINE CONTAINING CAFFEINE.

• A nuclear imaging agent will be injected into an IV (a needle placed into a vein in your arm or hand), about 30 minutes before pictures are taken in Nuclear Medicine.

• After the first pictures are taken, you will walk on a treadmill that increases in speed and incline every 3 minutes until your heart rate reaches peak level. The imaging agent is re-injected 1 or 2 minutes before the end of the exercise. Your blood pressure and heart will be monitored throughout the procedure by the cardiologist. After 30-60 minutes you will have more pictures taken in Nuclear Medicine.

• Typical time from start to finish is four to six hours; most of this time is just waiting to have more pictures taken after the imaging agent circulates.

• Common side effects include, but are not limited to, shortness of breath and fatigue.

NUCLEAR CARDIOLOGY: CARDIAC STRESS TESTS

What is Nuclear Cardiology?

Your doctor has ordered a cardiac stress test. The test will be done through the Nuclear Medicine Department. It is a two-part scan that will show if there are areas of the heart muscle that may not be getting enough blood either at rest or during stress or exercise. Depending on the test your doctor ordered, you will either be walking on the treadmill or you will get a medication to increase the blood flow to the heart.

For more information refer to page(s) entitled Nuclear Adenosine Stress Test, Nuclear Dobutamine Stress Test, or Nuclear Treadmill Stress Test.

NUCLEAR MEDICINE

WHAT IS NUCLEAR MEDICINE?

A Nuclear Medicine exam is sometimes called an “inside-out” x-ray, because it records the radiation coming out of your body instead of radiation that is passed through your body as in regular x-ray pictures.

A small amount of radioactive material is given through an injection, swallowing, or breathing in. As this material travels through your body, it sends out radioactive emissions. A special camera can see those emissions as they come from an organ, bone, or tissue, and pictures are taken and placed on film for the radiologist or cardiologist to read.

You will be asked to sign a consent that states you are not pregnant, and if you think you could be, a pregnancy test will be done in the lab before your Nuclear Medicine exam may be done. It will be important to tell the technologist if you have any allergies or if you are undergoing radiation therapy.

WHAT DO I NEED TO DO BEFORE THE EXAM?

You may be asked not to eat or drink the day of the exam. You may also be asked to stop taking some of your medicines 1 or 2 days before the exam. Your doctor or the Nuclear Medicine technologist will let you know.

Some of these exams take a few hours or you may have some pictures taken and then return a few hours later to have more pictures taken. It depends on which type of exam your doctor has ordered. The Nuclear Medicine technologist will be able to give you an idea of how long your particular test will take. Call the Diagnostic Imaging Department and ask for Nuclear Medicine.

AFTER THE EXAM

The radiation that you were exposed to is the same as or less than what you would receive with a standard x-ray. The radioactive material will naturally be eliminated from your body, and you may resume normal activity.

PARACENTESIS

WHAT IS A PARACENTESIS?

A needle biopsy is performed in the Diagnostic Imaging (Radiology) Department, by an experienced radiologist. A radiologist is a doctor specializing in reading and interpreting the images we get from x-ray procedures. The radiologist will use x-ray, CT scan or ultrasound to guide the needle to the exact location necessary in order to remove the excess fluid in your abdomen.

A paracentesis is usually done to relieve the pressure and discomfort that you feel when your abdomen is full of this excess fluid. Your doctor may order laboratory tests to be done on the fluid after it is removed in order to make a diagnosis as to why this fluid is accumulating. Your doctor will discuss why you need a biopsy as well as the risks and benefits of this procedure.

HOW SHOULD I PREPARE FOR THE PARACENTESIS?

You may be asked not to take certain medications that can thin your blood (such as Coumadin or Aspirin). Your doctor will let you know which medications to stop and when to stop them.

You will need to have blood tests drawn before the procedure, unless your doctor has blood test results in your chart that are recent. Then we will have your doctor fax them to us. If you need to have the blood drawn, we will ask you to arrive about one hour before your scheduled paracentesis.

WHAT HAPPENS DURING THE PARACENTESIS?

