CHAPTER 20
Radiology and
Diagnostic Imaging
Radiology and
Diagnostic Imaging Overview
• X-rays
– High-energy electromagnetic waves
– Travel in straight lines
– Shorter wave length than visible light
– Able to penetrate solid materials of varying
densities
– Capable of exposing a photographic plate
(X-ray film)
• Much the same way as a camera exposes film
2
Radiology and
Diagnostic Imaging Overview
• X-rays
– Used to visualize internal organs and
structures of body
– Provide valuable means for verifying
presence of illness or disease
• Radiology
– Study of the diagnostic and therapeutic uses
of X-rays
3
PROCEDURES
AND TECHNIQUES
Radiology and
Diagnostic Imaging
Angiocardiography
(Cardiac Catheterization)
• Pronounced
– (an-jee-oh-kar-dee-OG-rah-fee)
– (CAR-dee-ak kath-eh-ter-ih-ZAY-shun)
• Defined
– Specialized diagnostic procedure in which a
catheter is introduced into a large vein or
artery
– Usually of an arm or a leg, and is then
threaded through circulatory system to the
heart
5
Angiography
• Pronounced
– (an-jee-OG-rah-fee)
• Defined
– Series of X-ray films allowing visualization of
internal structures after the introduction of a
radiopaque substance
6
Cerebral Angiography
• Pronounced
– (seh-REE-bral an-jee-OG-rah-fee)
– (SER-eh-bral an-jee-OG-rah-fee)
• Defined
– Injection of a radiopaque contrast medium
into an arterial blood vessel (carotid, femoral,
or brachial) to make visualization of the
cerebral vascular system via X-ray possible
7
Renal Angiography
• Pronounced
– (REE-nal an-jee-OG-rah-fee)
• Defined
– X-ray visualization of internal anatomy of the
renal blood vessels (blood vessels of the
kidney) after injection of a contrast medium
8
Arteriography
• Pronounced
– (ar-tee-ree-OG-rah-fee)
• Defined
– X-ray visualization of arteries following the
introduction of a radiopaque contrast medium
into the bloodstream through a specific vessel
by way of a catheter
9
Arthrography
• Pronounced
– (ar-THROG-rah-fee)
• Defined
– Process of taking X-rays of the inside of a
joint, after a contrast medium has been
injected into the joint
• Contrast medium makes the inside of the joint
visible
10
Barium Enema (BE)
• Pronounced
– (BAH-ree-um EN-eh-mah)
• Defined
– Infusion of a radiopaque contrast medium,
barium sulfate, into the rectum
– Contrast medium is retained in lower
intestinal tract while X-ray films are obtained
of the lower GI tract
11
Barium Swallow
(Upper GI Series)
• Pronounced
– (BAH-ree-um SWALL-oh)
• Defined
– Oral administration of a radiopaque contrast
medium, barium sulfate, which flows into the
esophagus as the person swallows
• X-rays are taken as barium sulfate flows into the
upper GI tract
12
Bronchography
• Pronounced
– (brong-KOG-rah-fee)
• Defined
– Bronchial examination via X-ray following the
coating of the bronchi with a radiopaque
substance
13
Cholangiography
(Intravenous)
• Pronounced
– (koh-lan-jee-OG-rah-fee)
– (in-trah-VEE-nus)
• Defined
– Visualizing and outlining of the major bile
ducts following an intravenous injection of a
contrast medium
14
Cholangiography
(Percutaneous Transhepatic)
• Pronounced
– (koh-lan-jee-OG-rah-fee)
– (per-kyoo-TAY-nee-us trans-heh-PAT-ik)
• Defined
– Examination of bile duct structure using a
needle to pass directly into an intrahepatic
bile duct to inject a contrast medium
• Also known as PTC or PTHC
15
Cholangiopancreatography
(Endoscopic Retrograde)
• Pronounced
– (koh-lan-jee-oh-pan-kree-ah-TOG-rah-fee)
– (en-doh-SKOP-ic RET-roh-grayd)
• Defined
– Procedure that examines the size of and the
filling of the pancreatic and biliary ducts
through direct radiographic visualization with a
fiberoptic endoscope
16
Cholecystography
(Oral)
• Pronounced
– (koh-lee-sis-TOG-rah-fee)
• Defined
– Visualization of the gallbladder through X-ray
following the oral ingestion of pills containing
a radiopaque iodinated dye
17
Cineradiography
• Pronounced
– (sin-eh-ray-dee-OG-rah-fee)
• Defined
– Diagnostic technique combining the
techniques of fluoroscopy, radiography, and
cinematography by filming the images that
develop on a fluorescent screen with a movie
camera
18
Computed Axial
Tomography (CT, CAT)
• Pronounced
– (kom-PEW-ted AK-see-al toh-MOG-rahfee)
• Defined
– Painless, noninvasive diagnostic X-ray
procedure using ionizing radiation that
produces a cross-sectional image of the body
