Posts tagged ‘American’

August 22, 2014

Head Aches and Head Issues #4: Head MRI – What To Expect

MRI of headIf you are experiencing headaches and your evaluation by your doctor suggests the need for imaging, you may be sent for either an MRI or CT scan. CTs are quick and valuable in the evaluation of patients presenting with headaches after trauma. MRI is an alternative means of imaging the brain and adjacent tissues.

CT vs. MRI

The main differences in the two technologies are as follows. The decision as to which test is needed is based on your history and findings, as well as the following:

 

CT:

  • uses ionizing radiation (avoided in pregnancy unless there are significant findings or significant trauma) in conjunction with computers to generate images
  • takes 10 minutes or less
  • may or may not use IV iodinated contrast material
  • great in looking for blood in and around the brain, which can be traumatic or non-traumatic in origin
  • uses a short bored tube

 

MRI:

  • uses magnets and radiofrequency waves in conjunction with computers to generate images – no radiation
  • can be used in pregnancy after the first trimester and without IV contrast material
  • may or may not use IV gadolinium contrast material
  • takes 30 minutes or more
  • uses a long bore tube (can seem confining although there are ways of treating this sensation!)
  • shows anatomy in greater detail than CT
  • some pathologies such as multiple sclerosis are best visualized on MRI
  • must hold still for longer time periods – may be difficult for younger children

 

 

What To Expect

Before an MRI of the head, no special preparation is necessary. However, metal is a big issue (seriously, the machine is one giant magnet and any metal on your body can become a hazardous missile with potential for harm to you, the technologist or the machine). So – extreme care is used to ensure that you have no metal on your body. Also, metals in things like artificial joints and pacemakers can create problems so full disclosure is needed.

The procedure takes approximately 30 minutes with only the head moving through the machine.

Holding still during the imaging is key to getting good pictures. Images are taken without contrast to begin with and then if needed (and patient is not pregnant) additional series may be run after an IV injection of a contrast material containing the heavy metal gadolinium. This should be used in caution in certain patients with kidney problems, so we always obtain a full history prior to giving this, and may check your kidney function before giving it. The injection may cause a cooling sensation.

What Happens Next

After your exam is completed, the images are studied by your radiologist for interpretation and reporting. The results are then shared with your referring doctor to integrate the new information gained from your head MRI with clinical symptoms for a specific diagnosis. After the test, we recommend drinking extra fluids to help flush the contrast from your system if it was used.

On Your Way!

Headaches can be a vexing issue, and getting you on the road to being headache-free is the goal of the medical team, including the radiologist carefully analyzing those images. As ever, we hope to help to get you on the road to your best possible 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!

 

August 21, 2014

Head Aches, Head Issues #3: CT Scan of the Head

CT scan by NithinRao via Wikimedia Commons Copyright Public DomainSo if you’ve had a good wallop to the head (or it just feels like you have) your doctor may direct you to a head CT.

 

Like all CTs, a modifiable dose of radiation is used to image the body in “slices” which are then reconstructed into images. Use of radiation in pregnancy should be reserved for special cases, so let the technologists know if you are or could be pregnant.

 

What To Expect

 

Before a CT of the head, no special preparation is necessary. However, metal interferes with the images, so jewelry, hairpins and the like will need to be removed from the region of the head.

 

The procedure takes approximately ten minutes with only the head moving through the machine. Persons with claustrophobia typically do well with CT because the exam is fast and the machine itself is not too confining. Holding still is important – as with all images, motion causes blurring.

 

CT of the head is often performed without contrast. For cases following trauma or in an evaluation for headache a non-contrast examination may be sufficient.  There are times when IV contrast injection is necessary. This additional part of the study can be very helpful to evaluate the blood vessels in the head and for assessment of the brain tissues and its enhancement. The iodinated contrast material will be given thru an IV which may cause a feeling of warmth. Images are then taken in the same manner as the initial non-contrast series.

 

What Happens Next

 

After your exam is completed, the images are studied by your radiologist for interpretation and reporting. The results are then shared with your referring doctor to integrate the new information gained from your head CT with clinical symptoms for a specific diagnosis.

 

On Your Way!

 

That’s it! A CT head is a quick, simple procedure which can be invaluable in looking at your brain and surrounding tissues. It can help get you on your way to being headache- and anxiety – free!

 

 

(Image credit: CT scan by NithinRao via Wikimedia Commons Copyright Public Domain)

 

 

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!

August 19, 2014

Headaches and Head Issues #2: Looking Inside Your Head

800px-Brain_MRISo… there will be times when a headache prompts further evaluation. Imaging can be used to study the brain and its surrounding tissues. CT and MRI are both common imaging techniques for evaluating the brain and adjacent tissues when imaging for headaches is indicated.

 

For sudden onset headache, thunderclap headache, and headache following trauma in the past 48 hours, we often start with CT of the head.

