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Learn More About Diagnostic Radiology
Heart & Vascular
Baylor provides a full array of diagnostic and therapeutic services at our hospitals and imaging centers across the Dallas/Fort Worth Metroplex. Learn important information about the procedures listed below, including why the tests are needed, what to expect and results and risks for each.
Some women are at greater risk for osteoporosis — the decrease of bone mass and density as a result of the depletion of bone calcium and protein — than others. Your doctor can help you determine your risk of developing osteoporosis by taking your personal and family medical history, and by doing a bone density test or bone mass measurement.
A bone density test, also known as bone mass measurement or bone mineral density test, measures the strength and density of your bones as you approach menopause and, when the test is repeated sometime later, can help determine how quickly you are losing bone mass and density. These tests are painless, noninvasive, and safe. They compare your bone density with standards for what is expected in someone of your age, gender, and size, and to the optimal peak bone density of a healthy young adult of the same gender. Bone density testing can help to:
Detect low bone density before a fracture occurs
Confirm a diagnosis of osteoporosis if you have a fracture
Predict your chances of fracturing in the future
Determine your rate of bone loss or monitor the effects of treatment if the test is conducted at intervals of a year or more
If you have one or more of the following risk factors for osteoporosis, you may want to consider having a bone density test:
You have already experienced a bone fracture that may be the result of thinning bones.
Your mother, grandmother, or another close relative had osteoporosis or bone fractures.
Over a long period of time, you have taken medicine that speeds up bone loss, such as corticosteroids for treating rheumatoid arthritis or other conditions, or some anti-seizure medicines.
You have low body weight, a slight build, or a light complexion.
You have a history of cigarette smoking or heavy drinking.
Bone density measurements are preformed in order to find or confirm a diagnosis of osteoporosis.
Mammography is an X-ray exam of your breast tissue. The image it makes is called a mammogram. A mammogram can help find problems with your breasts, such as cysts or cancer. Mammography is the best breast cancer screening tool available.
Have screening mammograms and professional breast exams as often as your healthcare provider recommends. Also, be sure you know how your breasts normally look and feel. This makes it easier to notice any changes. Report changes to your healthcare provider as soon as possible.
Schedule the test for 1 week after your period. Your breasts are less sore then.
Make sure your clinic gets images of your last mammogram if it was done somewhere else. This lets the provider compare the 2 sets of images for any changes.
On the morning of your test, don’t use deodorant, powder, or perfume.
Wear a top that you can take off easily.
You will need to undress from the waist up.
The technologist will position your breast to get the best test results.
Each of your breasts will be compressed one at a time. This helps get the most complete X-ray image.
Your breasts will be repositioned to get at least 2 separate views of each breast.
More X-rays are sometimes needed. You’ll be called to schedule them.
You should receive your test results in writing. Ask about this on the day of your appointment.
Have mammograms as often as your healthcare provider recommends.
You’re pregnant or think you may be pregnant
You have breast implants
You have any scars or moles on or near your breasts
You’ve had a breast biopsy or surgery
This test uses x-ray pictures used to find tumors in the breast and determine malignancy.
A myelogram is a diagnostic imaging test generally done by a radiologist. It uses a contrast dye and X-rays or computed tomography (CT) to look for problems in the spinal canal. Problems can develop in the spinal cord, nerve roots, and other tissues. This test is also called myelography.
The contrast dye is injected into the spinal column before the procedure. The contrast dye appears on an X-ray screen allowing the radiologist to see the spinal cord, subarachnoid space, and other nearby structures more clearly than with standard X-rays of the spine.
The radiologist will also use a CT scan when doing a myelogram. A CT or CAT scan is an imaging test that uses X-rays and a computer to make detailed images of the body. A CT scan shows details images of the spinal canal. CT scans show more details than standard X-rays.
A myelogram may be done to assess the spinal cord, subarachnoid space, or other structures for changes or abnormalities. It may be used when another type of exam, such as a standard X-ray, does not give clear answers about the cause of back or spine problems. Myelograms may be used to evaluate many diseases, including:
There may be other reasons for your healthcare provider to recommend a myelogram.
You may want to ask your healthcare provider about the amount of radiation used during the procedure and the risks related to your situation. It is a good idea to keep a record of your radiation exposure, such as previous CT scans and other types of X-rays, so that you can inform your healthcare provider. Risks associated with radiation exposure may be related to the cumulative number of X-ray exams and/or treatments over a long period.