19
Computed Axial Tomography
20
Voiding Cystourethrography
• Pronounced
– (VOYD-ing sis-toh-yoo-ree-THROG-rahfee)
• Defined
– X-ray visualization of the bladder and
urethra during the voiding process, after the
bladder has been filled with a contrast
material
21
Digital Subtraction Angiography
(DSA)
• Pronounced
– (DIJ-ih-tal sub-TRAK-shun an-jee-OG-rahfee)
• Defined
– X-ray images of blood vessels only, appearing
without any background, due to the use of a
computerized digital video subtraction
process
22
Echocardiography
• Pronounced
– (ek-oh-kar-dee-OG-rah-fee)
• Defined
– Diagnostic procedure for studying the
structure and motion of the heart via
ultrasound
• Useful in evaluating structural and functional
changes in a variety of heart disorders
23
Fluoroscopy
• Pronounced
– (floor-or-OSS-koh-pee)
• Defined
– Radiological technique used to examine the
function of an organ or a body part using a
fluoroscope
24
Hysterosalpingography
• Pronounced
– (his-ter-oh-sal-ping-OG-rah-fee)
• Defined
– X-ray assessment of uterus and fallopian
tubes by injecting a contrast material into
these structures
25
Lymphangiography
• Pronounced
– (lim-fan-jee-OG-rah-fee)
• Defined
– X-ray assessment of lymphatic system
following injection of a contrast medium into
lymph vessels in the hand or foot
26
Magnetic Resonance Imaging
(MRI)
• Pronounced
– (mag-NET-ik REZ-oh-nans IM-ij-ing)
• Defined
– Noninvasive scanning procedure that
provides visualization of fluid, soft tissue, and
bony structures without the use of radiation
27
Mammography
• Pronounced
– (mam-OG-rah-fee)
• Defined
– Process of taking X-rays of the soft tissue of
the breast to detect various benign and/or
malignant growths before they can be felt
28
Myelography
• Pronounced
– (my-eh-LOG-rah-fee)
• Defined
– Introduction of contrast medium into the
lumbar subarachnoid space through a lumbar
puncture to visualize the spinal cord and
vertebral canal through X-ray examination
29
Positron Emission
Tomography Scan (PET)
• Pronounced
– (POZ-ih-tron ee-MISH-un toh-MOG-rah-fee)
• Defined
– Noninvasive diagnostic imaging method that
demonstrates the biological function of the
body before anatomical changes take place
• Scan produces computerized radiographic images
of the body structures when radioactive substances
are administered to the patient
– Substances are inhaled or injected
30
Pyelography
(Intravenous) (IVP)
• Pronounced
– (pye-eh-LOG-rah-fee)
– (in-trah-VEE-nus)
• Defined
– Radiographic procedure that provides
visualization of the entire urinary tract:
kidneys, ureters, bladder, and urethra
• Also known as intravenous pyelogram or excretory
urogram
31
Radiation Therapy
• Pronounced
– (ray-dee-AY-shun THAIR-ah-pee)
• Defined
– Delivery of ionizing radiation to accomplish
one or more of the following:
•
•
•
•
•
Destruction of tumor cells
Reduction of tumor size
Decrease in pain
Relief of obstruction
To slow or stop the spread of cancer cells
32
Radiation Therapy
• Radiation therapy
– Destroys rapidly multiplying cells regardless
of whether they are cancerous
– Goal is to reach maximum tumor control with
no, or minimal, normal tissue damage
– May be delivered by teletherapy (external)
– May be delivered by brachytherapy (internal)
33
Radioactive Iodine Uptake
• Pronounced
– (ray-dee-oh-AK-tiv EYE-oh-dine UP-tayk)
• Defined
– Examination that determines the position,
size, shape, and physiological function of the
thyroid gland through the use of radionuclear
scanning
• Image of the thyroid is recorded and visualized
after a radioactive substance is given
34
Scanning
(Bone, Brain, Liver, Lungs)
• Pronounced
– (SCAN-ing)
• Defined
– Scanning is the process of recording emission
of radioactive waves, using a gamma camera
(scanner)
• After an intravenous injection of a radionuclide
material into the particular part of the body being
studied
35
Scanning
(Bone, Brain, Liver, Lungs)
• Defined
– Image of the area being studied is
displayed by recording concentration or
collection of a radioactive substance
specifically drawn to that area
36
Scanning
• Bone
– Involves intravenous injection of a
radionuclide material absorbed by bone tissue
• Used to detect spread of cancer to the bones,
osteomyelitis, and other destructive changes in the
bones
37
Scanning
• Brain
