Diagnostic imaging


Fluoroscopy

image

Fluoroscopy is an imaging modality that uses x-rays to allow real-time visualization of body structures. During fluoroscopy, x-ray beams are continually emitted and captured on a screen, producing a real-time, dynamic image. This allows for dynamic assessment of anatomy and function. High density contrast agents may be introduced into the patient to allow for greater differentiation between structures.

Common clinical applications

  • Barium studies: Barium swallow, barium meal and follow-through, barium enema for evaluation of the gastro-intestinal tract.
  • Hysterosalphingography (HSG): for evaluation of the uterine cavity and the fallopian tubes.
  • Retrograde urethrogram, micturating cysto-urethrogram: for the evaluation of the abnormalities of the urinary system.
  • Fistulography: for the evaluation of fistulae.
  • Reduction of fractures under image guidance

Safety

  • Procedural complications due to intervention such as bleeding after HSG, or discomfort from catheterization.
  • Hypersensitivity reaction to contrast agents may range in severity from flushing to anaphylaxis. Risk factors for immediate hypersensitivity reactions to IV contrast include previous allergic reaction to IV contrast, history of asthma or food allergies.
  • Patients with renal insufficiency/failure, multiple myeloma, severe cardiac disease such as congestive heart failure, aortic stenosis, should not receive IV contrast. Other examples include severe dehydration, diabetics and sickle cell disease.
  • As with plain radiography, fluoroscopy utilizes x-ray radiation to produce images, however the radiation doses from fluoroscopy are higher. Pregnancy status must be established prior to exam. X-ray procedures should be delayed until after pregnancy where possible or non radiation imaging such as ultrasound or MRI utilized.
  • As children are more radiosensitive, x-ray procedures should be performed with caution.
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