Radiology Tests & Procedures

An arteriogram (also called an angiogram) is a diagnostic test in which a contrast dye is injected into one of the arteries so a road map of your vessels can be seen. An arteriogram provides an X-ray image of the blood vessels that enables your doctor to evaluate various vascular conditions such as an aneurysm (ballooning of a blood vessel), stenosis (narrowing of a blood vessel), or blockages. The test can show if and where arteries are blocked.

An arthrogram is a diagnostic test using X-ray and contrast medium to see what is wrong with a joint. The iodine serves as a contrast medium that helps your provider see joint problems that are causing pain.

In addition to helping your provider examine your joints, an arthrogram may be used to look at ligaments, tendons and cartilage and how they’re working inside your body. An arthrogram can help your doctor evaluate the need for joint replacement procedures. The test can be used to look at joints and tissue in the ankle, wrist, shoulder, hip, and knee.

Dual energy X-ray absorptiometry (DEXA) is a painless and quick test to detect bone loss. This test, which uses a very low-dose radiation X-ray, is so accurate it’s considered the “gold standard” of all the available bone mineral density tests. Even if you have bone loss of less than 2 percent, DEXA can detect it.

DEXA uses radiation of less than 1/20th of a standard chest X-ray to establish the bone density of the spine, hip or wrist. A computer translates your bone mineral density into a number that can be compared to the peak bone density for your gender, height and weight. It can also be compared to DEXA tests done later to determine the rate of bone loss.

Osteoporosis is a disease that reduces the strength of your bones, causing them to become brittle, lighter, and considerably more prone to fractures. It used to be that osteoporosis went undiagnosed, progressing silently over the years, until a fracture occurred. With the development of DEXA, early diagnosis is possible, and fractures associated with this disease can be prevented. Using DEXA and other bone density tests has allowed physicians to not only identify osteoporosis earlier, but also to treat and successfully mitigate effects of the disease.

X-rays are made by using external radiation to produce images of the body, the organs, and other internal structures for diagnostic purposes. X-rays pass through body structures onto specially treated plates (similar to camera film), and a “negative-type” picture is made—the more solid a structure is, the whiter it appears on the film. For this reason, bones appear very white on an X-ray film, but less dense tissue such as muscle, blood, skin, and fat appears darker. Chest X-rays may be used to assess heart and lung status.

Coronary CT Angiography (CCTA) is a diagnostic procedure using computed tomography to scan the coronary arteries. It is a noninvasive technique that allows clear visualization of narrowed and clogged arteries that can cause heart attack and stroke. CCTA is not appropriate for everyone, and a referral from your physician is required for the scan.

Computed tomography is an excellent diagnostic tool. In a CT scan, the X-ray beam moves in a circle around your body. This allows many different views and provides much greater detail than a standard X-ray. The X-ray information is sent to a computer that displays it in two-dimensional or three-dimensional form on a screen.

Cystoscopy is a procedure that enables your doctor to view the inside of your bladder and urethra in great detail. This is done by using a specialized instrument called a cystoscope. This instrument has lenses like a telescope or microscope. Some cystoscopes use optical fibers that carry an image from the tip of the instrument to a viewing piece at the other end. The cystoscope is as thin as a pencil and has a light at the tip.

The test may be performed for a variety of reasons:

• Diagnose and evaluate urinary tract disorders
• Check for cancer of the bladder or urethra
• Diagnose an enlarged prostate
• Help find out the cause of pain
• Diagnose recurrent bladder infections
• Check for urinary blockage, unusual growth, stone in the urinary tract
• Need for a bladder catheter
• Loss of bladder control
• Blood in the urine
• Unusual cells found in urine sample

CT stands for computerized tomography. In this procedure, a thin X-ray beam is rotated around the area of the body to be visualized. Using very complicated mathematical processes called algorithms, the computer is able to generate a 3D image of a section through the body. CT scans are very detailed and provide excellent information for the physician.

A hysterosalpingogram is a test to check the condition of a woman’s fallopian tubes and uterine cavity. This is done using a dye that makes the inside of the tubes and uterus visible by X-ray examination.

Sometimes this test is done to look for a cause of infertility or to look for a cause of repeat miscarriage. If scarring of the fallopian tubes has occurred, a hysterosalpingogram will show it. You may have a test for pelvic infection before having this test. Sometimes antibiotics are prescribed before having a hysterosalpingogram to prevent infection.

We perform several types of biopsy, or tissue sampling and medication injection therapy, including:

Needle localization

• Fine-needle aspiration biopsy:

A radiologist uses a thin, hollow needle to withdraw tissue from the lump and sends the tissue to a lab for microscopic analysis. The procedure takes about 30 minutes and is similar to drawing blood. A similar procedure—fine-needle aspiration—is typically performed to remove the fluid from a painful cyst, but it can also help distinguish a cyst from a solid mass.

