Posts tagged ‘abdominal’

April 16, 2015

All About the Belly: Abdominal Ultrasound

uplifting buddha by faria! via Flickr Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0)Bellies are where we keep things, from laughter to turkey dinners to babies. But bellies hold more than that! The anatomically correct name for that part of the body is the abdomen. The abdomen is home to important organs including the liver, gallbladder, spleen, pancreas, and towards the back, the kidneys.

So when we as radiologists are asked to look into someone’s belly, we have a lot to check out! Pain in the abdomen can arise from issues with any of the  organs, the blood vessels and ducts or even the supporting tissues. Because there is so much to see, we select our tools very carefully – starting with ultrasound technology.

Ultrasound is great because images are made with harmless sound waves instead of radiation. It is fast, noninvasive, and painless. The most uncomfortable one might feel is when the tender area is evaluated in the scan. In short, it’s an easy exam.

Once the gel is applied, a transducer (fancy name for a probe) is rubbed gently across the skin. A computer calculates black, white and grey images in real time, instantly showing on a screen. Your radiologist can then interpret those images and determine what’s healthy, or what needs to be healed.

When you have a focal symptom, such as a pain, we can look specifically at the area in question, even viewing it with you in different positions (as in, it hurts right here when I do this!). Flank pain (“renal colic”), especially in young patients, those who are pregnant, and those with known kidney stones are excellent candidates for abdominal ultrasound. Right upper quadrant pain or pain after eating fatty foods can be due to gallstones – best seen and evaluated by ultrasound. Right lower quadrant pain can be an indicator of appendicitis and in kids and young adults ultrasound is a great first imaging test.

No matter what the diagnosis, it’s important to take care of your belly – and all that it holds! Ultrasound is a powerful tool in helping us help you.

(Image Credit: uplifting buddha by faria! via Flickr Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0))

August 4, 2014

We Love… Get Your Rear In Gear!

Katie Couric VF 2012 Shankbone 2 by via david_shankbone Flickr Copright Creative Commons Attribution 2.0 Generic (CC BY 2.0)To end this series on GI imaging, we thought we’d shine a light of hope and health by talking about an organization we love… Colon Cancer Coalition!

 

This is an amazing group of people dedicated to the knowledge that early detection of colon cancer saves lives! Their mission?

 

“Empower local communities to promote prevention and early detection of colon cancer and to provide support to those affected.”

 

Katie Couric, through her own personal loss and resilience, has helped make colorectal cancer a nationally known and talked about  issue (and for this we are grateful). The Colon Cancer Coalition reminds us to Get Your Rear In Gear! This program in cities across the US funnels money back into the participating cities, supporting local education and screening efforts. Check for events in your community here.

 

Early detection is the key to saving lives from colon cancer which is a largely preventable disease – in most cases, colon cancer starts from small growths called polyps. If these are found early, no colon cancer will develop! From a healthy diet and exercise to regular check-ups and knowing the signs of colon cancer, we can all make a difference. Regular screening with colonoscopy at age 50 for folks of average risk can and will make a difference.

 

Catch up with the Coalition on Twitter. (We follow them too.)

 

Time to celebrate life – and kick cancer’s butt!

 

 

(Image credit: Katie Couric VF 2012 Shankbone 2 by david_shankbone via Flickr Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0))

 

 

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

July 30, 2014

MR Enterography

MR enterographyWhen investigating issues of the abdomen and intestines, there are multiple options, including small bowel series, small bowel enteroclysis and CT or MR enterography (entero- meaning intestine, our linguistic lesson for the day!).

 

Why would you need MR enterography?

 

MR enterography is performed for many of the same reasons as CT enterography. As with each imaging modality, there are nuances and benefits from the different techniques.

 

One of the reasons a patient may come in for MR enterography is due to an iodine allergy (iodine is the IV contrast agent for CT). MR technology uses a different IV contrast agent, one containing gadolinium.

 

Additionally, MR technology uses no radiation. This can be beneficial when the patient is pregnant (although only done in pregnancy after the first trimester). It is an ideal means for assessing younger patients with inflammatory bowel disease who may face the need for frequent, repeated imaging of the intestine.

