MRI-Magnetic Resonance Imaging

Magnetic resonance imaging is a diagnostic system using electromagnetic radio waves. An MRI displays images of the body in "slices" similar to that of a CT scan, but it is also able to reflect greater contrast between different types of body tissues. Magnetic resonance imaging is one of the most advanced ways to view precise details of the head, neck, spine, muscles, joints and bones. It is also used to image the chest, abdomen and pelvis.

During the MRI examination, the patient will be asked to rest motionless on a padded table for 30 to 90 minutes depending on the area of your body being scanned. The anatomic area of interest will be positioned in the center of the magnet. During the scan the patient will hear faint hums, and the thumping of radio waves. The patient is in constant contact with the MRI technician throughout the examination, and has access to a control button to alert the technician if necessary. To help make the MRI exam experience a pleasant one, we have a music system that patients can listen to during the exam. Patients are encouraged to bring a favorite CD.

No special preparation is required prior to the examination. Patients can continue to take all medication and follow their regular diet unless instructed otherwise. Prior to entering the scan room, the patient will be instructed to remove all jewelry, hairclips, watches, coins, keys and any other metal objects from their body. Credit cards and ATM cards must not be brought into the scan room, as the magnet will erase the magnetic codes on the cards. Patients with metallic or electronic implants, pacemakers or aneurysm clips should alert the technician prior to entering the scan room as the MRI may adversely affect these items.

Some MRI examinations require the use of a non-iodine containing injectible contrast material to increase the sensitivity of the examination and achieve additional information. The contrast material is injected into a vein using a very small needle, which is removed before the scanning begins. The decision to use the contrast material will be made by the referring physician and/or radiologist.

Top of page

64-Detector CT Scan

CT scan is an advanced system producing cross-sectional images of the body much like the slicing of a loaf of bread. It is a highly sensitive method to accurately view the internal anatomy and detect extremely small lesions. Utilizing high speed computers, the CT obtains 360 degrees of X-ray information. The information is processed into single slice images for display on a computer monitor and can be reproduced on film or high quality photographic paper.

Our GE 64 detector helical CT significantly shortens examination times and reduces the volume of intravenous non-ionic contrast material administered while providing exceptional resolution. Helical scanning produces, during a single breath hold, multiple contiguous slices so that extremely small lesions are not obscured. State-of-the-art 16 Detector technology provides the thinnest available motion-free slices necessary for CT angiography (direct mapping and analysis of the arteries of the body,such as aorta, carotids, coronaries, kidneys and extremities) and advanced 3D reconstruction of images. These features enhance diagnostic sensitivity, earlier detection, and consistent follow-up of pathology while allowing improved patient comfort.

16-detector CT is required for effective CT-enterography,the CT study of the small bowel , for the investigation of inflammatory bowel disease and abnormal growths within the bowel. The fluid-filled small bowel is depicted motion-free in various cross-sectional planes.

During the scan, the patient will be asked to rest motionless on a padded table for 5 to 15 minutes depending on the area of the body to be scanned. The table moves every few seconds as the images are obtained. The patient will hear faint humming and clicking sounds. Once the images are taken, a radiologist will review the images to ensure all of the area has been covered. Sometimes because of breathing or motion inside the body additional images are needed. Additional images do not mean there is a problem.

Depending on the part of the body being scanned different contrast materials are used. Very often contrast is given through the vein (intravenous). The contrast we use is non-ionic iodinated contrast. If the patient has an iodine allergy or if they have had a reaction to contrast in the past you should notify the office when you are making the appointment and also at the time of the scan so we may take additional precautions to avoid a problem.

Oral contrast is usually given for CT scans that include the abdomen and pelvis. For CT examinations that include the pelvis, the patient will be asked to arrive an hour before the actual scan time to drink. For a CT scan of only the abdomen the patient will be scheduled to arrive a half-hour before scanning. The early arrival is necessary to allow adequate filling of the intestines, which helps in the proper interpretation of the study.If the patient is breast-feeding or pregnant, please let the scheduler know before booking the examination.