 

CT Scans

The initial CT imaging is done without contrast; images are obtained through the skull while the patient lies still. This takes only a few minutes.

 

From this we can see hemorrhages in and around the brain – one of the serious causes for headaches that can be seen from both traumatic and non-traumatic causes.

 

Occasionally, the noncontrast study will be followed by postcontrast imaging after an IV injection of iodine-containing contrast – this highlights the vessels and demonstrates abnormal enhancement in the brain, such as masses.

 

CT uses radiation to make its images – therefore, use in pregnant patients will generally be reserved for special indications and circumstances.

 

MRI Scans

If there are any neurologic changes associated with your headaches (things like numbness, loss of strength or confusion) imaging with MRI may be requested. An MRI shows the internal structure of the brain in great detail. Masses and areas of abnormality from things such as strokes and multiple sclerosis are well shown with this modality. Because the procedure takes about 30 minutes to fully image the head, it does require the ability to lay on your back for a length of time. Images can be obtained both without and with IV contrast containing gadolinium, often times with both. Gadolinium contrast helps us look at vascular structure and for abnormal enhancement.

 

MRI can be used in some instances during pregnancy, but only after the first trimester is complete. No IV contrast is used for MRI in pregnancy.

 

Patients with pacemakers and other implanted surgical devices may not be able to undergo MR imaging. Let your doctor know of all surgeries and procedures prior to scheduling your MRI.

 

These exams can shed amazing light on the brain and its functions (or malfunctions). While we always work to image wisely, we can also image exquisitely. From the finest of endings to the largest of masses, we are able to have a noninvasive peak inside the inner workings of the brain. Through this we are able to get our patients on the road to their best possible health!

 

 

(Image credit: Brain fMRI via Wikimedia Commons, Copyright Public Domain)

 

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!

 

August 13, 2014

Headaches and Head Issues #1: When NOT To Image

headache by Pierre Willemin via Flickr Copyright Creative Commons Attribution-NoDerivs 2.0 Generic (CC BY-ND 2.0)Headaches are a common complaint and come in different forms. Most headaches, though they may not feel like “nothing” at the time, are often simple and solvable problems.

 

As radiologists we have a special role when it comes to headaches. Ready for this? Most times patients with headaches need not visit their friendly radiologists. The brain (and even the musculature around it) is a complex and honestly beautiful thing. We are advocates of imaging carefully – and there are times when that means no imaging at all.

 

The crux is this: it can be hard to know when a headache should prompt medical evaluation. Rules have been developed helping medical professionals determine when imaging will be most beneficial. if a headache has other symptoms associated with it (such as nausea or vomiting) or is new, significantly worse or comes on suddenly, medical evaluation is warranted and imaging may be needed.

 

According to a recent article published in the Journal of the American College of Radiology:

 

“Most patients presenting with uncomplicated, nontraumatic, primary headache do not require imaging. When history, physical, or neurologic examination elicits “red flags” or critical features of the headache, then further investigation with imaging may be warranted to exclude a secondary cause.”

 

What are the “red flags” that mean imaging may be necessary?

 

 

  • history of head trauma;
  • new, worse, or abrupt onset headache;
  • thunderclap headache;
  • headache with pain radiating to the neck;
  • one sided headache with facial pain;
  • persistent and positional headaches;
  • headache centered at side of head (temple) in older individuals.

 

 

It’s important to not ignore intuition. If something about your headache is unusual, or the circumstances predicating it are new, it is definitely worth seeing your doctor. However, if s/he doesn’t opt for imaging in the initial stages, that may be perfectly okay too. We love seeing our patients on the road to their best possible health!

 

 

(Image credit: headache by Pierre Willemin via Flickr Copyright Creative Commons Attribution-NoDerivs 2.0 Generic (CC BY-ND 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!

 

June 25, 2014

Lung Cancer Screening Gets Another Leg Up

Symbol kept vote Green by Zorglub via Wikimedia Commons Copyright Creative Commons Attribution-Share Alike 3.0 UnportedThe votes in support of low-dose screening CT chest for high risk smokers are growing. Recently the American Medical Association – the largest association of doctors from all specialties in the US – added their support to guidelines recommending this potentially life-saving exam.

 

Lung cancer is a killer. In the US, lung cancer causes more deaths than breast + prostate + colon cancer – more deaths than all of those cancers combined! Studies on low-dose CT screening (the National Lung Screening Trial) showed early detection saves lives! There was a 20% reduction in deaths in heavy smokers from lung cancer due to CT screening in this study. This is why low dose chest CT is so crucial. Finding lung cancer early, when it is potentially treatable is the goal of screening.

