Learn More About Your Procedure

Medical Imaging Radiology

Thank you for choosing Community Hospital’s Imaging and Radiology. Please click a procedure below to learn more about what to expect and your exam preparation.

Computed Tomography (CT)
MRI
Ultrasound
Nuclear Medicine
Mammography
X-Ray
Fluoroscopy
PET/CT
Echocardiogram
Interventional Radiology




Computed Tomography (CT)
What is a CT?
Computed Tomography (CT) is a form of imaging that uses special x-ray technology to obtain specific and detailed images of any part of the body. CT allows the radiologist and physician to view the body in cross-sectional and 3D images. CT scanning is a painless process. Different body parts will require different preparation. Most often contrast agents such as Oral contrast or IV contrast mediums maybe used to differentiate between abnormal and normal tissues.

What to expect
Your CT will be performed by a specially trained CT technologist. The technologist will most often have you change into a gown unless you are wearing clothing free of zippers or metallic buttons. The tech will review a questionnaire in regards to any allergies, diabetes, or kidney problems. If oral contrast is needed you will drink it 1 hour before the examination. If IV contrast is used the IV will be started at the time of the examination and any bloodwork needed will also be drawn at this time. You will then be placed comfortably on the CT table. When the examination starts you will lie as still as possible and the table will move through a circular structure called a gantry that looks like a donut. The gantry contains the source of the x-rays and your images will be taken while you move through. Scanning only takes a few minutes. Depending on the anatomy being scanned you may have to follow breathing instructions. Once the imaging is complete you are free to continue normal activities for the day. If any special restrictions or instructions are needed these will be given to you by the appropriate personnel. Your images will be interpreted by one of our board certified radiologist. Results will be available through your physician or on the patient portal within 24 hours.

*If IV contrast is given you will need to drink at least two quarts of water over the next 24 hours after the exam (as long as you do not have a diagnosis of congestive heart failure). The purpose of this is to clear the IV contrast out of your system. An hour after the examination the bandage may be removed from the IV site. If this site should become tender, red or swollen over the next week, please contact your primary care physician.

* Diabetic patients stop taking GLUCOPHAGE(METFORMIN), GLUCAVANCE (Glucotrol & Glyburide), or JANUMET (Junuvia) on the day of and up to 48 hours following your examination.

*Female patients must notify the technologist and their physician if they are or think they may be pregnant for further instruction.

*Any patients allergic to Iodine can complete the recommended 13 hour prep before imaging is done. Contact your ordering physician to get instruction and medication for the prep if needed.

* A current medication list is required for all patients receiving contrast, please bring one to the exam or have your physician fax a list with the order to (970) 644-3259.


How to Prepare
Look below for the examination that you are having with us. Preparation and any special instruction will be listed below the examination name. These instructions will also be given to you at the time the examination is scheduled. Any further questions please call (970) 644-3230.

CT Preps:
Abdomen/Pelvis
Chest
Extremities
Head
Neck Soft Tissue
Pelvis
Spine ( Cervical, Thoracic, Lumbar)
Procedure Instructions
For Providers


Abdomen/Pelvis
Without Contrast - Nothing to eat after midnight or 4 hours prior to examination. Water is okay. Arrive 15 minutes before your scheduled examination time.

With Contrast Exams - Nothing to eat after midnight or 4 hours prior to examination. Water is okay. Please be well hydrated before the CT. If examination is ordered with contrast you will arrive 1 hour and 15 minutes before scheduled examination time to check in and start drinking ORAL contrast.

Without and With - Nothing to eat after midnight or 4 hours prior to examination. Water is okay. Please be well hydrated before the CT. Arrive 1 hour and 15 minutes before scheduled examination time to check in and start drinking ORAL contrast.

Urogram or Hematuria Studies (Without and With) - Nothing to eat after midnight or 4 hours prior to examination. Water is okay. Drink 20 oz of water 15 min prior to the exam. Arrive 15 minutes before your scheduled examination time to check in.

Stone Study (Without Contrast) - Nothing to eat after midnight or 4 hours prior to examination. Water is okay. Arrive 15 minutes before your scheduled examination time.

Angiogram (ABD/Pelvis VIS, Includes Runoffs) - Nothing to eat 4 hours prior to CT. Clear liquids are okay. Please be well hydrated before the CT. Arrive 15 minutes before scheduled examination time to check in.

Chest
Without- No prep required. Arrive 15 minutes before your scheduled examination time.

With - Nothing to eat 4 hours prior to CT. Clear liquids are okay. Please be well hydrated before the CT. Arrive 15 minutes before scheduled examination time to check in.

CT Angio Chest (PE study) - Nothing to eat 4 hours prior to CT. Clear liquids are okay. Please be well hydrated before the CT. Arrive 15 minutes before scheduled examination time to check in.

Cardiac CT (Angiogram of the heart) - Nothing to eat 4 hours prior to CT. Water is okay. Please be well hydrated before the CT. However, no caffeine or sugary beverages the morning of procedure. If angiogram of the heart is the examination ordered ordering physician may prescribe beta blockers if no contraindications; usual dosage metoprolol 50 mg night before and morning of the procedure. Follow any instructions from your ordering physician if this is ordered. Take usual prescription medications the morning of exam.