You will be asked to change into a hospital gown. You will meet the radiologist who will perform the procedure and answer any questions that you may have. You will be asked to sign a consent for the procedure. The nurse will ask you questions about your medical history, medications that you take, and about possible allergies.

You will be lying on your back. The ultrasound technologist will place a plastic transducer (wand) covered with warm gel.

The skin on your abdomen will be cleaned with cool antiseptic swabs and covered with a sterile drape. The radiologist will then numb your skin with a local anesthetic. Once the skin is numb, the radiologist will pass a special needle into the abdomen. The small sample will be given to the pathologist to examine under the microscope. The results from the pathologist may take a few days to be completed, and those results will then be sent to your doctor. Your doctor will discuss the results with you.

WHAT HAPPENS AFTER THE BIOPSY?

If you received IV medication during the procedure, the nurse will monitor you for another hour or more. The nurse will monitor your vital signs and check for signs of possible bleeding. You may have a small band-aid over the biopsy site (liver and lung biopsy). If you did not receive IV medication, you will probably be free to leave after the procedure. For some biopsies (breast and thyroid), you will have a gauze dressing over the biopsy site and you will be given an ice pack to place over the dressing for a few hours. This cold pack helps to minimize swelling and bleeding. Before you leave you will be given discharge instructions to take home with you.

WHAT ARE THE POSSIBLE COMPLICATIONS?

Bleeding is the most common possible complication of this procedure. A slight bruise may also appear. If a lung biopsy is done, a small amount of blood may sometimes be seen in your sputum after the procedure. If a kidney biopsy is done, a small amount of blood may be noticed in the urine after the procedure. This small amount of bleeding should decrease over time.

Occasionally after a lung biopsy, it is possible to develop a pneumothorax (collapsed lung). This collapse is usually small and may be unnoticed by the patient. The radiologist will examine you closely after the biopsy to determine whether or not a pneumothorax has developed. We will continue to monitor you and do a chest x-ray. Occasionally, you may need to be hospitalized for a pneumothorax. In most cases the pneumothorax resolves on its own without treatment.

RADIOGRAPHY (X-ray)

WHAT IS AN X-RAY?

X-rays are used to take “pictures” of bones or various internal organs in your body so that the radiologist can help your physician determine the cause of your pain or symptoms.

General x-ray of the bones does not require a prep. For some of the exams your doctor will give you specific instructions to follow. You may be asked to drink only clear liquids the day before, or you might be asked not to drink anything at all after midnight the night before the exam. You may also be required to take a laxative the day before the exam to help clear your digestive tract. Please closely follow the preparations (prep) given to you for the exam you are scheduled to have. Call the Diagnostic Imaging (Radiology) Department if you have questions about your exam or prep.

If you are a woman of childbearing age (12-55 years old), the staff in the Diagnostic Imaging Department will ask you if there is a possibility you are pregnant, because an unborn child (fetus) may be sensitive to radiation exposure. You will be asked to sign a consent that states you are not pregnant, and if you think you could be, a pregnancy test will be done in the lab before your X-ray test may be done.

After your X-rays have been reviewed by a radiologist, your personal physician will receive a report of those findings. Your physician will give you the results.

The radiation that you are exposed to during X-rays, passes through you immediately. You are not “radioactive,” and it is not necessary to take any special precautions following your exam.

TRANSESOPHAGEAL ECHOCARDIOGRAPHY (TEE)

What is a Transesophageal Echocardiogram?

A TEE is done in ultrasound to look at the structures of the heart. “Pictures” are taken from a probe inserted into the esophagus (the tube that carries food from the mouth to the stomach). Because the probe sits directly behind the heart, the pictures are often clearer than those taken with a standard echocardiogram.

Do Not eat or drink anything after midnight the night before the procedure.

You will be asked to change into a hospital gown and lie in a bed on your left side. An IV (needle in a vein) will be placed in your hand or arm. You will be given medication into the IV that will sedate you and keep you relaxed for the procedure. A numbing medication will be sprayed in the back of your throat so that you will feel little as the probe is placed. The doctor will insert the tube down your esophagus. Pictures of the heart and blood flow through the heart will be taken. Once all the pictures are taken, the probe will be removed.

