 |
 |
||||||||||
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
Vista Radiology administers Pediatric Radiology through East Tennessee Children’s Hospital. Children’s Hospital was founded in 1937 as a not-for-profit health care facility to provide rehabilitation for pediatric polio patients. Today, the hospital is an independent, comprehensive pediatric medical referral center serving infants, children, and adolescents from East Tennessee, Southeastern Kentucky and Southwestern Virginia.
Vista Radiology is proud to be partners with East Tennessee Children’s Hospital in providing the best radiological care possible to its patients and physicians. The radiology dept at Children’s Hospital provides state-of-the-art diagnosis and reporting through CT, MRI, x-rays, nuclear medicine, and other diagnostic testing.
CT ( Computed Tomography)
Computed tomography, or CT, is a diagnostic procedure that produces images of the internal tissues of the human body when the x-ray tube and detector array within the doughnut-shaped gantry of the CT scanner rotate in a spiral motion around the patient. X-ray beams travel through the body and are picked up by the scan detectors. Computer pictures are generated and reflect the relative energy absorbed by the body tissues. The detailed images provided are then analyzed for abnormalities by the radiologist.
When is a CT Necessary?
There are many reasons for which your physician may request a CT. CT can be used to rule out disease or to facilitate medical, surgical, and other treatments for conditions of the brain, spinal column, and spinal cord; kidneys, urinary tract, and pelvic organs; abdominal organs and gastrointestinal tract; chest and lungs; bones, joints, and muscles; and eye, ear, nose, and throat. CT is often used to obtain specific diagnostic information not already provided by other imaging technologies such as ultrasound, nuclear medicine, and magnetic resonance imaging (MRI).
Preparation for a CT:
Unless the CT examination requires the injection or ingestion of a contrast agent for image enhancement, you may eat, drink, and take medication as usual. Specific dietary restrictions and other instructions may be necessary if sedation or anesthesia is necessary, or if other special care considerations are required. To insure your safety during the CT exam, it is important to adhere to these instructions. If instructions are not followed, your CT exam will need to be rescheduled. You must also notify the CT staff of any active illness, allergy, or previous drug reaction that may prohibit you from safely undergoing the examination.
During the CT Exam:
Once your appointment and registration is confirmed and completed, the radiology nurse and CT technologist will prepare you for the exam. This includes the administration of any necessary sedation, anesthesia, or contrast media.
The CT technologist positions and comfortably secures you on the bed of a large doughnut-shaped gantry of the CT scanner. The procedure is performed by the technologist and the radiologist. They are both in constant contact with the patient. Other emergency staff are also available for patients who have undergone sedation and anesthesia. All critically ill or unstable patients receive vital monitoring and support by a nurse or physician. During the procedure, you will hear some noise and feel the bed move. It is important to remain still at this time since the CT scanner is obtaining images. Pictures free of motion help shorten the total exam time and prevent delays. Depending on the type of information required by the radiologist and your physician, a CT exam may take anywhere from ten minutes to one hour.
The CT itself is a painless procedure. If an injection is required, you may feel minor discomfort from the needle. The amount of x-rays used in a CT is less than that of a normal x-rays due to advanced detector and computer technology that work to achieve the best image quality at the lowest possible radiation dose. In addition, protective shielding is applied routinely to prevent unnecessary radiation exposure to sensitive tissues.
After the CT:
After the images are obtained, you are free to go and resume your normal daily activity. Once your CT images have been analyzed, the radiologist will review the findings with your physician and provide a report. The physician will then discuss the results with you.
Magnetic Resonance Imaging (MRI)
MRI, or magnetic resonance imaging, is a routine diagnostic procedure used to view internal organs and produce diagnostic pictures of the human body. These images are produced by using the tiny magnets of hydrogen nuclei which are abundant in all of us as parts of water, fat, protein, and other molecules. The magnetic field of the MRI machine causes the hydrogen magnets to align, while applied radiowaves excite them to transmit signals. The locations of the signals within the body are identified using magnetic field gradient pulses which are the source of the loud knocking noises heard during the examination. Once enough signals have been collected, they are processed by powerful computers to generate pictures of the human anatomy in vivid detail for the radiologist to analyze and diagnose abnormalities.
When Is a MRI Necessary?
As with a CT, there are many reasons your physician may request a MRI. This procedure is used to obtain specific diagnostic information not already provided by other imaging technologies such as ultrasound, computed tomography (CT), and nuclear medicine. A MRI may be needed to rule out disease and to facilitate medical, surgical, and other treatments for conditions of the brain, spinal column and spinal cord; kidneys, urinary tract, and pelvic organs; eye, ear, nose and throat; bones, joints, and muscles, chest and lungs, abdominal organs and digestive tract; and heart and blood vessels.
MRI, like other imaging technologies in radiology, is FDA approved for its safety and effectiveness. MRI has been used to image patients since 1981 and no adverse biological effects have been reported from exposure to the magnetic fields or radiowaves.
Preparation For A MRI:
Unless the MRI examination requires the injection or ingestion of a contrast agent for image enhancement, you may eat and drink as usual. Specific dietary restrictions and other instructions may be necessary if sedation or anesthesia is necessary, or if other special care considerations are required. To insure your safety during the MRI exam, it is important to adhere to these instructions. If instructions are not followed, your MRI exam will need to be rescheduled. You must also notify the MRI staff of any active illness, allergy, or previous drug reaction that may prohibit you from safely undergoing the examination.