If physician prescribes medication to take prior to the CT exam, take it as prescribed. If a recent ECG has been done, please bring a copy with you. Please have your physician send operative report if you have had heart surgery.

Calcium Scoring (Screening of the heart) - Arrive 15 minutes before your scheduled examination time. These examinations are typically scheduled for afternoons only. Please limit caffeine intake to 1 early morning cup. No caffeine or sugary beverages up to 4 hours before the examination. You are required to pre-pay for this exam at check in. If you have had any prior cardiac issues, prior cardiac surgeries please let us know when scheduling. If you have a stent, or pacemaker this test is not diagnostic for you. Consult with you primary care physician in this case.

Extremities
No prep required for without studies. Arrive 15 minutes before your scheduled examination time to check in. If ordered with contrast nothing to eat 4 hours prior to CT. Clear liquids are okay. Please be well hydrated before the CT. Please bring previous films/CD if any.

Arthrogram - No preparation. Arrive 1 hour before CT to check in and have arthrogram completed in Fluoro. Let the technologist know of any Iodine or other allergies. The skin will be cleaned and prepped to create a sterile field. A local anesthetic will be administered and needle placed in the joint of interest using fluoro guidance. Contrast medium will be injected into the joint for enhancement. You will continue on to CT for further imaging.

Head
Without - No prep required. Arrive 15 minutes before your scheduled examination time to check in.

With and Without - Nothing to eat 4 hours prior to CT. Clear liquids are okay. Please be well hydrated before the CT. Arrive 15 minutes before scheduled examination time to check in.

IAC/Mastoids/Facial/Sinus
No prep required. Arrive 15 minutes before scheduled examination time to check in.
If ordered with contrast nothing to eat 4 hours prior to CT. Clear liquids are okay. Please be well hydrated before the CT.

Neck Soft Tissue
With - Nothing to eat 4 hours prior to CT. Clear liquids are okay. Please be well hydrated before the CT. Arrive 15 minutes before scheduled examination time to check in.

Pelvis
Without Contrast - No prep required. Arrive 15 minutes before your scheduled examination time.

With Contrast Exams - Nothing to eat after midnight or 4 hrs prior to examination. Water is okay. Please be well hydrated before the CT. If examination is ordered with contrast you will arrive 1 hour and 15 minutes before scheduled examination time to check in and start drinking ORAL contrast.

Spine ( Cervical, Thoracic, Lumbar)
No prep required. Arrive 15 minutes before your scheduled examination time to check in.

Procedure Instructions
Abscess Drainage
Nothing to eat or drink after midnight. Arrive 1 hour before scheduled examination time. The following lab results are needed prior to the imaging procedure: PT, PTT, INR and will be drawn before procedure starts unless done prior to coming to appointment. Avoid taking aspirin containing meds and anti-coagulants (example is Coumadin, Heparin, and Warfarin) for 7 days prior to procedure.

Biopsy Under CT
Nothing eat or drink anything after midnight. Arrive 1 hour before scheduled examination time. The following lab results are needed prior to the imaging procedure: PT, PTT, INR and will be drawn before procedure starts unless done prior to coming to appointment. Avoid taking aspirin containing meds and anti-coagulants (example is Coumadin, Heparin, and Warfarin) for 7 days prior to procedure.

Virtual Colonoscopy
Virtual colonoscopy is a study of the large intestine. It is critical to follow the prep correctly for this exam.

Patients will need to purchase the following for the prep: Magnesium Citrate, Miralax and Gatorade Prep. All the listed products are available over the counter and do not require a prescription. These products can be obtained at most drug stores, pharmacies and some grocery stores. For questions regarding the prep, please call (970) 644-3230.

For Providers
When scheduling imaging studies please provide patient insurance information and a written physician order. Order, laboratory results, patient medication list and specific instructions regarding pathology may be faxed to (970) 644-3259.

Please note the following instructions are for all imaging studies that require IV contrast (contrast):
If patient is over 25 or has renal issues, we must have a current BUN & Creatinine. If the patient has had these lab tests done within the last 30 days, please fax the lab results for BUN & Creatinine when faxing orders for the scheduled imaging study to (970) 644-3259. Otherwise when IV is started for examination BUN & Creatinine will be done with the ISTAT machine prior to injecting the patient.

A current medication list is required for all patients receiving contrast, please have the patient bring one to their exam or fax a list with the order to (970) 644-3259.

If the patient is allergic to iodine, please click here for pre exam prep allergic protocol for iodine.

If the patient is a diabetic, please click here for post-contrast instructions for diabetic patients.

Post IV Contrast Patient Instructions:
Instruct the patient to drink at least two quarts of water over the next 24 hours after the exam (as long as they do not have a diagnosis of congestive heart failure following an angiogram). The purpose of this is to clear the IV contrast out of the patient's system.

An hour after the exam the patient may take the bandage from their IV site off. If this site should become tender, red or swollen over the next week, please have them contact their primary care physician.