 

As accredited members of the American College of Radiology, we are thrilled that the ACR is fighting to support the recommendations of the United States Preventative Services Task Force for high-risk patients. (Read all about it here.) The Task Force recommended coverage beginning January 2015 for high risk patients, including those 55-80 years with significant smoking histories (defined as greater than a 30 pack-year history of smoking) or for those who were former heavy smokers who have quit in the last 15 years. The Task Force recommendations will apply to those patients with insurance.

 

The fight for coverage of Medicare patients is still on-going, and is the focus of the ACR and other groups. The Medicare Evidence Development and Coverage Advising Committee made a controversial stand against support of low-dose CT screening early this year. Medicare will make its final vote in the fall. We think including Medicare patients in coverage for this important, potentially life-saving exam is crucial.

Make your voice heard – add your vote in favor of low-dose screening CT chest for all who will benefit- including Medicare patients! Contact your local congresspersons (here) and let them know you agree.

(Image credit: Symbol kept vote Green by Zorglub via Wikimedia Commons Copyright Creative CommonsAttribution-Share Alike 3.0 Unported)

 

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!

 

April 1, 2014

The Places You’ll Go, the Things You’ll See… Imaging in Other Countries

Guest blogger, Rebecca

Guest blogger, Rebecca

Rebecca is our guest blogger today, one of our many great employees who make DIC what it is, committed to service not only here but in areas of great need…

We are proud of Rebecca for what she brings to our patients here and for her commitment to sharing her knowledge and compassion with those in need around the world.

 

Oh, The Places You’ll Go (by Dr. Seuss)

“You have brains in your head

You have feet in your shoes

You can steer yourself any direction you choose…”

This book was, and probably still is, a very popular graduation gift.  As young adults, the path to the future is wide open and many times uncertain.  I can say that I never imagined going to x-ray school then to ultrasound school in Kansas would lead me to Guatemala and Haiti to share that knowledge.

Luckily with time technology is catching up with the human need for quality healthcare.  The generosity of the American Society of Radiologic Technology and Rad-Aid who sponsored our Haiti trip and the Emporia United Methodist Church who sponsored the Guatemala trip is greatly appreciated.

Diagnostic Imaging Centers is committed to:  Dedication, Innovation, and Compassion.  All three are brought to our local community, but we also can bring those attributes to people in need – even in other countries.

Dedication:  Promoting patient care and safety. In Guatemala and Haiti, the maternal death rate during childbirth is high due to lack of knowledge of placenta location (placenta previa) or fetal position in the womb.  I was able to help instruct a midwife to learn these critical skills with ultrasound imaging. The Guatemalan midwife told our group that we were helping bring her dream of quality heathcare to reality and advance them to a higher level of care.  The dedication of many radiology personnel has helped form organizations for radiology medical missions. (For more information: www.odimguatemala.org)

Innovation:  The progressive innovation of increasingly smaller and truly portable ultrasound machines has helped bring quality healthcare to the poverty stricken and remote areas of the world.  But now the need is for trained professionals to teach the local doctors and potential students to use this equipment to the benefit of their patients.

Since the Haiti earthquake four years ago, most all healthcare supplies have been made available through donations.  Medical schools are open, but education for critical support staff such as technologists is limited.  At my location in Haiti, Hospital Bernard Mevs, there is a radiologic technologist school, but only one book to share among 6 students.  There is not currently an ultrasound technologist school.

The Rad-Aid group I was with hopes to change that reality. During the week in Haiti, we were doing lectures and hands-on training for the 1st class of Haitian radiology residents in 8 years, surgeons, and a few medical students.  A week is not enough time for proficiency, but with self motivated practice, internet capability to learn, donated textbooks (thanks to DIC‘s Dr. Linda Harrison), and hopefully future medical mission groups, we see a bright future for Haiti and other areas in need.

Compassion:  Compassion, consideration for another person, and living a life of service for others helps me enjoy my job and helped motivate me to search out these medical missions.

In Haiti, I did an obstetrical ultrasound on a 38 yr. old woman that had been in a car wreck, had a head injury, and bilateral mandible fractures.  She was 22 weeks pregnant at the time, and had never seen or knew about ultrasound before that day.  Due to machine and bed position, she was unable to watch the monitor.  And, unlike the USA, there was no picture printing or CD availability to provide her with images of her baby.  So, I took screen pictures of the baby on my camera to show her.

Though she had some memory loss and confusion, she was able to recognize her baby’s face.  The love that showed in her eyes and the smile on her face, I will never forget.  In Guatemala, my translator and I were able to attend a home visit with the midwife of a new mom and her infant son.  We brought her a gift for the baby and thanked her for allowing us to visit.  She said she wanted to thank us for wanting to meet them and learn about their culture.

In conclusion, I would like to encourage everyone to get involved with a group that supports your passion and to take that leap of faith to broaden your horizons.  It’s not always going to be easy and what you experience may not be easy to comprehend, but it will help make a better you and a better world.  I never thought my love of ultrasound, travel and service could be brought together, but now I can’t imagine separating them.