During the MRI Exam:
After having your appointment and registration confirmed by the scheduling coordinator, you will be asked to complete the MRI screening questionnaire. The MRI nurse will provide a clinical screening examination and ask you a few questions. You will then be asked to remove all metal objects and electronic devices and change into hospital attire unless you wore clothing that is comfortable and free of metal. At this point, you will be prepared for the MRI which may include oral or intravenous sedation by the radiology nurse, or anesthesia by an anesthesiologist.
The technologist positions and comfortably secures you on a narrow bed within the large magnet and adjusts the radiowave coil. The technologist, along with the radiologist, performs the MRI. During the procedure, you will hear several series of repetitive pulsing noises. It is important to remain still at this time since the MRI machine is obtaining images. Pictures free of motion help shorten the total exam time and prevent delays. Depending on the type of information required by the radiologist and your physician, a MRI exam may take anywhere from twenty minutes to one and a half hours.
The MRI itself is a painless procedure. If an injection is required, you may feel minor discomfort from the needle. If the loud pulsations cause hearing discomfort, ear plugs or ear phones will be provided. For people who suffer from claustrophobia, the enclosed MRI machine may present a problem. If there is concern about this possibility, the MRI staff should be notified in advance of the appointment.
After the MRI:
After the images are obtained, you are free to go and resume your normal daily activity. Since the interpretation of an MRI involves the review of multiple images, it often requires additional computer processing. There is usually a 15 – 20 minute minimum delay between the completion of the examination and the availability of the results. Once your MRI has been analyzed, the radiologist will review the findings with your physician and provide a report. The physician will then discuss the results with you.
Ultrasound
Ultrasound, another form of imaging technology, uses high frequency sound waves to view internal organs and produce diagnostic pictures of the human body. With ultrasounds no radiation is used.
Several ultrasound procedures are performed at East Tennessee Children’s Hospital. These include abdominal, cranial, hip, kidney, pelvic, neck and spine.
An abdominal ultrasound is an ultrasound of the internal organs, including the liver, gall bladder, spleen, pancreas, kidneys and urinary bladder. There are many different reasons why a physician might request an abdominal ultrasound including looking for causes of belly pain, stones in the gall bladder or kidney, or for enlargement of an abdominal organ. Pyloric stenosis, one cause of vomiting in babies, can be diagnosed with ultrasound.
A cranial ultrasound looks at the brain tissues and ventricles. It is usually performed on infants who still have a soft spot in their skull. Reasons for a cranial ultrasound include: enlarging head circumference in a baby; screening for bleeding in the brain; looking for signs of infection; and screening for congenital abnormalities.
Hip ultrasounds are used to look for dislocated or underdeveloped hips. Indications for a hip ultrasound include an abnormality found through a physical exam of the child’s hip, a family history of hip dysplasia, and breech presentation, among many others.
Kidney ultrasounds take pictures of both kidneys and the urinary bladder. However, it does not test the function of the kidneys. A kidney ultrasound can be used to establish the presence of an urinary tract infection, blood in the urine, high blood pressure, back or abdominal pain, kidney stones, prenatally detected abnormalities, syndromes and conditions associated with kidney abnormalities, or a family history of kidney disease.
A pelvic ultrasound takes pictures of the pelvic organs which include the uterus, ovaries, and bladder in girls. Pelvic ultrasound can also be done in boys. Pelvic pain is cause for a pelvic ultrasound or when searching for a possible mass.
A spine ultrasound is used to take pictures of the spinal cord in an infant who is usually no more than 2 or 3 months old. A child is usually referred for a spinal ultrasound to look for an abnormality of the spinal cord.
Diagnostic Radiology
Conventional diagnostic radiology uses x-rays generated by an x-ray tube to produce diagnostic pictures of the human body on film. At East Tennessee Children’s Hospital, radiologists, technologists, and staff are equipped to deliver high quality and rapid x-ray examinations at the lowest possible radiation doses for pediatric patients of any size, age, and medical condition.
Diagnostic procedures administered at East Tennessee Children’s Hospital include:
Barium Enema, an x-ray study in which a small tube is inserted into the rectum and the large intestine is filled with barium. This allows the radiologist to accurately diagnose many conditions which affect the large intestine. A barium enema may be considered if there have been symptoms of abdominal pain, severe constipation and rectal bleeding.
The procedure is completely safe with little discomfort. The only time the patient should experience any discomfort is during the insertion of the tube. Some cramping may occur for a short period during the test.
IVP, sometimes referred to as intravenous pyelography, is a test used to take pictures of the kidneys and bladder. This test is done early in the day in order for the pictures to come out clear. Patients are asked not to eat breakfast before the test.
During the first phrase of an IVP, the patient lie on their back while pictures are taken with a piece of equipment that resembles an oversized camera. During the second phrase, contrast material will be injected into the arm. There may be a small stinging discomfort at this point. Once all the contrast is injected, additional pictures will be taken every few minutes until all necessary films requested by the doctor are completed.
Upper Gastrointestinal Series, or UGI for short, is a type of x-ray that uses barium to fill and coat the intestines thus allowing the radiologist to accurately diagnose many illnesses which affect the esophagus, stomach and small intestine. An upper GI study is limited to the esophagus, stomach, and the first portion of the small intestine. In an upper GI with small bowel follow-through, the remainder of the small intestine is also studied. Some indications for which and UGI would be recommended include vomiting, abdominal pain, bleeding into the gastrointestinal tract and poor weight gain.
The patient will be asked not to eat or drink for some time prior to the procedure. Exactly how long will depend on the age of the patient. The procedure consists of a primary x-ray of the abdomen that will be evaluated by the radiologist. The patient will then be asked to drink the barium while lying down under the x-ray camera. The radiologist will take pictures during this time. In a small bowel follow through, pictures will be taken every half hour until the entire intestine has been viewed.