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MRI (Magnetic Resonance Imaging)
What is an MRI?
MRI (Magnetic Resonance Imaging) is technology that uses a combination of magnetism and radio waves. It creates detailed images of the bone and soft tissue structures throughout the body. It’s different than CT or xray in that there is no exposure to radiation. Imaging of orthopedic disorders, brain, and spine are a few of its many uses. An MRA is an MRI Angiogram which images blood vessels.

What to expect
Your MRI will be performed by a specially trained MRI technologist. The technologist will have you change into a gown. Any foreign objects such as jewelry or hairpins will need to be removed prior to entering the MRI suite. If you are claustrophobic please alert the technologist. You will be comfortably placed on the MRI table. You will be supplied with headphones or ear plugs for your comfort and will be able to communicate with the MRI technologist via intercom. The MRI is painless. The MRI will slide into the MRI system when the imaging is being performed. The scan time will be anywhere between 20-60 minutes, depending on the anatomy that is being imaged, and during the scan you will hear banging sounds and other noises. Some MRIs require IV contrast (Gadolinium). If IV contrast is used the IV will be started and any bloodwork needed will also be drawn at this time. You may resume normal activity after your examination. If any special restrictions or instructions are needed after the completion of the exam these will be given to you by the appropriate personnel. Your images will be interpreted by one of our board certified radiologists. Results will be available through your physician or on the patient portal within 24 hours.

*Please inform the scheduler of any implants you have and any prior imaging done at another facility for comparison.

*Female patients must notify the scheduler, technologist and their physician if they are or think they may be pregnant for further instruction.

*If IV contrast is given you will need to drink plenty of water over the next 24 hours after the exam (as long as you do not have a diagnosis of congestive heart failure). The purpose of this is to clear the IV contrast out of your system. Twenty minutes after the examination the bandage may be removed from the IV site. If this site should become tender, red or swollen over the next week, please contact your primary care physician.

How to prepare/ PREPS
Look below for the examination that you are having with us. Preparation and any special instruction will be listed below the examination name. These instructions will also be given to you at the time the examination is scheduled. Any further questions please call (970)644-3230.

MRI Prep Instructions

Abdomen/MRCP
Nothing to eat or drink four hours prior to examination (OK to take prescribed medication with a small amount of water). Arrive 15 minutes before your scheduled examination time to check in and fill out MRI questionnaire.

Enterography - Nothing to eat or drink four hours prior to examination (OK to take prescribed medication with a small amount of water). Arrive 1 hour and 30 minutes before your scheduled examination time to check in, fill out MRI questionnaire, and start drinking oral contrast.

Pelvis
No prep required in most cases. Arrive 15 minutes before your scheduled examination time to check in and fill out MRI questionnaire.

Arthrogram - No preparation. Arrive 15 minutes before your scheduled radiology time to check in, fill out MRI questionnaire, and have injection in x-ray. Let the technologist know of any Iodine or other allergies. The skin will be cleaned and prepped to create a sterile field. A local anesthetic will be administered and needle placed in the joint of interest using fluoro guidance. Contrast medium will be injected into the joint for enhancement. You will continue on to MRI for further imaging.

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Ultrasound
What Is An Ultrasound?
Ultrasound also known as sonography is an examination technique using high frequency sound waves to make still and live video pictures. Ultrasound is used to assess the condition of soft-tissue structures within the body. Exam sites can include the heart and breast, as will as digestive, reproductive and urinary tracts.

What to Expect
Exam Preparation - Most ultrasound exams do not require special preparation, unless otherwise instructed. If the exam is of your abdomen and/or pelvic region, you may be asked to fast, and/or arrive for your appointment with a full bladder. If you are having a gallbladder exam, you must be fasting for at least 4 to 6 hours, because recent food ingestion will interfere with scanning because food will cause the gallbladder to contract and will not be able to be evaluated.

During the Exam - Our Certified Sonographer may ask you to change into a gown and lie on the examination table next to the ultrasound equipment. The technologist and/or radiologist will apply a clear water-soluble gel to the part of the body to be examined. The technologist will guide the transducer - a hand held instrument - slowly across your skin. The images will appear on the ultasound monitor.

After the Exam - Upon completion, the technologist may ask you to remain in the department while reviewing the ultasound images. The radiologist may order additional images or a brief exam. A Board Certified Radiologist will interpret your results and provide a formal report to your healthcare provider.
Please contact our facility or check with your healthcare provider for additional information.