If you are pregnant or think you may be, tell your healthcare provider. Radiation exposure to the fetus may cause birth defects.
There is a risk of an allergic reaction to the contrast dye. Be sure to let your healthcare provider know if you have ever had a reaction to any contrast dye, or have any kidney problems.
Because the contrast is injected into the cerebrospinal fluid (CSF) which also surrounds the brain, there is a small risk of seizure after the injection. Some medications may place you at greater risk for seizure and you may be asked to stop taking these for 48 hours before and after the study. Make sure your healthcare provider has a list of all medicines (prescribed and over-the-counter) and all herbs, vitamins, and supplements that you are taking.
Because this procedure involves a lumbar puncture, these potential complications may happen:
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your healthcare provider before the procedure.
A myelogram may be done on an outpatient basis or as part of your stay in a hospital. The procedure takes about an hour, but may vary depending on your condition and the clinic's practices.
Generally, a myelogram follows this process:
You may experience discomfort during the myelogram. The radiologist will use all possible comfort measures and complete the procedure as quickly as possible to minimize any discomfort or pain.
You need to sit or lay down for several hours after the procedure to reduce your risk of developing a CSF (cerebral spinal fluid) leak.
You will be asked to drink extra fluids to rehydrate after the procedure. This helps to wash out the contrast dye and it helps your body replace the spinal fluid that was removed. It also reduces the chance of developing a headache.
A nurse will monitor your vital signs (blood pressure, temperature, pulse, and respirations) frequently after the test. You will be given pain medicine if you develop a headache.
When you have completed the recovery period, you will be taken to your hospital room or discharged to your home.
Once you are at home, tell your doctor of any changes including:
If the headaches persist for more than 24 hours after the procedure, or are worse when you change positions, you should contact your doctor.
You may be instructed to limit your activity for 24 hours after the procedure. Generally, if you don’t have any problems, you may return to your normal diet and activities.
Your doctor may give you additional or alternative instructions after the procedure, depending on your particular situation.
Before you agree to the test or the procedure make sure you know:
Myelograms use dye and x-rays to create an image of the spaces in between your spine.
Fluoroscopy is a study of moving body structures. It’s much like an X-ray "movie" and is often done while a contrast dye moves through the part of the body being examined. A continuous X-ray beam is passed through the body part and sent to a video monitor so that the body part and its motion can be seen in detail. Fluoroscopy, as an imaging tool, allows healthcare providers to look at many body systems, including the skeletal, digestive, urinary, cardiovascular, respiratory, and reproductive systems.
Fluoroscopy may be used to evaluate specific areas of the body. These include the bones, muscles, and joints, as well as solid organs, such as the heart, lung, or kidneys.
Fluoroscopy is used in many types of exams and procedures including:
Fluoroscopy is also used for:
Fluoroscopy may be used alone, or may be used along with other diagnostic procedures.
There may be other reasons for your healthcare provider to recommend fluoroscopy.
You may want to ask your healthcare provider about the amount of radiation used during the procedure and the risks related to your particular situation. It is a good idea to keep a record of your radiation exposure, such as previous CT scans and other types of X-rays, so that you can inform your healthcare provider. Risks associated with radiation exposure may be related to the cumulative number of X-ray exam and/or treatments over a long period.
If you are pregnant or think you may be, tell your healthcare provider. Radiation exposure during pregnancy may lead to birth defects.
If contrast dye is used, there is a risk for allergic reaction to the dye. Tell your healthcare provider if you are allergic to or sensitive to medicines, contrast media, iodine, or latex. Also, tell your healthcare provider if you have kidney failure or other kidney problems.
There may be other risks depending on your specific medical condition. Be certain your healthcare provider knows about all of your medical conditions.
Certain factors or conditions may interfere with the accuracy of a fluoroscopy procedure. For instance, a recent barium X-ray procedure may interfere with exposure of the stomach or lower back area. Make sure your healthcare provider knows about your medical history and any recent tests or treatments you have had.
Fluoroscopy may be done on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your healthcare provider's practices.
Generally, fluoroscopy follows this process:
While fluoroscopy itself is not painful, the particular procedure being done may be painful, such as the injection into a joint or accessing of an artery or vein for angiography. In these cases, the radiologist will take all comfort measures possible, which could include local anesthesia (numbing drugs), conscious sedation (medicines to make you sleepy), or general anesthesia (medicines to put you into a deep sleep and not feel pain), depending on the particular procedure.