 

How does a patient prepare for MR enterography?

 

Preparation for MR enterography is done similar to the CT version – fasting for up to 4 hours before the examination.

 

What can be expected when you have MR enterography?

 

As always, remember your basic MRI safety – no metal can enter the MR suite – this means all clothing with metal must be removed.

 

MR enterography relies on adequate distention of the small bowel, usually using the same oral contrast agent containing iodine as for CT enterography. Images of the abdomen and pelvis will be obtained while IV contrast containing gadolinium is injected. The imaging time is longer for MRI than for CT, usually close to 30 minutes total for MR. Holding still is important as any motion will cause loss of detail.

 

What can we find with MR enterography?

 

This can show vascular lesions of the wall of the GI tract, masses and mucosal lesions as can be seen with inflammatory bowel disease. It also allows us to see detail in the bowel wall and in the adjacent soft tissues. Fistulas (abnormal communications from bowel loops), strictures and blockages, and abscesses can be seen in patients, often in those with inflammatory bowel disease. Problems with the blood vessels going to the bowel will be shown, such as narrowings or aneurysms.

 

And after the exam?

 

To flush the excess contrast from your system – drink lots of water!

 

MR enterography is one more tool in the arsenal for imaging the small intestines able to produce beautiful images helping us keep you on the path to your best health.

 

 

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

July 23, 2014

CT Ent-enter-entero-enterography! Whew!

Screen Shot 2014-07-23 at 2.52.56 PMWhen investigating issues of the abdomen and intestines, your doctor may order a small bowel series or enteroclysis. However, CT technology is also an excellent noninvasive way of looking at internal organs. It also allows us to better see the tissues adjacent to the small bowel. If a dedicated view of the bowel and adjacent soft tissues is needed there is a special procedure called CT enterography which may be used.

 

Why would you need CT enterography?

 

There are many potential reasons why a patient may come in for CT enterography, with the goal of precisely defining anatomy and potential causes of symptoms. Symptoms can include:

 

  • Abdominal pain (especially in the left or right lower quadrant)
  • Blood in stool
  • Possible bowel obstruction, usually partial blockages of the small bowel which can be difficult to diagnose and difficult to find the cause of
  • Inflammatory bowel disease – with CT enterography we can see not just the disease of the bowel, but any complications in adjacent tissues which are frequent
  • Hernias
  • Masses
  • Narrowings or strictures
  • Infections
  • Masses in the mesentery or adjacent organs that can affect the GI tract

 

How does a patient prepare for CT enterography?

 

Patient prep for this type of imaging is fairly basic: fasting (no food or drink) for 4 hours before the CT may be requested. At times the study may be done without preliminary fasting.

 

What can be expected when you have CT enterography?

 

Typically, CT enterography uses fairly large volumes of oral contrast agents which are iodine-based and iodine-based IV contrast. The oral contrast material helps distend the bowel, so that the wall is well seen. The blood vessels and any inflammatory changes are best seen with the IV contrast highlighting the vessels.  If you have allergies, let us know so we can plan ahead. CT uses radiation, so this exam in general is not done in those that are pregnant or who may be pregnant.

 

What might we see with CT enterography?

  • Inflammatory bowel disease – bowel wall thickening, abnormal enhancement of the wall of the bowel, strictures, fistulas (abnormal communication between bowel loops), adjacent abscesses all may be signs of inflammatory bowel disease and imaging with CT enterography can help assess its degree of activity
  • Masses – benign polyps and cancers
  • Vascular problems to the small or large bowel, including narrowings of vessels or aneurysms (small saccular outpouchings)
  • Blockages – we can not only see the site of obstruction but many times can find the cause of the blockage
  • Infections

 

 

CT enterography is a fusion of the best of CT technology, allowing us to see the soft tissues in the abdomen, and enterography which distends the small bowel, allowing us to best see the wall. With this technique, small bowel diseases are beautifully demonstrated.

 

 

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

July 21, 2014

Intestinally Yours

small bowelIn our continuing series on gastrointestinal imaging, today we’re talking about the small bowel or small intestine. The small intestine is key in absorbing nutrients in our food.