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Nuclear Medicine
What Is Nuclear Medicine?
Nuclear Medicine is an excellent diagnostic tool that shows not only the anatomy of an organ or body part, but the function of the organ as well.
This exam is used mainly to allow evaluation of organs and regions within organs that cannot be seen or tested on conventional X-Ray images. A trace amount of radioactive material is introduced into the patient and in then detected by a machine called a gamma camera.
Nuclear Medicine is an integral part of patient care is extremely valuable in the early diagnosis of numerous medical conditions.
Overview
Nuclear Medicine Studies - With the aid of a gamma camera and computer, images are captured based on the detection of energy emitted from a radioactive substance previously given to the patient orally or intravenously.
What to Expect
Once the radioactive substance is given orally or intravenously, the imaging portion of the study may be performed immediately, a few hours later or even several days after the isotope is administered.
During the Exam - Most Nuclear Medicine procedures require you to lie on a scanning table and remain as still as possible while the images are being obtained.
The technologist will raise, lower and move the exam table in and out of the scanner opening in order to take pictures of the body.
The camera detects gamma rays emitted from the patient and sends the digitized images to a computer for reconstruction.
After the Exam - A Board Certified Radiologist will interpret your Nuclear Medicine scan and provide a formal report for your permanent record.
Patients usually resume normal diet and activities immediately after the exam.
The results for your exam will be sent to your referring healthcare provider. At that time, your healthcare provider may recommend further testing, or suggest a treatment plan for your condition. Most of the low-level radiopharmaceutical passes out of the body through natural urine or stool processes. Please contact our facility or check with your healthcare provider for additional information.

Ultrasound Exam Instructions
Each Nuclear Medicine procedure has very specific preparations.
Bone Scan
3-Phase Bone Scan
Gastric Emptying Study
GI Bleed Scan
Liver Hemangioma Scan
Lung Scan/VQ Scan
Meckel’s Scan
Muga
Myocardial Perfusion/Cardiolite Stress Test—Exercise
Myocardial Perfusion/Cardiolite Stress Test—Pharmacologic
Parathyroid Scan
Renal Function/MAG3
Sentinel Lymph Node Localization/Lymphoscintigraphy
Thyroid Uptake and Scan
Thyroid Scan with Technetium

Bone Scan
You may eat and drink normally, but should be well-hydrated prior to your appointment. When you arrive, you will be given an injection of a radioactive tracer that will go to the bones of your body. You will be asked to return in four hours for the scan itself. Usually the scan takes 15-20 minutes, but can take somewhat longer.

3-phase Bone Scan
You may eat and drink normally, but should be well-hydrated prior to your appointment. When you arrive, you will be given an injection of a radioactive tracer that will go to the bones of your body. Immediately after the injection a short series of images will be taken. You will then be asked to return in four hours for the rest of the scan. Usually this scan takes 15-20 minutes, but can take somewhat longer.

Gastric Emptying Study
Do not eat or drink anything after midnight, other than water. Withhold gastric medications on the day of the test. If you are diabetic, please bring your glucose monitor so the blood glucose level before the test can be recorded. You will consume a meal consisting of Eggbeaters (equivalent to two eggs) with a small amount of a tracer material added. The meal will also include two slices of toast with jelly, as well as half a cup of water. The first image will be taken immediately after you consume the meal, with additional images done once an hour for a maximum of four hours. Each image takes one minute.

GI Bleed Scan
There is no patient prep needed for this exam. An IV will be placed and a small amount of blood will be withdrawn. You will then wait in the waiting area for approximately a half hour while the technologist tags the red blood cells with a tracer material. The blood will then be re-injected through the IV and you will lie on your back on the scan table. The scan itself can take up to approximately an hour. On rare occasions, it may be necessary to do follow-up delayed images

Liver Hemangioma Scan
There is no patient prep needed for this exam. An IV will be placed and a small amount of blood will be withdrawn. You will then wait in the waiting area for approximately a half hour while the technologist tags the red blood cells with a tracer material. The blood will then be re-injected through the IV and you will then return to the waiting area for approximately an hour. At that time, you will be placed on the scanner and images will be taken of your abdomen. These will take approximately 45-60 minutes.

Lung Scan/VQ Scan
There is no patient prep needed for this exam. There are two separate parts to this test. Typically, the first part will be the perfusion study. In this part of the study, a small amount of a radioactive tracer will be injected into a vein of your arm. You will then lie on your back on the scan table and the scanner will move around you taking a series of images of your lungs. The second part of the test will require you to breathe in a nebulized tracer that will outline the airways of your lungs. Then you will have a second scan where the camera will move around you much like it did for the first scan. The total process will take approximately an hour.

Meckel’s Scan
Do not eat or drink anything four hours prior to your appointment. No barium studies can be performed for four days prior to this scan. Adult patients are to take 300mg of Tagamet (Cimetidine) 4 times per day for the two days prior to the scan. Children are to take 20 mg per kilogram Tagamet (Cimetidine) two days prior to the scan. Tagamet can be purchased at any pharmacy. You will receive an injection of a radioactive tracer followed by a scan of up to an hour in length.

Muga
There is no patient prep for this exam. An IV will be placed and a small amount of blood will be withdrawn. You will then wait in the waiting area for approximately a half hour while the technologist tags the red blood cells with a tracer material. The blood will then be re-injected through the IV and you will lie on your back on the scan table. The scan itself can take up to approximately an hour.

