What is mammography?
Digital Mammography is an x-ray exam that produces images of the internal structures of the breasts. These images can detect lumps that are too small to be felt by you or your doctor, as well as abnormal calcifications. Full-field digital mammography is now available at OGH Imaging, which makes it possible to obtain superior images with a very small radiation exposure. The American Cancer Society recommends mammography, along with breast self examination and periodic exams by your doctor, as the best means to detect breast cancer in its earliest stages when it is most curable.
How do I prepare for my mammogram?
Very little preparation is required. You may eat, drink, and take regular medications. If you are premenopausal, it is preferable to have your digital mammogram the week following your period when your breasts will be the least tender. You will be asked to undress from the waist up, so it is advisable to wear a skirt or slacks rather than a dress the day of your exam. Do not wear underarm deodorant, powders, ointments, or creams on your breasts on the day of the exam. These can show up on the digital mammogram images and confuse the test results. Spray deodorant will be available in the digital mammography suite after your exam.
What can I expect during my mammogram?
All exams are performed by female registered technologists who have had specialized training in digital mammography. Your technologist will take a brief history from you and then have you change into a gown. If this is your first exam, she will explain the procedure to you step by step. Please feel free to ask any questions during your exam. A routine digital mammogram consists of four pictures, two of each breast. The technologist will firmly, but gently, pull as much breast tissue as possible onto the x-ray detector. She will then apply compression to firmly press your breast against the detector. You may find the compression uncomfortable for a few seconds. The technologist will only apply as much compression as you can tolerate, but adequate compression is essential to view your breast tissues. The testing takes approximately 15 to 30 minutes. After the technologist has completed the exam, she will ask you to wait while she checks to make sure the images offer a complete exam. On some occasions, additional views might be necessary.
What is the difference between digital and standard film mammography?
Both digital mammography and film mammography use x-rays to produce an image of the breast. In film mammography, the image is created directly on a film. While standard film mammography is very good, it is less sensitive for women who have dense breasts. A major limitation of film mammography is the film itself. Once a film mammogram is obtained, it cannot be altered. Digital mammography takes an electronic image of the breast and stores it directly in a computer, where it can be viewed and enhanced by the radiologist. Digital mammography uses less radiation than film mammography. Digital mammography also results in less repeat images.
What is Ultrasonography?
Ultrasonography, also called ultrasound or sonography, is a technique that uses high frequency sound waves to produce pictures of various organs and tissues in the body. The sound waves are produced by a hand-held device called a transducer. Much like sonar, the sound waves bounce off the organs of the body and are converted into pictures. Ultrasound is a highly sophisticated, safe, and painless technique.
Ultrasonography can provide your doctor with information about your internal organs, such as the liver, gallbladder, and kidneys. It can be used to look at arteries and veins. One of the more well known uses of ultrasound is for imaging the unborn child.
How do I prepare for my ultrasound examination?
If you are scheduled for an abdominal exam, you will be instructed not to eat or drink for at least six hours prior to your testing. If you are scheduled for a pelvic or obstetrical exam, you will be instructed to drink 40 ounces of clear fluid one hour prior to your exam and not to urinate. While uncomfortable, a full bladder helps to enhance the ultrasound image of the pelvic organs. If your bladder is not full at the time of the exam, the test may be delayed while you drink more water. No preparation is needed for vascular exams.
What can I expect during my ultrasound exam?
For some exams you will be asked to change into a gown. The sonographer, a registered technologist with specialized training in ultrasound, will discuss the procedure with you and answer any questions you might have.
You will lie on an examination table next to the ultrasound scanner. A special gel will be applied to the area of your body to be examined. The sonographer will then take the transducer and slowly guide it across your skin in the area to be examined. The sonographer will watch the corresponding image which appears on a TV monitor. Pictures will be taken periodically for further study. The exam takes approximately 20 to 60 minutes.
The sonographer will show your examination to the radiologist, and additional images will be obtained if needed.
What will happen following my ultrasound exam?
After your ultrasound exam, you may resume your normal activities, diet, and medications unless instructed otherwise by the technologist or your doctor. There are no after effects from the exam.
DEXA Bone Density Scan
What is a Bone Density Scan (DEXA)?
Bone density scanning, also called dual-energy x-ray absorptiometry (DEXA) or bone densitometry, is an enhanced form of x-ray technology that is used to measure bone loss. DEXA is today's established standard for measuring bone mineral density (BMD).
An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.
DEXA is most often performed on the lower spine and hips. In children and some adults, the whole body is sometimes scanned. Peripheral devices that use x-ray or ultrasound are sometimes used to screen for low bone mass. In some communities, a CT scan with special software can also be used to diagnose or monitor low bone mass (QCT). This is accurate but less commonly used than DEXA scanning.
What are some common uses of the procedure?
DEXA is most often used to diagnose osteoporosis, a condition that often affects women after menopause but may also be found in men. Osteoporosis involves a gradual loss of calcium, as well as structural changes, causing the bones to become thinner, more fragile and more likely to break.
DEXA is also effective in tracking the effects of treatment for osteoporosis and other conditions that cause bone loss.
The DEXA test can also assess an individual's risk for developing fractures. The risk of fracture is affected by age, body weight, history of prior fracture, family history of osteoporotic fractures and life style issues such as cigarette smoking and excessive alcohol consumption. These factors are taken into consideration when deciding if a patient needs therapy.
Bone density testing is strongly recommended if you:
- are a post-menopausal woman and not taking estrogen.
- have a personal or maternal history of hip fracture or smoking.
- are a post-menopausal woman who is tall (over 5 feet 7 inches) or thin (less than 125 pounds).
- are a man with clinical conditions associated with bone loss.
- use medications that are known to cause bone loss, including corticosteroids such as Prednisone, various anti-seizure medications such as Dilantin and certain barbiturates, or high-dose thyroid replacement drugs.
- have type 1 (formerly called juvenile or insulin-dependent) diabetes, liver disease, kidney disease or a family history of osteoporosis.
- have high bone turnover, which shows up in the form of excessive collagen in urine samples.
- have a thyroid condition, such as hyperthyroidism.
- have a parathyroid condition, such as hyperparathyroidism.
- have experienced a fracture after only mild trauma.
- have had x-ray evidence of vertebral fracture or other signs of osteoporosis.
The Lateral Vertebral Assessment (LVA), a low-dose x-ray examination of the spine to screen for vertebral fractures that is performed on the DEXA machine, may be recommended for older patients, especially if:
- they have lost more than an inch of height.
- have unexplained back pain.
- if a DEXA scan gives borderline readings.
How should I prepare?
On the day of the exam you may eat normally. You should not take calcium supplements for at least 24 hours before your exam. You should wear loose, comfortable clothing, avoiding garments that have zippers, belts or buttons made of metal. Objects such as keys or wallets that would be in the area being scanned should be removed.
You may be asked to remove some or all of your clothes and to wear a gown during the exam. You may also be asked to remove jewelry, dentures, eye glasses and any metal objects or clothing that might interfere with the x-ray images.
Inform your physician if you recently had a barium examination or have been injected with a contrast material for a computed tomography (CT) scan or radioisotope scan. You may have to wait 10 to 14 days before undergoing a DEXA test. Women should always inform their physician and x-ray technologist if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation. If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby.
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