Posts tagged ‘study’

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 and general radiology 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 and general radiology Visit our sites for more helpful information!


April 10, 2014

Bone Density: High Impact

Double Dutch Street Performance by Matsuri @ Vancouver City Centre Station by GoToVan via Flickr Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0)And you thought jumping rope was just for fun… Well, it is! But it also might be good for the health of your bones. We’re not saying you have to hit 332 jumps per minute, but even at a leisurely pace, a little jumping can be good for your bones.


As it turns out, when bones receive a moderate impact (we’re talking a moderate impact from movement like running or jumping) bones make themselves stronger.


In a recent study (playfully titled Physical activity and bone: may the force be with you) it was discovered that young persons, whose bones are still developing, can increase bone density with physical exercise which included moderate impact activities. The hope is that building bone density in young people will help provide protection from future bone loss issues such as osteoporosis, although further research into long-term effects is needed. And these clever scientists weren’t the only ones to find such promising results from moderate impact exercise. In another study of premenopausal women, when bones were subjected to a moderate force from jumping, hip bone density increased.


As we age, the risk of bone loss and all its negative side effects increases. One of the best preventives for future problems with osteoporosis is to start with strong bones. These studies show we can improve bone strength over a relatively short period of time with purposeful, moderate impact activity.


Want to read more? Check out this article from the New York Times, here. Hop to it!

(Photo credit: Double Dutch Street Performance by 祭 – Matsuri @ Vancouver City Centre Station by GoToVan via Flickr Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0))

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

March 4, 2014

Effective, Cost Effective, Life-saving CTs

Lung cancer is the leading cause of cancer deaths in the United States. The number of people dying from lung cancer in the US per year is greater that the number of deaths from breast, prostate and colon cancer combined. Despite the scope of the problem of lung cancer, early detection has been the subject of debate. Recent studies have shown that low-dose CT screening for lung cancer in high-risk smokers can reduce cancer deaths. The detection of small lung cancers before spreading outside the lungs has been shown to save lives.

According to a newly published study, there’s more good news about CT lung screening for smokers age 55-75. This study shows the success of CT screening out in the communities – not just in academic centers. Naturally, the best way to save lives from lung cancer is to never use tobacco or to stop using it. But as long as patients are fighting the uphill battle for lung health, it is keenly important to fight it on all fronts, from prevention to early detection.

For successful lung cancer screening, CT scans must be “low dose”, referred to as LDCT. We are always conscious of and try to limit radiation dose wherever possible in our practice. The principle of imaging is using the lowest dose possible to achieve the images we need. Studies have shown we can safely use LDCT for early detection of lung cancer. This study in particular shows that low dose CT programs can hit the trifecta of helpfulness: they are effective in finding lung cancer, can be performed cost-effectively and can save lives. There you have it.

The January recommendation from the US Preventative Services Task Force said that high-risk patients could benefit greatly from regular low-dose CT screenings. This is timely news as the US Centers for Medicare and Medicaid Services are currently determining coverage feasibility. This recent study shows that execution and efficacy are possible!

Hopefully, we will be seeing programs develop and expand as a result of these findings. For those at high risk, lung cancer screening with low dose CT and early detection can be life changing and life saving.

February 18, 2014

Smoking kills – Seriously, In More Ways Than One!

Smoking Kills by Vanderloot ∴ via Flickr Copyright Creative Commons Attribution-ShareAlike 2.0 Generic (CC BY-SA 2.0)

Smoking Kills by Vanderloot ∴ via Flickr Copyright Creative Commons Attribution-ShareAlike 2.0 Generic (CC BY-SA 2.0)

We typically don’t go for sensationalized article titles (there’s plenty of that out there without having to drum up extra) but the recent word from the Surgeon General’s office is serious.

USA Today quoted Thomas Frieden, director of the CDC as saying, “Amazingly, smoking is even worse than we knew – even after 50 years we’re still finding new ways that smoking maims and kills people.”

In this year, the fiftieth anniversary of the Surgeon General’s office calling tobacco what it is – a killer, the report (which can be found here) enumerates the sins of the smoke. Most people know that tobacco contains known carcinogens, and is related to lung and other head and neck cancers. The damage of smoking to the lungs is widely known and acknowledged. The acceleration of vascular disease and the association between smoking and cardiovascular disease is well-studied and widely known.

The more widespread effects of tobacco are less well known, and new associations are increasingly being recognized. The surgeon general in this report concluded that smoking is causally-linked – many smoking can directly cause -diabetes, liver and colorectal cancers. These are fairly recent additions to the list of diseases and damage from smoking.

The body – from the top of your head to the bottom of your toes and all parts between – is harmed by tobacco and smoking. Did you know smoking is related to macular degeneration (a leading cause of blindness), erectile dysfunction, rheumatoid arthritis, growth problems in fetuses whose mothers smoke as well as cleft lips and palates? Amazing that after 50 years scientists are still uncovering more ways tobacco damages the body.

This is not intended as a public shaming campaign for smokers, but a call to health for all. We need to work together to educate and keep others from starting on the path to addiction and help those who are addicted. We know it’s not easy. Some resources for quitting can be found here.

December 31, 2013

Nuclear Medicine: Tell me about three phase bone imaging… with Dr. Sid Crawley

December 26, 2013

Nuclear Medicine: Tell me about a gastric emptying study… with Dr. Sid Crawley

August 15, 2013

Arthrography: what body parts are studied? – Dr. Angela Noto