 

Why would you need an imaging study of the small bowel?

 

The small bowel is a coiled tube in the abdomen up to 23 feet in length connecting the stomach and the colon.  In contrast to the stomach and colon which are easy to evaluate by endoscopy, much of the small bowel is beyond the reach of endoscopes.

 

Symptoms which might prompt a small bowel evaluation include:

 

  • diarrhea
  • blood in stools
  • abdominal pain
  • malabsorption
  • suspected partial small bowel obstruction
  • inflammatory bowel disease
  • anemia

 

There are two types of fluoroscopy exams a patient can have to evaluate the small bowel: a small bowel series or a small bowel enteroclysis.

 

How does a patient prepare for small bowel imaging?

 

The prep for these studies is simple: no food or drink by mouth for 4 hours. Clothing with metal will need to be removed. Radiation is used, so these studies are not performed in pregnant women. If you have an allergy or sensitivity to oral barium please advise the radiologist.

 

What can be expected of a small bowel imaging procedure?

 

Both exams will start with a preliminary film which is used to assess the gas in the intestine. Signs of obstruction or bowel perforation may lead to the exam being cancelled or modified.

 

1. Small bowel series

For this procedure, the patient will be given barium to drink. Sufficient barium is necessary in order to fill up the small bowel in order to image it. Next, we will take a series of x-rays to follow the barium through the entire small bowel all the way to the cecum (first part of colon). Additionally, we will take images with gentle compression of the small intestine including the  terminal ileum which is the point at which small bowel ends and joins the colon. Please note it can take up to 4 hours for the contrast to travel all the way through!

2. Small bowel enteroclysis

This procedure uses a tube placed through the mouth or nose until the tip is in the first part of the small bowel. This tube is used to instill a solution of barium at a rate which distends the small intestine and limits normal peristalsis (those normal contractions which move food along). Images are then taken in the same method as above. The entire study can take up to 3-4 hours to complete.

 

So, what are radiologists looking for? What can we expect to find?

 

Images from either method will allow a beautiful depiction of your small bowel anatomy and a little about how it is functioning. Imaging can find:

  • tumors – benign polyps and cancers
  • inflammatory bowel disease IBD (inflammatory bowel disease)
  • infections
  • strictures or narrowings which might partially block small bowel – frequent in patients with IBD
  • fistulas or abnormal communication between bowel loops – frequently found in patients with IBD
  • celiac disease

 

After a small bowel exam, drink lots of fluids! This will help flush out the contrast that was introduced for the exam.

 

The small bowel series and small bowel enteroclysis are methods of viewing the elusive small intestine. The resulting images can be phenomenal. We love being able to see into the human body to get you on the road to your best possible health!

Diagnostic Imaging Centers blogs on regularly about women’s health atwww.mammographykc.com and general radiology atwww.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

July 18, 2014

Imaging of the Lower GI

Barium and Air lower GIYou would probably not consider a barium enema an exam to add to your bucket list, but this imaging study of the colon has the potential to save lives and diagnose many different conditions of the large intestine. While not the most pleasant test we perform, it does create beautiful (ok – we think they’re beautiful!) images of the colon, allowing us to find problems and prevent future ones.

 

So, why would you need an imaging study of the lower gastrointestinal (lower GI) tract?

 

A barium enema shows the anatomy of the large intestine or colon. Colonoscopy allows direct visualization of the mucosal lining and the inside of your colon through a long endoscope, and is often the first study performed for evaluation of the colon. Barium enema is an alternative means of imaging the colon that is less invasive, but not as sensitive at finding some things (especially smaller polyps). Your doctor may recommend lower GI imaging if you have the following symptoms:

 

  • blood in stools
  • change in bowel habits
  • constipation
  • excessive or chronic diarrhea
  • inexplicable weight loss
  • irritable bowel syndrome (IBS)
  • pain in the abdominal region
  • to screen for colon cancer – colonoscopy or CT colonography are often the studies of choice; if colonoscopy cannot reach all of the colon, barium enema may be used to screen the part of the colon not seen; screening for colon cancer is important as most colon cancers start as small growths called polyps – if such polyps are removed, no cancer will develop!

