Why do I receive two bills with my radiology study?
Although you may not see them all, there are many people involved in your exam. Two components make up the exam, technical and professional. The technical part is the exam itself. This charge is for all of the high tech equipment and the highly trained technologists that help perform the exam. The professional charge is for the radiologist, an independent physician, who works closely with the technologists and your doctor to get the appropriate study. They then interpret the exam, make the diagnosis and forward the results to your health care provider.
Eric M. Williams, M.D.
Diagnostic Radiology
Why is October Breast Cancer Awareness Month?
Some may ask why we need a special month to make us aware of something that affects only a small number of people. The truth is it affects more than just the woman who is having the mammogram. In the United States breast cancer is the second leading cause of death among women. The chance of a woman developing breast cancer in her lifetime is one in eight. Early detection is the best protection against the disease, and by practicing self-examination and having regular check-ups, you could save your life. Call today to schedule your appointment, (402) 423-SCAN (7226).
Douglas Winjum, M.D.
Diagnostic Radiology
Why don't some breast cancers show up on mammogram?
While mammogram does detect most cancers, there is some overlap in the appearance of normal breast tissue and breast cancer. Both normal breast tissue and cancer can be white and strandy or patchy. It would be like looking for a small snowball in a field of fresh snow. Sometimes the only indication on mammogram is a very small change from previous exams which is why regular mammograms are so important. In women with a higher risk of breast cancer or with especially dense breasts (very white on mammogram) an MRI may be ordered which gives additional information regarding breast cancer.
Douglas Winjum, M.D.
Pediatric Radiology
How accurate is mammogram?
Mammography detects about 90% of breast cancers. That is why breast self examination (starting about age 30) and annual physical examination (starting at age 40) are also important. Mammography also finds areas that look suspicious, but are not found to be cancer when they are evaluated further. Despite these limitations, mammography is still the best method to find early breast cancer; and largely because of mammography, breast cancer is often found at a curable stage.
Douglas Winjum, M.D.
Diagnostic Radiology
I have heard of MRI, but what is MRA?
Magnetic resonance angiography (MRA) uses a magnetic field and pulses of radio wave energy to provide pictures of blood vessels inside the body. In many cases, MRA can provide information that cannot be obtained from an X-ray, ultrasound, or CT scan. MRA can detect problems with the blood vessels that may be causing reduced blood flow. With MRA, both the blood flow and the condition of the blood vessel walls can be seen. The test is often used to evaluate the blood vessels leading to the brain, kidneys, and legs. During MRA, the area of the body being studied is positioned inside an MRI machine. Contrast material is often used during MRA to make blood vessels show up more clearly.
Douglas Winjum, M.D.
Interventional Radiology
Why do I get an IV injection with CT and MRI scans?
Intravenous contrast material is often, but not always, used in today's CT and MRI studies to help with diagnosis. An iodine based material is used for CT and gadolinium is used for MRI. The purpose is to “enhance” the tissues and organs of the body in such a way as to make them better stand out from each other, and to allow better visualization of abnormal areas within normal areas. This ability to differentiate normal from abnormal is important to make the correct diagnosis.
Eric M. Williams, M.D.
Diagnostic Radiology
I had chest pains after a long airline flight. I went to the ER and they did a CAT (CT) scan of my chest what are they looking for?
One of the recent developments in CT scanning in recent years is called CT angiography. This is a special technique using the latest generation CT scanners and intravenous contrast material. The scanner rapidly images the chest while the IV contrast material is injected into a vein. The test is looking for clots in the pulmonary arteries. Clots in these arteries in the lungs are very dangerous and potentially life threatening if not treated quickly and properly. Additionally, the CT of the chest may also show other causes of chest pain such as pneumonia.
Eric M. Williams, M.D.
Diagnostic Radiology
I have bulging, twisting, painful varicose veins in my legs. How can they be treated?
Symptoms caused by varicose veins include heaviness/aching legs, leg swelling, skin discoloration, and even ulceration. Endovenous laser ablation is a minimally invasive outpatient procedure performed by an interventional radiologist. The laser energy is applied to the inside of the vein, sealing the vein closed. Once the diseased vein is closed, other healthy veins take over carrying blood back to the heart. Several advantages over vein stripping: no surgery, resume normal activity same day, no general anesthesia, tiny scar, 97% success. To schedule a consultation with a doctor, call (402) 423-SCAN (7226).
Douglas Winjum, M.D.
Interventional Radiology
I have pain in my upper abdomen. My family doctor says we need to evaluate my gallbladder. What tests are available?
