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Other X-ray Examinations Using Contrast Media


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.

 
Myelography


This 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 This examination is now superseded by MRI.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.  

Cholangiography

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).

 

Sinography

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

 

Dacryocystography


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.

 

Sialography

 
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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Last Updated:
Thursday, 21 August, 2003