Because you received a sedative, you will be very sleepy. A nurse will monitor you for 1-2 hours until the sedative effects wear off. You may not be able to eat or drink anything hot or cold for a few hours. You will be given instructions before you go home if you are an outpatient.

IMPORTANT : OUTPATIENTS – You must bring someone with you to drive you home after the procedure.

UPPER GASTROINTESTINAL SERIES (Upper GI)

What is an Upper GI series?

An upper GI series is an X-ray examination of the esophagus, stomach, and small bowel. The esophagus is the tube that runs from your mouth to your stomach. Barium is a liquid used to coat the stomach wall so it may be examined under X-ray.

For the exam to be successful, your stomach and upper GI must be completely empty. This means you probably will be asked not to eat or drink anything after midnight the night before the exam. You will be asked to change into a hospital gown for the exam. You will be positioned behind a piece of equipment called a fluoroscope, which is an x-ray machine combined with a television screen. You may be given effervescent (fizzy) granules to help put air (gas) in your stomach. It is important not to belch, because the combination of barium and air will allow the radiologist to see your stomach with much greater detail. Following the granules, you will be given a cup containing liquid barium to drink. This coats the walls of your upper GI tract so that they may be seen on x-ray.

You will be asked to roll in different positions as the barium flows through your system. After the fluoroscopic pictures are taken, the technologist will take regular x-rays of your upper GI tract. After the exam you will be asked to wait while the radiologist reviews the films to decide if any more x-rays must be taken.The radiologist (a doctor) will interpret the films and a report will be sent to your primary physician who will explain the results to you. When the exam is finished, you may change clothes and return to your regular diet unless otherwise instructed by your doctor.

AFTER THE EXAM

You should increase your water intake for the next few days following the upper GI series. The barium may color your stools slightly whitish for the next day or two. This is normal. If you experience constipation after the examination, tell your doctor.

ULTRASOUND

WHAT IS ULTRASOUND?

Sonograms are studies done with high-frequency sound waves called ultrasound. When the ultrasound is directed at various body organs, some of the sound waves that are passed through the body are bounced back to the transducer. Special computer equipment then converts these “echoes” into an image on a screen, which is then photographed and studied.

Ultrasound imaging may be used to evaluate the body organs, vessels, and tissue. Ultrasound may be used to detect breast cysts. to guide needle placement for biopsies, and to guide drainage of cysts or fluid collections in the body that may result for illnesses. Because ultrasound uses sound waves instead of radiation to create images, it is a safe form of fetal (unborn baby) imaging.

Depending upon the body part being examined, you may be asked not to eat before your exam. Or, you may be asked to drink water before your exam to fill your urinary bladder. Your doctor will give you the preparations (prep) required, or you may call the Diagnostic Imaging Department (Radiology) if you have questions.

During the Examination

Total examination time may range from 30 minutes to 1 hour, depending upon the part of the body being examined. You may be asked to change into a gown depending on the part of the body to be scanned.

The sonographer will position you on the examination table and apply a clear lotion to your skin directly above the area being studied. The lotion is odorless, harmless, and water-soluble: it acts as a conductor, making it easier for sound waves to travel into the underlying anatomy. After the lotion is applied, the sonographer will move a device called a transducer over the lotion-covered skin. The transducer sends out sound waves and receives echoes. These echoes are relayed to a computer for processing and displayed on a monitor as a picture. Some of these pictures will be saved on film or video tape.

The ultrasound examination does not generally cause discomfort, unless the area being viewed is tender. Most people simply feel light pressure from the transducer being moved over the skin. When the exam is complete, your ultrasound scans will be given to a radiologist to interpret and send the results to your physician.

VCUG

What is a VCUG?

VCUG stands for voiding cystourethrogram. This is a test that shows how your urinary bladder is working. It is commonly ordered by your doctor to look for reflux of urine into the ureters.

To do this test, we place a small catheter into your bladder through the urethra. Once the catheter is in place, we fill up your bladder with contrast material and take pictures with the fluoroscope. As soon as you feel the need to urinate, the radiologist will have you urinate on a bed pan or pad on the table and we will take more pictures of the urethra. Once you have finished urinating, the test is over.