• Core needle biopsy 
  

A radiologist or surgeon uses a hollow needle to remove tissue samples from a breast lump. As many as 15 samples, each about the size of a grain of rice, may be taken and then are sent to a pathologist to be analyzed for malignant cells. The advantage of a core needle biopsy is that it removes more tissue for analysis. Sometimes your radiologist or surgeon may use ultrasound to help guide the placement of the needle.

Pain injections

• Corticosteroid joint injections

An intravenous pyelogram is a type of X-ray examination specifically designed to study the kidneys, bladder and ureters (the tubes that carry urine from the kidneys to the bladder). After iodine-based contrast dye is injected intravenously, a series of images are taken at timed intervals.

The kidneys are responsible for removing the contrast dye from the blood and collecting it in urine. Abnormalities in the appearance of the kidneys or ureters, distribution of contrast within a kidney, asymmetry in the amount of contrast in each kidney, or defects in the collecting systems can be identified and are suggestive of particular diseases and conditions.

The procedure helps evaluate infections in the bladder and the kidneys, blood in the urine, flank pain (which may be from kidney stones), tumors, and also evaluates the urinary tract for damage after an abdominal injury.

Interventional radiology is the use of imaging technology—such as MRI and ultrasound—to help guide procedures for diagnosing and treating certain medical conditions. Interventional radiology offers less invasive diagnosis and treatment options for conditions that have traditionally required surgical intervention. Our dedicated interventional radiologists are board-certified doctors who specialize in minimally invasive procedures used in the diagnosis and treatment of a wide variety of conditions.

Interventional radiology has many advantages, including:

• Shorter recovery time, due to fewer, smaller incisions than traditional open surgery
• Shorter hospital stay (for outpatient procedures)
• Less anesthesia required for conscious sedation

Magnetic resonance imaging (MRI) is a noninvasive way to take pictures of the body. Unlike X-rays and computed tomographic (CT) scans, which use radiation, MRI uses powerful magnets and radio waves.

During MRI, a table moves the patient into a large open cylinder. Once positioned, radio waves pass through a magnetic field around the patient, creating 2D and 3D images of the internal structures. The creation of these radio waves creates a loud knocking sound, so you will be provided with headphones through which we can play music of your choice.

A screening mammogram is done to detect cancer before it can be felt during a breast exam and before there are any symptoms. This type of X-ray is performed by a mammography technologist using a special machine that compresses and flattens the breast for a short time during which two X-ray views of the breast are taken. One view looks at the breast from top to bottom and the other from side to side.

If you have a breast lump or other concern, you may have a diagnostic mammogram. This type of X-ray focuses on a particular area of your breast and can help a radiologist (a doctor who specializes in reading X-ray images) determine whether a breast lump is normal tissue, a harmless cyst, or a potentially cancerous tumor.

It is essential to your health and well-being that you get a high-quality mammogram and an accurate interpretation of that image. We offer experienced radiologists and technologists and the best mammography options available. These include computer-aided detection, digital 3D mammography (tomosynthesis), and breast MRI. Virginia Mason Franciscan Health is certified as a Breast Center of Excellence by the American College of Radiology.

• Computer Aided Detection (CAD) digitally scans a mammogram and identifies areas of concern for the radiologist to review. Studies show the use of CAD may increase the detection rate of cancer.
• Digital breast tomosynthesis (also known as 3D mammography) helps radiologists better distinguish between normal and abnormal breast tissue by creating multiple images of different layers of the breast. Tomosynthesis is of greatest benefit to women with dense breast tissue or for women having their first mammogram. Please refer to the chart above to find a location near you.
• Breast MRI can be used for screening women who are at higher-than-average risk of getting breast cancer. This includes women who have a strong family history of breast cancer or women who have a genetic mutation such as BRCA1 or BRCA2. Breast MRI is also used in women who have just been diagnosed with breast cancer to see if there are any other abnormal spots in either breast or any suspicious-looking lymph nodes.

A PET-CT scan combines two state-of-the-art imaging technologies—PET, or positron emission tomography, a nuclear medicine exam; and CT, or computerized tomography, an X-ray exam—into a single scan. A PET-CT scan merges technologies to quickly provide a high-quality image of both body organs and their function.

Upper/lower GI diagnostic tests include: 

• Barium swallow (esophagram)
• Cystograms
• Gastric emptying
• Gastrostomy tube
• Small bowel series

We offer the following radiation oncology services:

• Brachytherapy (sealed source radiotherapy)
• Prostate seed implants
• Y-90 liver cancer treatment

We offer the full spectrum of ultrasound services, including:

• General abdominal
• OB/gyn and transvaginal ultrasound
• Thyroid, parathyroid and testicular ultrasound
• Penile doppler
• Carotid doppler
• Liver elastography
• Lower and upper extremity venous duplex to rule out DVT
• Noninvasive lower extremity arterial studies
• Prostate ultrasound for prostatitis
• TcpO2 oxygen studies
• Renal transplant doppler
• Abdominal doppler studies
• Automated breast screening ultrasound 
• Ultrasound guided paracentesis and thorocentesis
• Transcranial duplex for vasospasm
• Finger and toe photoplethysmography