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Southern DHB Radiology - Otago

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    The Radiology Department at Dunedin Hospital encompasses a wide variety of disciplines:

    • General Radiology (Inpatients, Outpatients, Theatre, Mobiles units, A&E)
    • Fluoroscopy
    • CT (Computed Tomography - CAT scan)
    • MRI (Magnetic Resonance Imaging)
    • Ultrasound
    • DSA (Digital Subtraction Angiography)
    • Nuclear Medicine
    • A general x-ray service to 'Urgent Doctors'

    The Radiology team comprises:

    • Radiologists
    • Resident Doctors (Registrars)
    • MRTs (Medical Radiation Technologists)
    • Sonographers ( MRTs specialised in Ultra Sonography)
    • Registered Nurses

    As we are a teaching hospital we often have students in training. There is a possibility you may be x-rayed by a supervised student but you will be informed of this and have the right to refuse.

    Procedures

    X-ray

    An X-ray is a high frequency, high energy wave form.  It cannot be seen with the naked eye, but can be picked up on photographic film. Although you may think of an X-ray as a picture of bones, a trained observer can also see air spaces, like the lungs (which look black) and fluid (which looks white, but not as white as bones).   What to expect? You will have all metal objects removed from your body.  You will be asked to remain still in a specific position and hold your breath on command.  There are staff present, but they will not necessarily remain in the room, but will speak with you via an intercom system and will be viewing the procedure constantly through a windowed control room. The examination time will vary depending on the type of procedure required, but as a rule it will take around 30 minutes.

    Computed Tomography (CT)

    With CT you can differentiate many more things than with a normal X-ray. A CT image is created by using an X-ray beam, which is sent through the body from different angles, and by using a complicated mathematical process the computer of the CT is able to produce an image.  This allows cross-sectional images of the body without cutting it open.  The CT is used to view all body structures but especially soft tissue such as body organs (heart, lungs, liver etc.).   What to expect? You will have all metal objects removed from your body.  You will lie down on a narrow padded moveable table that will be slid into the scanner, through a circular opening. You will feel nothing while the scan is in progress, but some people can feel slightly claustrophobic or closed in, whilst inside the scanner.  You will be asked to remain still and hold your breath on command.  There are staff present, but they will not necessarily remain in the room, but will speak with you via an intercom system and will be viewing the procedure constantly through a windowed control room, from where they will run the scanner. Some procedures will require Contrast Medium.  Contrast medium is a substance that makes the image of the CT or MRI clearer. Contrast medium can be given by mouth, rectally, or by injection into the bloodstream. The scan time will vary depending on the type of examination required, but as a rule it will take around 30 minutes.

    Magnetic Resonance Imaging (MRI)

    An MRI machine does not work like an X-ray or CT; it is used for exact images of internal organs and body structures.  This method delivers clear images without the exposure of radiation. The procedure uses a combination of magnetic fields and radio waves which results in an image being made using the MRI’s computer.   What to expect? You will have all metal objects removed from your body.  You will lie down on a narrow padded moveable table that will be slid into the scanner, through a circular opening. You will feel nothing while the scan is in progress, but some people can feel slightly claustrophobic or closed in, whilst inside the scanner.  You will be asked to remain still and hold your breath on command.  There are staff present, but they will not necessarily remain in the room, but will speak with you via an intercom system and will be viewing the procedure constantly through a windowed control room, from where they will run the scanner. Some procedures will require Contrast Medium.  Contrast medium is a substance that makes the image of the CT or MRI clearer. Contrast can be given by mouth, rectally, or by injection into the bloodstream. The scan time will vary depending on the type of examination required, but as a rule it will take around 30 minutes.

    Ultrasound

    In ultrasound, a beam of sound at a very high frequency (that cannot be heard) is sent into the body from a small vibrating crystal in a hand-held scanner head.  When the beam meets a surface between tissues of different density, echoes of the sound beam are sent back into the scanner head.  The time between sending the sound and receiving the echo back is fed into a computer, which in turn creates an image that is projected on a television screen.  Ultrasound is a very safe type of imaging; this is why it is so widely used during pregnancy.   Doppler Ultrasound A Doppler study is a noninvasive test that can be used to evaluate blood flow by bouncing high-frequency sound waves (ultrasound) off red blood cells. The Doppler Effect is a change in the frequency of sound waves caused by moving objects. A Doppler study can estimate how fast blood flows by measuring the rate of change in its pitch (frequency).  A Doppler study can help diagnose bloody clots, heart and leg valve problems and blocked or narrowed arteries.   What to expect?After lying down, the area to be examined will be exposed.  Generally a contact gel will be used between the scanner head and skin.  The scanner head is then pressed against your skin and moved around and over the area to be examined.  At the same time the internal images will appear onto a screen

    Nuclear Medicine (Scintigraphy)

    This is a specialised scanning method using very small amount of low-level radioactive isotopes injected into the bloodstream. Once administered these radioactive tracers can localise to specific organs where the scanner, called a gamma camera, is used to measure the radiation levels given off from the isotopes. This allows assessment of the functional abnormalities in very specific parts of the body such as: assessment of thyroid function, location of tumours and possible spread, checking of bone fractures and assessing damage to the heart after coronary episodes.

    Barium Enema

    A barium enema is an X-ray procedure to examine the lower part of the gastro-intestinal tract (large bowel). Barium is a thick white chalky substance that shows up on an X-ray.  Barium moves quickly through the gastrointestinal tract and is not easily absorbed by the body. This procedure allows a clear picture of the outline of the bowel and shows up any abnormalities. The test takes around 45 minutes.   What to expect? A barium enema requires special preparation and it is important to carry out the instructions you are given, otherwise the procedure may not be carried out or give good enough results. The bowel must be clean and clear of faeces before the examination.  Dietary instructions need to be followed, such as having clear fluids, then a prescriptive laxative must be taken and lastly enemas to clear out any remaining faeces. During the procedure, you will lie on your side upon an X-ray table.  A well-lubricated tube is then gently inserted into the rectum.  Barium and air then fills the colon.  Air helps to keep a good flow of barium around the colon. You will then be asked to move into a number of different positions, to ensure that the barium coats all the surfaces of the bowel, which means achieving a good picture. X-rays will then be taken; holding of the breath for a number of seconds and keeping still is required during this. Sometimes intravenous medication is given to help relax the patient.  This can also help with some of the discomfort from the procedure. This examination is not a comfortable one; most people have a feeling of fullness of the bowel during the procedure, lower abdominal cramping and the urge to pass wind or a bowel motion.  Knowing what to expect beforehand, will make the procedure easier to cope with.

    Mammography

    A mammogram is a special type of x-ray used only for the breast. Mammography can be used either to look for very early breast cancer in women without breast symptoms (screening) or to examine women who do have breast symptoms (diagnostic).   What to expect?You will need to undress from the waist up.  One of your breasts will be positioned between two plastic plates which will flatten the breast slightly. Most women find that this is a bit uncomfortable, but not painful. Generally two x-rays are taken of each breast. It is also useful to compare the results with earlier examinations and you should take any previous mammography results with you.

    DEXA Bone Densitometry

    DEXA (which stands for dual energy x-ray absorptiometry) scanning uses special x-rays to measure the density of your bones. The density of your bones will show how strong they are. The exposure to x-rays is very low and is similar to what you would receive on a long distance plane flight.   What to expect? You will lie very still on a padded table for 5-10 minutes while the arm of the machine passes over the area to be measured (usually the lower spine and hip, although the forearm can also be measured). This is quite painless.You can remain in your normal clothing, although you may have to take off anything with large buttons, buckles or metal zips.