Top of page

Ultrasound

Ultrasound utilizes sound waves rather than x-rays to produce a medical image or picture of various organs and tissues in the body. As the ultrasound waves penetrate the body, they are reflected back to the transducer by the internal organs. These echoes contain information that is converted into an image of the organ being examined.

The testing process begins when a transmission gel is spread onto the area of the body to be examined. A transducer will be moved slowly over the body part being imaged producing a sensation of light pressure on the patient's skin. The ultrasound images will appear on a monitor similar to a television screen is recorded on film, or high quality photographic paper, for a detailed study.

MAKIMAGING conducts head, neck, abdominal, pelvic, thyroid, breast, extremity and scrotal sonograms. Our ultrasonic equipment allows excellent evaluations with both transabdominal and transvaginal techniques. Our office is also equipped with Color Flow Doppler capabilities for venous and arterial studies.

Top of page

PET/CT       

Positron Emission Tomography is a non invasive, diagnostic imaging technique for measuring the metabolic activity of cells in the human body.  It is useful clinically in patients with certain conditions affecting the brain and the heart as well as in patients with certain types of cancer. 

PET is unique because it produces images of the body's basic biochemistry or function.  Traditional diagnostic techniques, such as x-rays, CT scans or MRI, produce images of the body's anatomy or structure.  The premise of these techniques is that the alteration in structure or anatomy that occurs with disease can be visualized by the technique.  Biochemical processes which are altered by disease may occur before there is a CT or MR-visible change in gross anatomy.  PET is an imaging technique that is used to visualize some of these metabolic alterations. Even in early disease where there is no gross structural abnormality visible on CT or MRI, the PET scan may be able to show a biochemical change. 

A PET scan is a simple procedure.  It involves the use of a small amount of a radioactive material, similar to what is used in other nuclear medicine. procedures.  The radioactivity is attached or tagged to a compound that is familiar to the body, most commonly glucose sugar.  Other compounds similar to glucose, water, ammonia, and certain drugs may be used.  The radioactive tracer is injected by vein, and a specially designed positron scanner images how the body processes the tracer.  PET has been in clinical use since the early 1990's.

 PET/CT is the state-of-the-art standard for performing PET, which includes a superimposed CT evaluation which shortens the amount of time the patient spends on the table, and improves the accuracy of the examination by mapping out more precisely any areas of abnormality.

Top of page

NM (Nuc Med)

Bone, Thyroid, Hemangioma, Parathyroid, Gastric Emptying, Tumor Imaging, MUGA, Gallium, Kidney

NM Scintigraphy scans are diagnostic examinations in which a trace amount of radioactive material is injected and travels through the bloodstream to the target organ. These tracers transmit a pattern of rays representing the organ size, shape and function. The rays are detected by a special gamma camera which when coupled with a computer produce a characteristic image on a screen. The radiation dose is quite small, with half the dose out of the body in 6 hours and almost all is gone in 24 hours.

Our equipment permits whole body and spot imaging. The patient will be asked to rest on a padded table during the examination. Studies of the liver/spleen, gallbladder, kidneys and breast are performed right after the injection. Bone scans are performed between 2 and 3 hours after, and a gallium scan is performed 2 to 3 days after receiving the agent.

Normally, there is little or no preparation required. Our office staff will inform you of any specific instructions. If the patient is breast-feeding or pregnant, please let the scheduler know before booking the examination.

Top of page

A mammogram is an X-ray picture of the breast. When a patient gets a mammogram, they should make sure that the American College of Radiology has accredited the radiology equipment.

Mammography is the relatively painless procedure that is performed by a specially trained radiology technologist. The technician will guide the patient through the steps of the procedure and can answer many of the questions regarding the procedure. The technician will perform the mammography by compressing the breast between two plates attached to a specially designed X-ray machine. The breast is then "photographed" from two separate angles and the results are examined by the radiologist. Any discomfort the patient may experience is most likely the result of pressure exerted on the breast by the plates. The pressure is necessary to achieve the highest possible detail while minimizing radiation exposure.