 

How do you prepare for lower GI imaging? What’s to expect?

 

Tests of the lower GI are performed… carefully. In order to find masses or abnormalities of the mucosal lining, the colon must be completely empty. A preliminary prep to accomplish this is necessary for most studies. It will require fasting for a time period, around 24 hours. The prep will include a combination of laxatives and enemas with the goal that all particulate matter is eliminated from your system by the morning of the test. Any medications necessary should be taken with a small amount of water.

 

We occasionally do the study on children. Special preparations may or may not be necessary depending on the age of the child and the conditions being evaluated.

 

The test involves radiation, so will not be used on pregnant women or those who might be pregnant. Let your radiologist know if you have an allergy to latex.

 

We will start the procedure with a preliminary x-ray or film of your abdomen. This allows the radiologist to make sure the prep has worked and the colon is empty. It also allows us to assess for signs the test should not be done, such as when there is a possible obstruction or bowel perforation. The exam involves placing a catheter into the rectum, where a small balloon is inflated. Barium is introduced through the catheter into the rectum by gravity. Room air is then introduced. We use fluoroscopy to get the right amount of barium and air into and coating the colon. This will involve changing your position on the table (lots of rolling!) and changing the table position. Once the colon mucosa is coated with barium and distended with air, a series of x-rays in dedicated positions will be taken so that all parts of your colon will be seen.

 

It will help you tolerate the study if you concentrate on breathing – this actually relaxes the muscles in the wall of the colon, lessening any cramping you may experience.

What do we look for when imaging the lower intestinal tract?

 

We can find a wealth of information from the health of the mucosal lining to blockages. We will assess for normal anatomy and look for signs that all of your colon, from the rectum to the cecum,  is seen. We can evaluate for:

 

  • tumors – both benign polyps and cancers
  • diverticular disease – diverticula are saccular outpouchings from the colon wall which can become inflamed
  • inflammation as can be seen in inflammatory bowel disease or colitis
  • strictures or narrowings
  • blockages in children, as from Hirschsprung’s disease or from intussusception, which can also be treated and reduced with a barium enema

 

What happens after a lower GI exam?

Your radiologist will review all of the films. Once all areas of the colon have been well-seen, the catheter will be removed and you will be allowed to the restroom. Images after using the restroom may or may not be needed.

 

Your radiologist will evaluate all of your images and the final report will be sent to your referring physician.

 

Be sure to drink plenty of water following the procedure. This is needed to flush the remaining contrast agents from you system. You can resume your normal diet immediately.

 

The well-being of your gastrointestinal system is important, and the barium enema is an imaging tool which can provide valuable information, keeping you on the road to your best possible health.

 

Diagnostic Imaging Centers blogs on regularly about women’s health atwww.mammographykc.com and general radiology atwww.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

July 16, 2014

Upper GI Pain and Imaging

UGI imagingEver wondered what happens when you swallow or what your stomach looks like? Upper GI (gastrointestinal) and esophagrams are tests used to assess  the first part of the gastrointestinal system and can be used to answer these questions and much more.

 

Why would you need one of these tests?

These exams may be used for a variety of symptoms including but not limited to:

  • Abdominal pain
  • Epigastric pain
  • Heartburn or other symptoms of reflux disease including chest pain or discomfort, a burning sensation, or excessive burping; more unusual symptoms of reflux can include sinusitis, anosmia (loss of smell), aspiration, and chronic cough.
  • Trouble swallowing
  • Choking
  • Vomiting
  • Blood in stools
  • Ulcers

 

Prior to the study:

It is very important that a patient coming in for an upper GI imaging procedure not eat or drink anything after midnight the day before the exam. In order to look at the structures and anatomy, the stomach and esophagus must be empty. Even a small amount of water can keep the contrast material from coating and sticking to the lining of the structures which would limit what the radiologist can see. Due to radiation exposure UGI imaging is not used in women who are or may be pregnant.

 

It is okay to eat and drink before an esophagram.

 

You will change into a gown, removing all clothing that has metal. We don’t want metal buttons, zippers or underwires hiding any of your lovely GI structures!

