FLUROSCOPY

What is Fluoroscopy?

Fluoroscopy is a method of using low intensity X-ray beams to continuously visualize the area of interest in "real time".

The modern fluoroscope consists of an image intensifier tube and a fluorescent screen that is stimulated by X-rays that pass through the body.

The image on the screen is electronically amplified and viewed on a television monitor.

The image intensifier can be moved to view any part of the patient's body and recordings of each study can be made using videotape, a cine camera, digitally or with conventional films.

TYPES OF FLUROSCOPY

C-ARM FLUOROSCOPY

TUBE UNDER THE TABLE

Fluoroscopy UsesFluoroscopy is most often used to monitor barium studies and angiographic studies.( blood vessels)

It is also used for innumerable other procedures that require continuous visualization including endoscopy, bronchoscopy, orthopedic surgery, myelography (spinal cord), diaphragmatic motion studies, arthrography (joint ), and urethrography ( urethral pathology).

RISK FACTORS

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Protection of Radiographer and Radiologist

• Single step away from the table decreases exposure exponentially (inverse sq law)• Bucky slot cover• Lead rubber drape• Radiologist as shielding

• Used when it is not possible to remain behind a barrier– Lead aprons– Lead gloves– Lead glasses– Thyroid shields

• 0.25 –1.0 mm lead eq

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Enteroclysis procedure (SMALL INTESTINE )

Advantages

• relatively inexpensive

• readily available

• portable, useful in theatre

Disadvantages

• limited applications • no cross sectional imaging• useful for hollow organs, vessels

MAMMOLOGRAPHY• Radiographic examination of the breast must be

performed with equipment that is specifically dedicated to breast imaging.

• A dedicated mammography unit uses high-resolution film and fluorescent screens, and has a unique film processing technique, resulting in extremely high spatial resolution images.

• The breast must be imaged in at least two planes and the chest wall and axillary tissue should be included for a complete examination.

• The breast must be compressed between two plates in order to achieve the best possible quality images.

• The firmer the compression the better the image.

• The examination is often uncomfortable but should not be painful.

standard views

• The standard views obtained include the supero-inferior view (also called craniocaudal) and the medio-lateral oblique.

Indications

• Early detection of breast cancer• Detection of micro calcifications, • Nodules,• Masses

Limitations

• dense breasts (young patients) and• very large breasts, where small lesions

may be missed

Advantages

• Excellent anatomical detail with high soft tissue contrast

• Standardized technique• Highly sensitive in the detection of

breast cancer (95% sensitive when combined with examination findings, 80 - 85% sensitive without physical examination).

Disadvantages

• 10% of breast cancers are not visible with mammography.

• less useful in young