– Nuclear scanning of cranial contents two
hours after an intravenous injection of
radioisotopes
• Useful in diagnosing abnormal findings such as an
acute cerebral infarction, cerebral neoplasm,
cerebral hemorrhage, brain abscess, aneurysms,
cerebral thrombosis, hematomas, hydrocephalus,
cancer metastasis to the brain, and bleeds
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Scanning
• Liver
– Noninvasive scanning technique that enables
the visualization of the shape, size, and
consistency of the liver after the IV injection
of a radioactive compound
• Useful in detecting cysts, abscesses, tumors,
granulomas, or diffuse infiltrative processes
affecting the liver
39
Scanning
• Lung
– Visual imaging of the distribution of ventilation
or blood flow in the lungs by scanning the
lungs after the patient has been injected with
or has inhaled radioactive material
40
Scanning
• Spleen
– Noninvasive scanning technique that enables
the visualization of the shape, size, and
consistency of the spleen after injection of
radioactive red blood cells
• Useful in detecting damage, tumors, and other
problems
41
Single-Photon Emission
Computed Tomography (SPECT)
• Pronounced
– (single FOH-ton ee-MISH-un
kom-PEW-ted toh-MOG-rah-fee)
• Defined
– Nuclear imaging procedure that shows how
blood flows to tissues and organs
• Tracking of radioactive material allows physician to
see perfusion of blood to tissues and organs
42
Small Bowel Follow-Through
• Pronounced
– (Small Bowel Follow-Through)
• Defined
– Oral administration of a radiopaque contrast
medium, barium sulfate, which flows through
the GI system
• X-ray films are obtained at timed intervals to
observe progression of barium through small
intestines
43
Tomography
• Pronounced
– (toh-MOG-rah-fee)
• Defined
– X-ray technique used to construct a detailed
cross-section, at a predetermined depth, of a
tissue structure
• Useful in identifying space-occupying lesions in
the liver, brain, pancreas, and gallbladder
44
Ultrasonography
(Ultrasound)
• Pronounced
– (ull-trah-son-OG-rah-fee)
• Defined
– Procedure in which sound waves are
transmitted into body structures as a small
transducer is passed over the patient’s skin
• Sound waves are reflected back into the transducer
and are interpreted by a computer that converts
waves to a composite picture form
45
Ultrasonography
• Abdominal ultrasound
– Use of reflected sound waves to provide
reliable visualization of the liver, gallbladder,
bile ducts, pancreas, kidneys, bladder, and
ureters
46
Ultrasonography
• Pelvic ultrasound
– Noninvasive procedure that uses highfrequency sound waves to examine the
abdomen and pelvis
– Can be used to locate a pelvic mass, an
ectopic pregnancy, or an intrauterine device,
and to inspect and assess the uterus, ovaries,
and fallopian tubes
47
Ultrasonography
• Renal ultrasound
– Noninvasive ultrasound of the kidneys that is
useful in distinguishing between fluid-filled
cysts and solid masses, detecting renal
calculi, identifying obstructions, and evaluating
transplanted kidneys
• Thyroid Echogram (ultrasound)
– Ultrasound examination important in
distinguishing solid thyroid nodules from cystic
nodules
48
Venography
• Pronounced
– (vee-NOG-rah-fee)
• Defined
– Technique used to prepare an X-ray image of
veins
– Veins are injected with a radiopaque contrast
medium
– Phlebography
49
X-rays
• Pronounced
– (ECKS-rays)
• Defined
– Use of high-energy electromagnetic waves,
passing through the body onto a photographic
film, to produce a picture of the internal
structures of the body for diagnosis and
therapy
50
X-rays
• Chest X-ray
– Visualization of interior of chest
– Provides diagnostic information about:
• Tumors, inflammation, accumulation of fluid,
accumulation of air, bone fractures, diaphragmatic
hernia, size of heart, calcification, placement of
centrally located intravenous access devices
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X-rays
• Chest X-ray views
– Posteroanterior (PA)
• X-rays pass through the posterior (back) to the
anterior (front)
– Lateral
• X-rays pass through the person’s side
– Oblique
• X-rays are taken from different angles
– Decubitus
• X-rays are taken with person in recumbent lateral
position – aids in localizing fluid
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