The type of care needed after the procedure will depend on the type of fluoroscopy that is done. Certain procedures, such as cardiac catheterization, will require a recovery period of several hours with immobilization of the leg or arm where the catheter was inserted. Other procedures may need less time for recovery.
If you notice any pain, redness, and/or swelling at the IV site after you go home, you should tell your healthcare provider as this may be a sign of infection or other type of reaction.
Your healthcare provider will give more specific instructions related to your care after the procedure.
X-Ray & Fluoroscopy is a machine that sends x-ray particles through the body, creating a picture that is captured on a special type of film.
Computerized tomography scans are used in order to get a quick and detailed picture of the brain, chest, spine or stomach.
Magnetic resonance imaging (MRI) is a test that lets your doctor see detailed pictures of the inside of your body. MRI combines the use of strong magnets and radio waves to form an MRI image.
You may need to stop eating or drinking before the test. Each health care facility has its own guidelines on this. It also depends on the type of exam you are having. Ask your health care provider if you should stop eating or drinking before the test.
Ask your provider if you should stop taking any medicine before the test.
Follow your normal daily routine unless your provider tells you otherwise.
You'll be asked to remove your watch, jewelry, hearing aids, credit cards, pens, pocket knives, eyeglasses, and other metal objects.
You may be asked to remove your makeup. Makeup may contain some metal.
Most MRI tests take 30 to 60 minutes. Depending on the type of MRI you are having, the test may take longer. Give yourself extra time to check in.
MRI uses strong magnets. Metal is affected by magnets and can distort the image. The magnet used in MRI can cause metal objects in your body to move. If you have a metal implant, you may not be able to have an MRI unless the implant is certified as MRI safe. People with these implants should not have an MRI:
Ear (cochlear) implants
Certain clips used for brain aneurysms
Certain metal coils put in blood vessels
Be sure to tell the radiologist or technologist if you:
Have had any previous surgeries
Have a pacemaker, surgical clips, metal plate or pins, an artificial joint, staples or screws, ear (cochlear) implants, or other implants
Wear a medicated adhesive patch
Have metal splinters in your body
Have implanted nerve stimulators or drug-infusion ports
Have tattoos or body piercings. Some tattoo inks contain metal.
Work with metal
Have braces. You must remove any dental work.
Have a bullet or other metal in your body
Also tell the radiologist or technologist if you:
Are pregnant or think you may be
Are afraid of small, enclosed spaces (claustrophobic)
Are allergic to X-ray dye (contrast medium), iodine, shellfish, or any medicines
Have other allergies
Have a history of cancer
Have any serious health problems. This includes kidney disease or a liver transplant. You may not be able to have the contrast material used for MRI.
You may be asked to wear a hospital gown.
You may be given earplugs to wear if you need them.
You may be injected with a special dye (contrast) that improves the MRI image.
You’ll lie down on a platform that slides into the magnet.
You can get back to normal activities right away. If you were given contrast, it will pass naturally through your body within a day. You may be told to drink more water or other fluids during this time.
Your doctor will discuss the test results with you during a follow-up appointment or over the phone.
Your next appointment is: __________________
Magnetic resonance imaging uses magnets and radio waves to take pictures inside the body.
Nuclear medicine is a specialized area of radiology that uses very small amounts of radioactive materials, or radiopharmaceuticals, to examine organ function and structure. Nuclear medicine imaging is a combination of many different disciplines. These include chemistry, physics, mathematics, computer technology, and medicine. This branch of radiology is often used to help diagnose and treat abnormalities very early in the progression of a disease, such as thyroid cancer.
Because X-rays pass through soft tissue, such as intestines, muscles, and blood vessels, these tissues are difficult to visualize on a standard X-ray, unless a contrast agent is used. This allows the tissue to be seen more clearly. Nuclear imaging enables visualization of organ and tissue structure as well as function. The extent to which a radiopharmaceutical is absorbed, or "taken up," by a particular organ or tissue may indicate the level of function of the organ or tissue being studied. Thus, diagnostic X-rays are used primarily to study anatomy. Nuclear imaging is used to study organ and tissue function.
A tiny amount of a radioactive substance is used during the procedure to assist in the exam. The radioactive substance, called a radionuclide (radiopharmaceutical or radioactive tracer), is absorbed by body tissue. Several different types of radionuclides are available. These include forms of the elements technetium, thallium, gallium, iodine, and xenon. The type of radionuclide used will depend on the type of study and the body part being studied.
