Fluoroscopy (Clinical Applications, Components)

Summary

This video script offers an introduction to fluoroscopy, a medical imaging technique that captures real-time X-ray images, akin to creating a 'movie' of the body's internal movements. It covers diagnostic applications like myelograms and barium swallows, as well as interventional uses such as stent placements and cardiac ablations. The script details the components of a fluoroscopy system, including the X-ray tube, filters, collimators, and detectors, and touches on the importance of dose control and image processing for both diagnostic and interventional procedures.

Takeaways

• 🎥 Fluoroscopy is a method of making movies with x-rays to observe movements within the body over time.
• 💉 Fluoroscopy has diagnostic and interventional uses, including real-time guidance for procedures like catheter placements.
• 🧠 Myelograms involve injecting contrast into the spinal fluid to visualize details in the spine, though CT scans have largely replaced them.
• 🥛 A barium swallow helps image the upper GI tract by using barium to create contrast in x-ray imaging.
• 🩺 Angiography is performed by injecting a contrast agent to visualize blood vessels in real-time using fluoroscopy.
• 📉 Percutaneous interventions, like stent placements, use fluoroscopy to guide procedures, offering faster recovery than open-heart surgeries.
• 🔥 Ablation is another interventional use of fluoroscopy, where tissue causing irregular heartbeats is burned to restore rhythm.
• ⚙️ The key components of a fluoroscopic system include an x-ray tube, filters, a collimator, and a flat panel detector to capture images.
• 🖥️ System control is performed by the technologist or interventional radiologist, with real-time image display and dose management tools.
• 🦶 The interventionalist can control the system using foot pedals to start and stop x-rays during the procedure for accurate guidance.

Q & A

What is fluoroscopy?

Fluoroscopy is a medical imaging technique that uses X-rays to obtain real-time moving images of the body's structures. It is used for both diagnostic and interventional procedures.

What are the two main applications of fluoroscopy mentioned in the script?

The two main applications of fluoroscopy mentioned are diagnostic and interventional guidance. Diagnostic fluoroscopy is used to visualize internal structures, while interventional guidance uses fluoroscopy to assist in procedures like stent placement.

What is the difference between diagnostic and interventional fluoroscopy?

Diagnostic fluoroscopy is used to visualize and record the movement of internal structures over time, whereas interventional fluoroscopy is used to guide minimally invasive procedures such as catheter placement or stent insertion.

What is a myelogram and how is it performed?

A myelogram is a diagnostic procedure where contrast is injected into the cerebral spinal fluid in the spine to visualize the spine's details. It is performed under fluoroscopic guidance to ensure accurate placement of the contrast.

Why has CT replaced myelograms for certain diagnostic purposes?

CT has replaced myelograms for certain diagnostic purposes because it can create three-dimensional images and better visualize low-contrast structures compared to traditional X-ray imaging.

What is a barium swallow and what is it used for?

A barium swallow is a diagnostic exam where barium, which absorbs more X-rays than surrounding tissues, is swallowed. It is used to image the upper gastrointestinal tract and provide contrast for better visualization.

How does angiography utilize fluoroscopy?

Angiography uses fluoroscopy to inject a contrast agent into blood vessels, making them appear bright against the darker background. This allows for the visualization of the vessels and the flow of contrast through them.

What is a barium enema and how does it assist in visualization?

A barium enema is a procedure where barium is introduced into the lower digestive tract, specifically the colon, to visualize it. The barium provides contrast, making the colonic walls visible under fluoroscopy.

How does fluoroscopy assist in stent placement?

Fluoroscopy assists in stent placement by providing real-time X-ray images that guide the interventional radiologist or cardiologist in positioning the stent accurately within a blood vessel.

What is the purpose of an anti-scatter grid in fluoroscopy?

An anti-scatter grid in fluoroscopy is used to reduce the influence of scattered X-rays, which can degrade image quality. It helps to improve the clarity and contrast of the images by blocking scattered radiation.

What is the role of a flat panel detector in fluoroscopy?

A flat panel detector in fluoroscopy is a state-of-the-art image receptor that captures the X-ray images after they pass through the body. It is responsible for converting the X-ray data into digital images for review and analysis.

Why is fluoroscopy with low dose settings compared to a real-time movie?

Fluoroscopy with low dose settings is compared to a real-time movie because it provides continuous imaging of the body's structures as they move, similar to how a movie captures continuous frames of action.