Myocardial Perfusion/Cardiolite Stress Test—Exercise
Do not eat or drink anything four hours prior to your appointment time, with the exception that you may drink water only. Do not eat or drink anything with caffeine for 24 hours prior to your appointment. Do not take any nitroglycerine for at least one hour prior to your appointment. Also, do not take any beta blockers or calcium channel blockers the morning of the test. Please bring a list of your medications and a pair of comfortable walking shoes. An IV will be placed in a vein of your arm and a radioactive tracer will be injected. Then you will wait for approximately a half hour or a little more before being positioned on the scan table. This first scan will take about 20 minutes. After that, you will be taken to the stress area where you will walk on a treadmill with the goal of reaching a target heart rate that is based on your age. A second injection of imaging tracer will be injected at that time, after which you will be taken for a second set of images.

Myocardial Perfusion/Cardiolite Stress Test---Pharmacologic
Do not eat or drink anything four hours prior to your appointment time, but you may drink water only. Do not eat or drink anything with caffeine for 24 hours prior to your appointment. Do not take any nitroglycerine for at least one hour prior to your appointment. Also, do not take any beta blockers or calcium channel blockers the morning of the test. Please bring a list of your medications and a pair of comfortable walking shoes. An IV will be placed in a vein of your arm and a radioactive tracer will be injected. Then you will wait for approximately a half hour or a little more before being positioned on the scan table. This first scan will take about 20 minutes. After that, you will be taken to the stress area where you will be given a medicine that will dilate the vessels that feed your cardiac tissue. There will then be a second injection of the tracer material, followed by a second set of imaging.

Parathyroid Scan
There is no patient prep for this scan. You will receive an injection of a radioactive tracer material followed by a short wait of about 15 minutes. The first scan will then be done, taking about twenty minutes. You will then come back for another series of images approximately two hours after the injection. This series will take about 45 minutes.

Renal Function/MAG3
Be well-hydrated prior to this appointment. An IV will be placed in a vein of your arm and then you will be positioned on the scan table. At this time, you will be injected with a radioactive tracer and scanned for approximately a half hour. About ten minutes into this scan a dose of Lasix will be administered through the IV.

Sentinel Lymph Node Localization/Lymphoscintigraphy
No patient prep is necessary for this procedure. You will receive a series of three or four injections just beneath the surface of the skin in the area of concern. For breast sentinel node localization, a brief image will be taken after the injections. For melanoma sentinel node localization, imaging will be done to localize the lymph nodes that drain the area of the melanoma. This can take varying times up to an hour or on rare occasions longer.

Thyroid Uptake and Scan
You will need to be off thyroid medications for three weeks prior to this scan and have had no CT scans with contrast for six weeks prior. You will be given a capsule with a small amount of radioactive I-123. You will be asked to return in 3 ½ hours at which time imaging will be done of your thyroid as well as an uptake measurement to determine how much of the iodine in the capsule has been taken up by your thyroid. This portion of the test will take about 45 minutes to an hour. You will then return the next day (24 hours after you take the capsule) for an uptake measurement. This normally takes less than 15 minutes.

Thyroid Scan with Technetium
There is no patient prep for this exam. Upon arrival you will be given an injection of a radioactive tracer material which will go to your thyroid. After waiting 10-15 minutes, a series of images will be taken. These images will take about a half hour.

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X-Ray
What is an X-Ray?
X-rays are used to identify abnormalities of the bone and surrounding soft tissues. Diagnostic x-ray is performed by a special trained radiologic technologist. The technologist will position you on the x-ray table as needed and will take images using an x-ray tube and digital receptor plate that is placed under the anatomy of interest.

What to Expect?
The technologist will have you change into a gown if necessary to remove any foreign objects from the imaging field. You will need to lie very still while the x-ray is being taken. Your images will be interpreted by one of our board certified radiologists. Results will be available through your physician or on the patient portal within 24 hours.

How to Prepare
No preparation needed.

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Fluoroscopy
What is Fluoroscopy?
Fluoroscopy is a type of continuous, or live x-ray imaging that is performed on many parts of the body such as the digestive, urinary, reproductive, and muskoskeletal systems. This allows the anatomy of interest to be observed on a TV monitor while in motion. Most often some type of contrast agent is used to aid the radiologist in visualization of details of the structures during this motion.

What to expect
Most often you will be asked to change into a gown provided to you by the technologist. For some procedures you will be asked to sign an informed consent which gives the Radiologist permission to perform the procedure. The informed consent will explain the risk, benefits, and reason for the procedure. Patients under the age of 18 will be required to have a parent or guardian sign. During the procedure you will need to lie still during the imaging part of the examination. If there are any special restrictions or instructions following your exam these will be given to you by the appropriate personnel. Your images will be interpreted by one of our board certified radiologist. Results will be available through your physician or on the patient portal within 24 hours.