After the radionuclide has been given and has collected in the body tissue under study, radiation will be given off. This radiation is detected by a radiation detector. The most common type of detector is the gamma camera. Digital signals are produced and stored by a computer when the gamma camera detects the radiation.
By measuring the behavior of the radionuclide in the body during a nuclear scan, the healthcare provider can assess and diagnose various conditions, such as tumors, infections, hematomas, organ enlargement, or cysts. A nuclear scan may also be used to assess organ function and blood circulation.
The areas where the radionuclide collects in greater amounts are called "hot spots." The areas that do not absorb the radionuclide and appear less bright on the scan image are referred to as "cold spots."
In planar imaging, the gamma camera remains stationary. The resulting images are two-dimensional (2D). Single photon emission computed tomography, or SPECT, produces axial "slices" of the organ in question because the gamma camera rotates around the patient. These slices are similar to those performed by a CT scan. In certain instances, such as PET scans, three-dimensional (3D) images can be performed using the SPECT data.
Scans are used to diagnose many medical conditions and diseases. Some of the more common tests include the following:
Renal scans. These are used to examine the kidneys and to find any abnormalities. These include abnormal function or obstruction of the renal blood flow.
Thyroid scans. These are used to evaluate thyroid function or to better evaluate a thyroid nodule or mass.
Bone scans. These are used to evaluate any degenerative and/or arthritic changes in the joints, to find bone diseases and tumors, and/or to determine the cause of bone pain or inflammation.
Gallium scans. These are used to diagnose active infectious and/or inflammatory diseases, tumors, and abscesses.
Heart scans. These are used to identify abnormal blood flow to the heart, to determine the extent of the damage of the heart muscle after a heart attack, and/or to measure heart function.
Brain scans. These are used to investigate problems within the brain and/or in the blood circulation to the brain.
Breast scans. These are often used in conjunction with mammograms to locate cancerous tissue in the breast.
As stated above, nuclear medicine scans may be performed on many organs and tissues of the body. Each type of scan employs certain technology, radionuclides, and procedures.
A nuclear medicine scan consists of 3 phases: tracer (radionuclide) administration, taking images, and image interpretation. The amount of time between administration of the tracer and the taking of the images may range from a few moments to a few days. The time depends on the body tissue being examined and the tracer being used. Some scans are completed in minutes, while others may need the patient to return a few times over the course of several days.
One of the most commonly performed nuclear medicine exams is a heart scan. Myocardial perfusion scans and radionuclide angiography scans are the 2 primary heart scans. In order to give an example of how nuclear medicine scans are done, the process for a resting radionuclide angiogram (RNA) scan is presented below.
Although each facility may have specific protocols in place, generally, a resting RNA follows this process:
The patient will be asked to remove any jewelry or other objects that may interfere with the procedure.
If the patient is asked to remove clothing, he or she will be given a gown to wear.
An intravenous (IV) line will be started in the hand or arm.
The patient will be connected to an electrocardiogram (ECG) machine with electrodes (leads) and a blood pressure cuff will be attached to the arm.
The patient will lie flat on a table in the procedure room.
The radionuclide will be injected into the vein to "tag" the red blood cells. Alternatively, a small amount of blood will be withdrawn from the vein so that it can be tagged with the radionuclide. The radionuclide will be added to the blood and will be absorbed into the red blood cells.
After the tagging procedure, the blood will be returned into the vein through the IV tube. The progress of the tagged red blood cells through the heart will be traced with a scanner.
During the procedure, it will be very important to lie as still as possible. Any movement can adversely affect the quality of the scan.
The gamma camera will be positioned over the patient as he or she lies on the table, and will obtain images of the heart as it pumps the blood through the body.
The patient may be asked to change positions during the test. However, once the position has been changed, the patient will need to lie still without talking.
After the scan is complete, the IV line will be discontinued. The patient will be allowed to leave, unless the healthcare provider gives different instructions.
A specialized area of radiology that uses small amounts of radioactive matter to examine organ function and structure.
Virtual colonoscopy is a procedure that is done to look for small polyps or other growths inside your colon. Polyps that grow on the inside lining of the colon sometimes turn into colon cancers. The American Cancer Society recommends that most men and women begin screening for colon cancer at age 50. If you have a family history of colon cancer or are at high risk for other reasons, your healthcare provider may want you to begin screening even earlier. Virtual colonoscopy every 5 years is one of several screening choices.