The results of the mammogram will show the normal features of the breast and may reveal suspicious areas that require further investigation. Even if the results are not suspicious, a physician may recommend further investigation based solely on the physical examination, as a small percentage of cancers are undetected by mammography. Occasionally women who undergo mammography require magnification or compression views. These magnification views enable the radiologist to better view tiny calcium deposits called microcalcifications or small masses that are undetectable during clinical breast examination. Often, a magnified or compression view of a suspicious area eliminates it as an area of concern and the radiologist recommends only follow-up. Sometimes, the radiologist may recommend a follow-up mammogram in several months to make sure the area is stable, not changing.

Top of page

Breast ultrasound is frequently used to distinguish a liquid-filled cyst (fluid-filled mass) from a solid mass in the breast. The ultrasound is performed by covering the breast with gel and sliding a transducer across the breast surface. The transducer produces sound waves that will pass through a cyst or will bounce off a solid tumor, creating highly distinct images on the screen. If a mass turns out to be a cyst, aspiration or observation may be appropriate.

If the mass turns out to be solid, a biopsy might be necessary. A biopsy is a procedure that removes a sample of abnormal tissue or cells from the breast so that it can be examined under a microscope by a pathologist for analysis and diagnosis. Pathologists are trained to identify the nature of the tissue or cells. If a pathologist determines that the tissue or cells are benign (i.e., a benign tumor, cyst or calcification) then you do not have cancer, and regular follow-up may be all that is recommended.

Cells that are considered benign, but not completely normal, may indicate a condition that, while not cancerous, puts you at an increased risk for cancer. Atypical hyperplasia with atypia is such a condition. The breast tissue is determined to have certain abnormal changes. While these changes are not cancerous, they do increase the chances that cancer will develop. For this reason, women with atypical hyperplasia are recommended to have more frequent clinical breast exams and mammograms.

If the cell turns out to be malignant (cancer), your condition will be diagnosed as cancer and your surgeon will discuss the various treatment options with you.

Top of page

Biopsy Procedures

The physician will determine what type of biopsy is needed. The type of biopsy depends on whether the suspicious area is palpable (can be felt), such as a mass or thickening. Non-palpable findings (cannot be felt), such as micro-calcifications, very small mass or vague densities that have shown up only on a mammogram also require a biopsy.

Minimally invasive MR guided breast biopsy :
Using GE dedicated breast imaging coils and In-Vivo DynaCAD software, our high-field MR can now deliver the most detailed computer-guided images for simultaneous analysis and biopsy of suspicious areas in both breasts.
This 30 minute procedure can pinpoint and analyze small cancers which are either not visible or appear inconclusive on mammograms or ultrasound studies. It is particularly useful in women at high risk for breast cancer, and in women with dense or augmented breasts. The specialized biopsy equipment offers highly targeted tissue sampling with minimal scarring. CLICK HERE

Top of page

X-RAY

X-ray imaging is perhaps the most commonly known form of diagnostic testing. Similar to visible light, x-rays use electromagnetic radiation, which contain wave-like forms of energy. The energy found in electromagnetism comes from tiny, powerful particles called photons.

In x-rays, the wavelengths are shorter and the photons hold more energy than those of visible light do. It is these shorter wavelengths that allow for penetration and imaging of the human body. The technical name for x-ray energy is ionizing radiation. Many different diagnostic techniques, such as angiography, also employ x-ray technology in capturing internal images of the human body. There are two different types of x-ray imaging: fluoroscopy, which requires a moving x-ray camera and a monitor displaying the internal images, and radiography, which uses traditional film technology.

Because this diagnostic test does involve exposure to ionizing radiation, modern machines are more precise in targeting an area with x-rays so as not to expose other areas of the body needlessly. In addition, a heavy, lead cover may be placed over the patient to prevent unnecessary exposure to radiation. Women who are pregnant or have reason to believe they might be pregnant should consult their physician before having a x-ray test.

X-ray testing can look at any bone structure or organ of the body, including:

• Breasts
• Heart
• Spine
• Colon/Rectum

Bone Densitometry

Also known as Dual energy X-ray Absorptiometry or DEXA, bone densitometry is the technology used to measure and monitor changes in bone density. The gradual loss of density weakens the bones and leads to fractures. This condition is called osteoporosis. Many factors such as dietary habits and family history contribute to the development of this disease. A bone densitometer can let patients know whether or not they have osteoporosis or if they are at risk for developing the disease.

Top of page