How to prepare/Preps
Look below for the examination that you are having with us. Preparation and any special instruction will be listed below the examination name. These instructions will also be given to you at the time the examination is scheduled. Any further questions please call (970)644-3230.
Fluoroscopy Prep Instructions
Arthrogram
BE (Barium Enema)
Cystogram
Esophagram
Fistulagram
Hysterosalpingiogram
IVP (Intravenous pyelogram)
Joint Injection
Lumbar Puncture
Myelogram
SBFT (Small Bowel Follow Through)
T-Tube Cholangiogram
UGI (Upper Gastrointestinal Series)
Vertebroplasty


Aathrogram- No preparation. Arrive 15 minutes prior to examination to check in. Let the technologist know of any Iodine or other allergies. The skin will be cleaned and prepped to create a sterile field. A local anesthetic will be administered and needle placed in the joint of interest using fluoro guidance. Contrast medium will be injected into the joint for enhancement. You will continue on to MRI or CT for further imaging.

BE (Barium Enema) - Prep instruction will be given at the time exam is scheduled to clean out the colon. Arrive 15 minutes early to check in for examination. First scout images will be taken then an enema tube will be placed into the rectum and a barium will flow into the large intestine. When the colon has enough barium the technologist will take a series of x-rays. Once the exam is complete the barium will be emptied out of the colon back into the bag and the enema tube will be removed. Typically if barium is used it may stay in your system for as long as five days. Staying well hydrated helps to speed up the process of elimination.

Cystogram - No preparation. Arrive 15 minutes prior to examination to check in. A urinary catheter will be placed in the bladder. The bladder will be filled with a contrast agent and imaging will be done while it is in place. Post-void plan film may also be taken.

Esophagram- NPO after midnight. No water, coffee, gum, smoking, or medications can be taken prior to the examination. First, scout images will be taken. Then you will drink barium and fluoro images are taken to show the progression of the contrast in the esophagus. Stay well hydrated following the examination to avoid potential constipation.

Fistulagram- No preparation. Arrive 15 minutes prior to examination to check in. Let the technologist know of any Iodine or other allergies. The skin will be cleaned and prepped to create a sterile field. A catheter will be placed into the fistula and filled with contrast medium to obtain images of the extent of the sinus tract. Once the procedure is complete the catheter will be removed.

Hysterosalpingiogram - No preparation. Arrive 15 minutes prior to examination to check in. You will be asked to lie down on the imaging table. The radiologist will use a speculum and catheter to inject a contrast agent into the uterus and fallopian tubes to check for obstructed fallopian tubes or patency of tube blocking devices such as Essure.

IVP (Intravenous pyelogram)- Nothing to eat after midnight. Hydrate well before examination. Arrive 15 minutes prior to examination to check in. Let technologist know of any iodine or other allergies. Also, let the technologist know if you are taking medication for diabetes. An IV contrast will be injected into a vein and images are taken of the contrast filtering through the kidneys, ureters, and bladder to image the function of each of these. Once the exam is complete the IV will be removed and discharge instructions will be given.

Joint Injection- No preparation. Arrive 15 minutes prior to examination to check in. Let the technologist know of any Iodine or other allergies. The skin will be cleaned and prepped to create a sterile field. A local anesthetic will be administered and needle placed in the joint of interest. Medication will be injected into the joint using fluoro guidance.

Lumbar Puncture - Nothing to eat or drink after midnight. Arrive 1 hour before scheduled examination time. The following lab results are needed prior to the imaging procedure: PT, PTT, INR and will be drawn before procedure starts unless done prior to coming to appointment. Avoid taking aspirin containing meds and anti-coagulants (Coumadin, Heparin, and Warfarin) for 7 days prior to procedure. Let technologist know of any allergies to Iodine or other medications. You will lie on your stomach and after the skin is cleaned and prepped to create a sterile field a local anesthetic will be administered. The radiologist will insert a spinal needle and draw fluid out using fluoro guidance. The fluid will be sent to the lab for testing. Plan on staying up to 1 hour following the examination with some possibility of a headache. Have someone available to drive you home.

Myelogram - Nothing to eat or drink after midnight. Arrive 1 hour before scheduled examination time. Avoid taking aspirin containing meds and anti-coagulants (Coumadin, Heparin, and Warfarin) for 7 days prior to procedure. Let technologist know of any allergies to Iodine or other medications. You will lie on your stomach, and after the skin is cleaned and prepped to create a sterile field a local anesthetic will be administered. The radiologist will insert a spinal needle and inject a contrast medium using fluoro guidance. You will then go to CT for a quick scan. Plan on staying up to 1 hour following the examination with some possibility of a headache. Have someone available to drive you home.

SBFT (Small Bowel Follow Through) - Nothing to eat or drink after midnight. No water, coffee, gum, smoking, or medications can be taken prior to the examination. First, scout images will be taken. Then you will drink barium and fluoro images are taken to show the progression of the contrast in the stomach followed by X-ray abdominal images to show the progression of the contrast through the small intestines. These examinations can take anywhere from 2-4 hours depending upon how quickly the barium moves through the small intestine. Stay well hydrated following the examination to avoid potential constipation.

T-Tube Cholangiogram- No preparation. Arrive 15 minutes prior to examination to check in. Let the technologist know of any Iodine or other allergies. The previously surgically placed tube will be injected with contrast medium under fluoro guidance to check for abnormalities.