How are the tests done?

For an UGI we start with a preliminary x-ray or image of the abdomen- this makes sure there is no blockage before we begin the test. In order to optimally see your GI tract on x-ray using fluoroscopy, we have to give you a contrast material by mouth. General GI imaging can be done with contrast material such as barium and crystals of gas – the barium lines the esophagus (the connection from the mouth to the stomach) and the stomach; the crystals create gas which expands the organs, allowing radiologists to beautifully see the mucosal lining.

 

The contrast travels thru the pharynx, esophagus, stomach and duodenum; observing real-time with fluoroscopy allows us to see function as well as anatomy.

 

Images are obtained of all parts of the upper GI tract, usually starting with you positioned upright and then horizontal. fluoroscopy allows a real time look at what is happening.  X-ray images are also recorded for better detail.

 

For an esophagram, we focus on the pharynx and esophagus only, using oral contrast agents, gas and sometimes foods like crackers coated with barium paste.

 

What can be found using these tests?

  • masses- anywhere along the upper GI tract; these can be benign like polyps or cancerous;
  • ulcers (gastric or duodenal);
  • hiatal hernia (a condition where the stomach is positioned above the diaphragm predisposing to reflux disease and it’s complications like Barrett’s esophagus which is a pre-cancerous condition; this is one of the reasons to not ignore your reflux symptoms!);
  • reflux -we can see the barium going from the stomach back up into the esophagus- we will try different positions and maneuvers to try to elicit reflux;
  • esophagitis or gastritis-conditions of inflammation from many different causes;
  • congenital abnormalities-sometimes the upper GI tract is not connected normally or there may be congenital cysts or masses along the upper GI tract;
  • motility disorders- most often of the esophagus; imaging real-time allows us to see how your upper GI tract is functioning
  • swallowing disorders

What happens after the test?

The radiologist may be able to discuss some of your results at the end of the test. A final report will be made by your radiologist after reviewing all of the images, with the official report going to your doctor.

 

We will ask that you drink lots of fluids to help flush the barium out of the system! (Besides, drinking water is good for you no matter what!). You can resume your normal diet immediately.

 

Upper GI exams can result in amazing images and can be a key to diagnosis of a wide variety of conditions. Seeing your body in action helps us keep you on the road to your best possible health!

Diagnostic Imaging Centers blogs on regularly about women’s health atwww.mammographykc.com and general radiology atwww.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

June 20, 2014

We Love… The National Stroke Association!

Does the face look uneven by Charles Hope via Flickr Copyright Creative Commons Attribution-NonCommercial-ShareAlike 2.0 Generic (CC BY-NC-SA 2.0)Just to be clear, we love the National Stroke Association, which is the opposite of loving strokes. After our series on vascular imaging as well reporting on recent studies on stroke prevention, it’s important to talk about the warning signs, additional prevention and what can be done if someone is suspected of having a stroke.

 

In health, action is everything.- for strokes, time means brain.The longer those neurons or brain cells go without blood flow, the greater their chance of death and loss of function. The sooner we  react to a situation, the better the chances of recovery. This is why it’s important to know the signs of a stroke and what to do if one is happening.

 

First, if you believe a stroke is occurring, call 911 immediately. What are signs of a stroke? They are sudden and can include any of the following: numbness, weakness, confusion, trouble seeing, walking or speaking, and/or severe headache. Nerve changes like numbness and weakness may occur on only one side of the body. Act immediately – time equals brain!

 

Risks for cerebrovascular disease and stroke include modifiable and nonmodifiable risk factors. The National Stroke Association has an excellent breakdown of the many, many potential risk factors here. If you have any of these risk factors, from family history of strokes, to diabetes or high blood pressure (to name just a few), extra vigilance and modification of those factors you can control is key.

 

Strokes are disorienting experiences and can present with a wide spectrum of findings, based on which part of the brain is being affected. For an insightful first-person account, Jill Bolte Taylor’s TEDtalk about her experience (“My Stroke of Insight”) is a fascinating video.

 

Because of all their hard work toward the best possible health for all, we love The National Stroke Association. And if you like them too, you can do so here!