There are two ways to initially evaluate the gallbladder. An ultrasound is a painless test that uses high frequency sound to look inside the body and gallbladder to check for any abnormalities such as gallstones. Gallstones may cause problems by blocking the outlet from the gallbladder to the intestines and cause pain, a gallbladder attack. Sometimes the gallbladder may not have stones but still not function properly. Another way to evaluate the gallbladder is with a nuclear medicine study that uses a low dose radionuclide injected into a vein to visualize the gallbladder. Then, a second medication is administered to see if the gallbladder contracts normally. Decreased contraction may also be a cause of upper abdomen pain.
Eric M. Williams, M.D.
Diagnostic Radiology
Are there any new ways to evaluate Gallbladder problems?
One of the newer ways to evaluate gallbladder and bile duct problems is the use of MRI imaging. The study does not use any IV or oral contrast and can be done relatively quickly. Using protocols that show the bile within the liver, gallbladder, and bile ducts, in conjunction with 3-D reconstructions, a good picture of the gallbladder and bile ducts can be obtained. This study is often used to determine if more aggressive evaluation is needed.
Eric M. Williams, M.D.
Diagnostic Radiology
What is a kyphoplasty?
Osteoporotic compression fractures of the vertebral bodies of the spine may result in persistent back pain despite conservative treatment. Kyphoplasty is a minimally invasive treatment for compression fractures of the spine performed by an interventional radiologist. A balloon is used to straighten the fractured area, and then bone cement is injected to stabilize the fracture. The procedure takes about 45minutes per fractured vertebral body and pain relief is usually immediate. The procedure is performed through two small incisions in the back and the patient can usually leave the hospital the next day. To schedule a consultation with a doctor, call (402) 423-SCAN (7226).
Douglas Winjum, M.D.
Interventional Radiology
Our new baby spits up a lot. What should we do?
Gastroesophageal reflux is common in infants and generally resolves spontaneously within the first year of life. After a thorough assessment your baby’s doctor may need to order a test to rule out other causes of excessive spitting up. The most common test is an upper GI exam in which the infant drinks barium while the radiologist watches with x-ray. This will show any blockage or twisting of the bowel which may be causing the spitting up. Sometimes an ultrasound will be ordered to look at the “exit” opening of the stomach which can become abnormally thickened in the first few weeks of life. This condition is called pyloric stenosis.
Douglas Winjum, M.D.
Pediatric Radiology
Our toddler began limping and the doctor ordered x-rays. What is he testing for?
Among the more common conditions which can cause a limp in a toddler is a nondisplaced fracture of the lower leg bone, tibia, which is actually called a "toddler's fracture". This occurs with minimal trauma such as the frequent falling down that toddlers often experience while learning to walk. Another cause of limp in a toddler is hip joint fluid (effusion). This can occur from overuse or from infection and is sometimes subtle on X-ray. If there is a question of joint fluid, an ultrasound may be obtained which is a more accurate test for this condition.
Douglas Winjum, M.D.
Pediatric Radiology
I have pain in my flank area. My doctor wants me to get a CAT scan. Why?
It sounds like your family doctor wants to check for kidney stones. To do this a CAT (CT) scan is done typically without any oral or intravenous contrast material. The CT is done with thin sections through the kidneys, ureters (the tubes from the kidneys to the bladder) and the bladder to look for any stones (calculi) that may be causing any blockages and thereby flank pain. Usually stones in the kidneys don’t cause pain, but if they move into the ureters a blockage can occur and cause pain. Depending on the size of the stones they may pass into the bladder on their own, or if they are too large, a urologist may need to remove them.
Eric M. Williams, M.D.
Diagnostic Radiology
What is a PET scan?
PET (positron emission tomography) is a medical imaging technology that uses short-lived radionuclide tracers that are injected in a vein. The most common tracer used is a form of sugar. This is taken up by certain cells; especially cancer cells, but also in normal brain cells and normal heart muscle. This imaging technique is very sensitive for finding certain types of cancers and following their response to treatment.
Douglas Winjum, M.D.
Diagnostic Radiology
My doctor was pretty sure that I had appendicitis, but I had a CT exam anyway, why?
The study was probably done for several reasons. One was to confirm the diagnosis. In the days before CT, many people had their appendix removed although it turned out to be normal. Second, the cause of one's pain may be contributed to abnormalities that don't need surgery, (ovarian cyst, inflammatory bowel disease) or possibly a different type of procedure (kidney stone). Also, if the appendix has ruptured, the surgeon is aware of this before the operation and can plan accordingly.
Eric M. Williams, M.D.
Diagnostic Radiology
Who should have a DXA scan?
DXA (pronounced “dexa”) stands for dual energy X-ray absorptiometry. This is one of the most accurate methods of evaluating bone strength and risk for fractures. Your physician should determine if you may be at risk and whether a scan is indicated. Risk factors include age, gender (women over the age of 50 have more risk), lifestyle, diet, and patient size. Certain diseases, and taking certain medications may increase the risk for osteoporosis. There are medications and lifestyle adjustments than can be made to reduce the chances for fracture in patients at risk.