UGI (Upper Gastrointestinal Series)- Nothing to eat or drink after midnight. No water, coffee, gum, smoking, or medications can be taken prior to the examination. First scout images will be taken. Then you will drink barium and fluoro images are taken to show the progression of the contrast in the esophagus. Stay well hydrated following the examination to avoid potential constipation.

UGI (Upper Gastrointestinal Series) With SBFT (Small Bowel Follow Thru) - Nothing to eat or drink after midnight. No water, coffee, gum, smoking, or medications can be taken prior to the examination. First scout images will be taken. Then you will drink barium and fluoro images are taken to show the progression of the contrast in the stomach followed by X-ray abdominal images to show the progression of the contrast thru the small intestines. These examinations can take anywhere from 2-4 hours depending upon how quickly the barium moves through the small intestine. Stay well hydrated following the examination to avoid potential constipation.

Vertebroplasty- Nothing to eat or drink after midnight. Arrive 1 hour before scheduled examination time. The following lab results are needed prior to the imaging procedure: PT, PTT, INR and will be drawn before procedure starts unless done prior to coming to appointment. Avoid taking aspirin containing meds and anti-coagulants (Coumadin, Heparin, and Warfarin) for 7 days prior to procedure. Let technologist know of any allergies to Iodine or other medications. A consent form will be obtained with the procedure being explained, and the radiologist will perform the procedure. Plan on being at the hospital for 2-4 hours.

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PET/CT

What Is A PET/CT Scan?
Positron Emission Tomography or PET is often referred to as ‘functional imaging’ and is an imaging technique that is different than conventional radiology exams, such as X-Ray, CT, Ultrasound or MRI. PET images contain information about tissue function and can provide important information that can affect the diagnosis and management of many diseases. PET is a powerful diagnostic tool in the fields of Oncology, Neurology and Cardiology. Combining PET and CT scanners into a single gantry, that sequentially and in the same session form a single superimposed image. PET/CT scans give the ability to visualize human function with structure.

What to Expect
< i>Exam Preparation

  • You must not eat or drink anything other that water for six hours prior to the exam.
  • Do not exercise for 24 hours prior to the exam.
  • Drink 16 oz. of water one hour prior to the exam.
  • Wear comfortable, warm clothing, without zippers or any metal parts, (e.g. sweatshirt and sweatpants).
  • Wear your hearing aid, glasses or dentures as normal.
  • Take any prescribed medications on the day of your test unless your are instructed not to do so.
  • Avoid all beverages with caffeine and sugar.


During the Exam
After the injection you will wait approximately 60 to 90 minutes while the glucose is distributed throughout your body. This compound will collect in the various organs and tissues. When the scan begins, you will be asked to lie still on the table while the images are acquired. The technologist will check on you during your exam. The PET scanner records signals which are emitted by the glucose tracer and the computer turns the signals into actual images and are superimposed with the anatomic images acquired by the CT scan.
The actual time you may be in the sanner can range from 20 minutes to 40 minutes.

After the Exam
A Board Certified Radiologist with specialized training will interpret your study and provide a formal report for your permanent record.
The results for your exam will be sent to your referring healthcare provider. At that time, your healthcare provider may recommend further testing, or suggest a treatment plan for your condition.

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Echocardiogram (Echo)
What is an Echocardiogram (Echo)
An echocardiogram is an exam that uses ultrasound waves to produce moving images of your heart. This exam allows the physician to determine the size of your heart, how well your heart is working overall and if you have any problems with your heart valves. There are three types of echocardiograms: Transthoracic Echo, Transesophageal Echo, and Stress Echo.

What to expect in a transthoracic echocardiogram:
This is the most common type of echocardiogram and may simply be referred to as an “Echo”. It is performed by a specially trained cardiac sonographer. Once in the exam room, the sonographer will explain the exam and then instruct you to change out of your shirt and into a gown. Three patches will then be attached to your skin for the heart rhythm tracing and you will be instructed to lay on your left side with your left arm by your head. This position allows the sonographer to obtain better images of your heart. The sonographer will place gel on a small transducer (probe) and then move it over the chest, the upper abdomen and the base of the neck. The exam usually takes approximately 45 minutes to an hour to complete. Once completed, the sonographer will take off the patches and provide you with a towel to wipe off any excess gel. The echocardiogram will later be interpreted by a cardiologist and the physician ordering the exam should receive a copy of the report in 24 to 48 hours.

How to prepare for an echo (or transthoracic echo):
There is no specific preparation for this exam. Simply wear comfortable clothing that will be easy to change out of from the waist up.

What to expect in a Transesophageal Echocardiogram (TEE):
A transesophageal echocardiogram is performed by a cardiologist with a cardiac sonographer assisting with the ultrasound machine. TEE is used when more detailed pictures of the heart are needed for diagnosis and treatment. Your doctor will explain the procedure and you will be asked to sign a consent form that says you understand the risks of the test and agree to have it done. A nurse will be present to monitor you and give medication to relax you for the test. It involves a flexible tube (probe) with a transducer at its tip. Your doctor will guide the probe down your throat and into your esophagus (the passage leading from your mouth to your stomach). The TEE itself will take approximately 20-30 minutes. You will be instructed to arrive one hour prior to the procedure for preparation and plan on one hour of recovery after the procedure. Be sure to make arrangements in advance for someone to pick you up after the test. You will not be able to drive for at least 12 hours after the procedure. The health care provider who ordered the exam should receive a copy of the report in 24 to 48 hours.