Virtual colonoscopy is also called CT colonography. It is done by taking hundreds of cross-sectional X-rays of the colon using a powerful type of computer. The computer can put all the images together to create 3-D images of your colon and rectum. These images can then be looked at by your healthcare providers. This type of imaging is called CT. The machine that makes them is called a CT scanner.
Colon cancer is the third most common cancer in men and women. The reason for virtual colonoscopy is to find colon cancer at an early stage when it can be treated most successfully. Colon polyps that are found by virtual colonoscopy can be removed using conventional colonoscopy before they turn into cancer.
Conventional colonoscopy is also done to screen for colon cancer. This procedure is done by placing a long, flexible, lighted scope and tiny camera through the rectum and into the colon. This lets the healthcare provider look at the colon directly and remove any polyps that are present.
Virtual colonoscopy has several advantages over conventional colonoscopy:
Virtual colonoscopy is less uncomfortable and invasive than conventional colonoscopy. It usually does not need any pain medicine or anesthesia.
Virtual colonoscopy takes less time. It also poses less risk of puncturing the large intestine.
In certain cases, virtual colonoscopy may be used in people who have problems such as swelling, bleeding, or breathing difficulties. It may also be done for some people who may not be able to have conventional colonoscopy.
Virtual colonoscopy may be able to show areas of the large intestine if conventional colonoscopy can't reach them for some reason. This might be if part of the intestine is narrowed or blocked.
Virtual colonoscopy is generally a safe procedure, but it's not without risk. But conventional colonoscopy also has some drawbacks. Among the risks and disadvantages of virtual colonoscopy:
During virtual colonoscopy, a small, short tube is placed into your anus so that air can be pumped into your colon. This inflates your colon so that polyps or other growths are more easily seen. Pumping air into the colon carries a very small risk that it may cause a rupture. But the risk is thought to be much less than with conventional colonoscopy.
Polyps or suspicious growths cannot be removed or biopsied during virtual colonoscopy. You will still likely need to have a conventional colonoscopy if polyps or other suspicious areas are found.
Virtual colonoscopy can miss some polyps that may turn into cancer if they are smaller than 10 mm. Some of these might be seen by conventional colonoscopy.
Unlike most other screening tests, virtual colonoscopy uses X-rays to create pictures of the colon and rectum. Radiation received during virtual colonoscopy is small, but it could be dangerous for pregnant women. If you are or could be pregnant, you should discuss this risk with your healthcare provider before the procedure.
Virtual colonoscopy is still fairly new. It may not always be covered by health insurance.
You may have other risks, depending on your health condition. Be sure to discuss any concerns with your healthcare provider before the procedure.
Before having a virtual (or a conventional) colonoscopy, you will need to have a bowel prep. A bowel prep is a way of emptying everything solid from your colon so that the CT images will be clear. Here is what is often involved with a bowel prep:
Your healthcare provider may ask you to limit your diet to clear liquids for a day or two before the procedure. These might be water, clear broth, or an electrolyte solution.
The day before the procedure, you will be given a strong laxative in pill or liquid form to help you empty your colon. You will likely have several loose or liquid bowel movements in the following hours.
Just before the procedure you may be given a type of liquid to drink called contrast media. This helps the inside of your colon show up brighter for the X-rays.
Always tell your healthcare provider about any medicines you are taking. Also tell your provider if you've had any reactions to contrast media for other X-rays in the past.
Virtual colonoscopy can be done wherever a CT scanner is available. In most cases you will go to the radiology department of a hospital or medical center. The actual procedure takes only about 10 to 15 minutes. This is what usually happens during a virtual colonoscopy:
The thin tube will be placed into your rectum to inflate your colon with air. You may feel a slight fullness.
A radiologist will put you face up on a table that slides into the CT scanner.
The radiologist will leave the room. The CT scanner will be operated from a separate control room. You will be able to hear and talk with the staff.
The table will move into and through the scanner. You may hear some whirring and clicking noises.
You may be asked to hold your breath at times.
The scan may need to be repeated while you lie face down.
In most cases, you should be able to return home without help and go back to your normal diet and activities. You usually will not need medicines or special instructions. But always check with your healthcare provider and the radiology staff if you have any questions.
Less invasive than a traditional colonoscopy, VCs combine software with MRIs or CT Scans.
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