(Image Attribution: Does the face look uneven? by Charles Hope via Flickr Copyright Creative CommonsAttribution-NonCommercial-ShareAlike 2.0 Generic (CC BY-NC-SA 2.0))

Diagnostic Imaging Centers blogs on regularly about women’s health atwww.mammographykc.com and general radiology atwww.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

June 18, 2014

The Study Is Out: Animal Proteins and Strokes

 

Copper river sockeye smoked salmon mit salat und crumpet 07.04.2012 20-30-53 by Dirk Ingo Franke via Wikimedia Commons Copyright Creative Commons Attribution-Share Alike 3.0 UnportedNow that we’ve discussed carotid Doppler, CT angiography and MR angiography, here’s a reminder that we are advocates for an ounce of prevention over a pound of cure. Preventing vascular disease is much better than detecting it!

 

According to a recent analysis of seven health studies, one of the best ways to fight stroke is by a healthy diet (pause to act surprised here). One key to that healthy diet is lean animal protein (okay, you’re allowed to be surprised now).

 

The study showed that as lean protein intake increases, stroke risk decreases. This study included over 250,000 patients but was focused on those living in countries where unsaturated, lean proteins like fish are popular. Those who ate 20 additional grams of protein a day had a 26% lower risk of stroke. What is behind the reduced risk is less well-understood. Likely, there are multiple factors involved. For instance, a protein-rich diet can also naturally include extra nutrients like potassium, magnesium and dietary fiber, all of which may be stroke deterrents.

 

We should not take this study to mean increase your protein intake without considering the type or quality of the protein -lean animal protein seems to be the key here. While the occasional steak or hamburger is acceptable, increasing your daily dietary intake of these type proteins will not yield the same results seen in this study.

 

The long and the short of it is this: a careful diet is good for you; proteins, including lean animal proteins, seem to help with reducing stroke risk. For further reading, there are articles summarizing the findings here and here.


For your best vascular health, don’t smoke, keep cholesterol and glucose levels healthy, and consider a diet focused on healthy lean proteins.

June 13, 2014

Vascular Series Part 3 – MRA

MRAAs part of our continuing series on vascular health and imaging, we’d like to talk about another way of seeing into your body and imaging blood vessels: MR angiography, or magnetic resonance angiography.

 

MR angiography is different than CT angiography in that it uses MRI or magnetic resonance imaging with no radiation. This is a benefit of MR angiography.  MR angiography may or may not require use of an IV injection. When needed, MR angiography uses a different type of contrast material for injection – gadolinium-based instead of iodine-based. This is particularly helpful for people with iodine-contrast allergies or poor kidney function.

 

MR angiography can be used to image the blood vessels and blood flow. The procedure can produce some truly beautiful pictures of blood vessels (the physics behind creating those images is fascinating – and complex!). The vessel walls and adjacent tissues can be seen, as opposed to traditional angiography which shows only the vessel lumen or the inside of the vessel. CTA is the best tool for showing the walls of the vessels themselves.

 

So, what do we use MRA for?

 

We can use it to evaluate almost any artery or vein in the body. For example, MR angiography of the head (usually done without contrast) is helpful when looking for aneurysms (saclike outpouchings arising from blood vessels which can be deadly or disabling if they bleed) or areas of artery narrowing. To evaluate the abdominal aorta, we can look for aneurysms (abnormal dilatation) or dissection (when there is a tear in the vessel creating two channels). We may be asked to evaluate the renal arteries for narrowings- renal artery stenosis is one of the treatable causes of high blood pressure.  MR angiography can also be used to examine the leg arteries when needing to evaluate for causes of pain when walking.

As we have discussed, there are lots of ways of imaging the blood vessels. Often, ultrasound with Doppler is used first to see if there is a need for further investigation. CT angiography or MR angiography can further define the vessels and identify problems that may need to be addressed either surgically or with interventional radiology procedures (angioplasty, stenting). Traditional catheter angiography is often reserved for those cases that will benefit from vascular intervention.

Diagnostic Imaging Centers blogs on regularly about women’s health atwww.mammographykc.com and general radiology atwww.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!