How to prepare for a TEE:
Wear comfortable clothing. Do not eat or drink after midnight prior to the exam. Bring a copy of your list of medications. Assure that you have someone to drive you home after the procedure and plan on resting the remainder of the day. If you have medical problems involving the throat, esophagus, or stomach, tell your doctor before getting this test.

What to expect in a Stress Echocardiogram:
A stress echo is a test performed to see whether your heart muscle is getting enough blood flow and oxygen when it is working hard (under stress). Ultrasound images of your heart are obtained by a cardiac sonographer with a cardiologist overseeing the stress portion of the exam. There are two types of stress echo. In both cases, several patches are placed on your chest and wires connected to a small box usually attached to a belt around your waste. You are then instructed to lay on your left side with your left arm up by your head so the sonographer can obtain resting images of your heart. Once these images are obtained, the cardiologist checks the images and the “stress” portion of the test begins (either on the treadmill or with medication). Your blood pressure will be taken periodically and the cardiologist will monitor your heart rhythm. Most people physically walk on a treadmill to increase the heart rate and cause the heart to work harder. Slowly (about every 3 minutes), you will be asked to walk faster and on an increasing incline. It is like being asked to walk fast or jog up a hill. Once the test is stopped you will be asked to quickly lay back down on your left side with your left arm up again for imaging. If you are unable to walk on a treadmill, the second option involves starting an IV and injecting medication to increase your heart rate and cause your heart to work harder while you continue to lay on your left side. In this case, images are taken while your heart rate increases. For both stress tests, the cardiologist will stop the test:
  • When your heart is beating at the target rate
  • When you are too tired to continue
  • If you are having chest pain or a change in your blood pressure that worries the provider administering the test

When the test is over, the cardiologist then compares the resting images with the exercise images to see if there are any areas of the heart muscle that are not working as they should. The health care provider who ordered the exam should receive a copy of the report in 24 to 48 hours.

How to prepare for a stress echo:
Wear loose, comfortable clothing and shoes for walking. Eat a light breakfast and ask your health care provider if you should take your routine medications the morning of the exam. Never stop taking any of your medicine without first talking to your doctor. Bring a copy of your list of medications.

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Interventional Radiology (IR)
Interventional Radiology (IR)
Interventional radiology (IR) is a subspecialty in radiology that is minimally invasive and uses image-guided procedures to diagnose and treat. These less invasive techniques minimize recovery time, are less painful. IR is used on many body systems and is continuously evolving.
About Your Interventional Radiology Procedure
Generally, you will not be put completely to sleep. Almost all procedures require that you be given local anesthesia at the site of entry into the skin. For some procedures, the radiology nurse may give you medicine to help you relax. You may be drowsy, but you will remain conscious and able to speak and follow directions throughout your procedure. Your blood pressure, blood oxygen level, heart rhythm and breathing rate will be continually monitored throughout the procedure. Our goal is for you to remain comfortable and relaxed.
Most often interventional radiology procedures do not require an incision. A small nick in the skin about the size of a pencil tip is made where the catheter enters the body.
Any medical procedure has risks. The radiologist will discuss the risks of the procedure with you before your procedure is performed. If you have any questions, at any time, discuss them with your doctor or a staff member.
Prior to Your Procedure
  • Inform your doctor if you have had an allergic reaction to contrast dye or iodine.
  • Complete any necessary tests required for your procedure as prescribed by your doctor. This includes all blood work.

  • DO NOT STOP A MEDICATION ON YOUR OWN. Ask your doctor whether it is safe for you to stop taking blood thinning medication, such as coumadin, warfarin, Plavix or aspirin, for a certain time period prior to your procedure. Your doctor needs to advise you if it is necessary and when to stop taking your medications. If this is unclear, please call your doctor.
    Preparing for your Exam
    On the Day of Your Interventional Radiology Procedure:
    Bring a list of all prescription and over-the-counter medicines you are currently taking. Bring your insurance card. Bring your films or X-rays.
    DO NOT EAT OR DRINK anything after midnight on the night before your procedure. Unless given special instructions otherwise.
    YOU MUST have a responsible adult available to drive/escort you home from the hospital. Note: If you are unaccompanied, your procedure will have to be rescheduled.
    Procedure time can vary from 30 minutes up to four hours in length. But be prepared to spend four to eight hours at the hospital, depending on your procedure.
    A nurse remains with you throughout your entire procedure. If you have any questions, please feel free to ask your nurse. If you have questions prior to your procedure, please ask your doctor.
    Recovering from Your Interventional Radiology Procedure
    You will receive specific instructions for recovery based on your exact procedure. Following your procedure, you may receive a phone call from the Interventional Radiology Department to answer any additional questions you have. If you should have any questions regarding recovery once you are home, please call 970-644-3230. Call 911 in case of an emergency.


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