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Other
X-ray Examinations Using Contrast Media
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here
are several other X-ray based examinations, which are not frequently
performed with the advent of newer methods. However, these examinations
are still an essential part of radiology, especially if newer methods are
not available. Like all other X-ray examinations that use contrast medium,
any history of allergy or asthma in the patient should be made known to
the radiologist or radiographer. Even though these examinations involve
exposure to ionising radiation, the risk is minimal when considering the
benefit to the patient in terms of diagnosis and further management. These
examinations will only be described briefly.
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Myelography
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T his is a
special X-ray examination, which shows the spinal cord, and nerve
roots by injection of contrast medium into the spinal canal via
a needle into the patient’s lower back. The contrast medium will outline
the spinal cord and nerve roots. This examination is most commonly used to
evaluate the cause of low back pain, sciatica or other neurological
problems. This examination is now superseded by MRI. However, for those
patients who cannot undergo an MRI examination, then myelography followed
by a CT may be the examination of choice.
The patient is required to inform the radiologist if he or
she is on any anti-epileptic medication. The examination is done by
cleaning an area in the lower back following which a local anaesthetic
will be injected, to numb the area. A very fine needle will then be used
to inject the contrast medium into the spinal canal after which the needle
is removed. Following this, X-rays will be taken. The table on which the
patient is lying on may need to be tilted downwards or upwards while the
radiologist takes images. In most cases, myelography will be followed by a
CT examination.
Following the examination, the patient will be required to
rest in bed with the head raised. Plenty of fluid is encouraged and the
patient may eat normally, 4 to 6 hours of bed rest is usually advised.
A common side effect of the examination is headache with some
giddiness, which usually responds to paracetamol or aspirin.
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Cholangiography
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This
x-ray examination consists of several different examinations to demonstrate
the bile ducts in the liver and sometimes the gallbladder. This examination
is to find out the cause of jaundice in a patient. There are a few
different methods for carrying out this procedure. Preparations for all the
different types of examinations differ and the radiologist and attending
doctor will decide which examination would be the best for the patient. This
examination may be done by direct puncture of the liver and injection of
contrast medium into the bile ducts (called percutaneous transhepatic
cholangiography), injecting contrast medium through a tube placed at
the time of surgery (called T-tube cholangiography) or following
passage of an endoscope down into the oesophagus and stomach (endoscope)
and injecting contrast medium into the bile ducts (called endoscopic
retrograde cholangiopancreatography).
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Sinography
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This X-ray examination is to demonstrate the site and route
of any abnormal discharge on the skin surface. This is done by placing a
very fine tubing into the opening of the discharge (called a sinus)
following which contrast medium is injected. X-rays are then taken. In
selected cases, the radiologist may decide to proceed to a CT.
site and route of any
abnormal discharge on the skin surface. This is done by placing a very fine
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Dacryocystography
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This
examination is useful to demonstrate any blockage of the duct, which
normally drains tears from the eyes, which may be the cause of excessive
tearing in patients. To do this, a very fine catheter or needle is placed
into the tear duct located on the inner aspect of the eyelids and contrast
medium injected. X-rays are then taken.
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Sialography
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This
examination is to demonstrate the ducts within the salivary glands for the
presence of stones, narrowing or any other disease, that may be the cause of
pain and swelling of the salivary glands. A fine tube or needle is
introduced into the opening of the salivary duct, which lies in the mouth,
and contrast medium injected. X-rays are then taken. Occasionally this
examination will be followed by a CT. There may be minimal discomfort when
contrast medium is injected into the ducts. The contrast medium may also
have, a not too pleasant taste.
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Copyright © 2001-2008 College of Radiology, Academy of Medicine of Malaysia
All Rights Reserved
Terms
of Use
Last Updated:
Thursday, 21 August, 2003
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