Real images of the patient are taken with the device called fluoroscopy, which is one of the medical imaging techniques. It can be applied to many people. This technique is commonly used to visualise the digestive system, urinary system, reproductive organs and organs with cavities such as the stomach by administering contrast material.
In the system, the patient is imaged between an X-ray beam and a fluorescent screen. It starts by recording with the CCD video camera together with the monitor and modern screen. It is one of the very successful methods. It is among the imaging methods usually performed in the presence of doctors. In case of any problem, the patient can be intervened immediately. After the modernisation of endoscopic procedures such as gastroscopy and colonoscopy, the fluoroscopy method lost its former popularity after the 90s.
Fluoroscopy is one of the first examination methods of radiology. Today, it is widely used in the examination of the thorax, digestive system (GI tract), urinary tract, female reproductive organs and many other parts of the body.
X-rays are used in fluoroscopy. Structures that cannot be seen on normal radiograms are made visible by staining with contrast media administered via oral, intravenous, rectal or vaginal routes. Contrast agents are drugs containing barium and nonionic iodine radiopaque substances. Contrast agents are given to the patient by drinking, enema, urinary catheter or intravenously, depending on the nature of the radiological examination to be performed. After the administration of the contrast agent, the organ to be examined is monitored on the screen by the doctor and radiograms are taken in different positions according to the characteristics of the pathology and the organ.
During the examination, the patient is affected by X-rays in proportion to the duration of the examination and the duration of fluoroscopy. As in all radiological examinations, it is essential to consider the side effects of X-rays in this examination, the aim is to consider the benefit of the diagnosis to be made to the patient and the treatment to be performed accordingly. The examining physician and radiological technicians sit behind a protective partition or wear lead aprons to protect themselves from the side effects of X-rays.
Before the examination, patients are informed about the examination, if necessary, their written informed consent is obtained, they remove all their clothes and metal jewellery and wear the patient gown prepared for the examination. Patients with the possibility of pregnancy or drug allergy inform the clinician at the time of request and the doctor who will perform the examination before the examination.
After the examination, the radiograms are evaluated by the doctors performing fluoroscopy and a report is written to be given to the doctor who ordered the examination.
THE ORGANS MOST FREQUENTLY EXAMINED BY FLUOROSCOPY ARE
- Upper digestive system
- Small intestines
- Urinary tract
- Female reproductive organs
Radiological examination of the upper digestive tract
It is called oesophagus – stomach – duodenum (oesophagus – stomach – duodenum) radiogram. The internal surfaces of these organs are made visible by administering barium contrast material to the patient. Preparation is necessary before the examination.
The patient should not eat, drink water or smoke at least 8 hours before the examination. If the patient has medicines that he/she uses continuously and compulsorily, he/she can take them with a very small amount of water at the specified time by talking to the doctor who will perform the examination.
HOW IS THE EXAMINATION PERFORMED?
First, a drug that reduces the movements of the stomach is injected intravenously. Then the patient swallows a gas-forming tablet so that the stomach swells and can be better visualised. The patient then drinks barium contrast medium under fluoroscopic observation. The progress of the drug through the oesophagus and stomach and the peristalsis of the organs are monitored by the doctor and radiograms are taken in various positions. A normal examination is completed in about half an hour.
Radiological examination of the small intestine
It is the examination of the small intestine by injection of contrast medium (small bowel passage radiography). Preparation is necessary beforehand.
For 2 days prior to the examination, the patient should take watery food. Before the examination, at least 12 hours of fasting and the use of laxatives for bowel cleansing are required.
HOW IS THE EXAMINATION PERFORMED?
The patient is given barium contrast material and its progress in the small intestine is monitored on the screen by the doctor. The contrast material progresses to the large intestine and during this process, radiograms are taken at different intervals and in various positions, and spot radiograms are also taken where necessary. In cases requiring more detailed examination, the patient swallows a thin tube through the nose. This tube is inserted into the duodenum and air is introduced through the tube along with the contrast medium and radiograms are taken. The duration of the examination varies according to the passage time of the contrast material into the large intestine.
Radiological examination of the bladder and urinary tract
In micturition cystography, the urinary tract is visualised during voiding by means of a contrast medium introduced into the bladder through a catheter. Urine culture should be performed beforehand to prevent a possible infection from being transferred to the kidneys. In case of microbial growth in the culture, the examination is performed after the infection is treated. If the culture is clean, there is no harm.
HOW IS THE EXAMINATION DONE?
A catheter is inserted into the bladder and radiograms are taken by filling the bladder with contrast material given through the catheter, then the catheter is removed, the patient starts to urinate, during this time, various radiograms are taken to see whether there is escape from the bladder to the upper urinary tract. No discomfort is felt during the procedure except for the insertion of the catheter and a feeling of tightness. All procedures are completed in approximately 25 minutes.
Radiological Examination of Female Reproductive Organs
It is the examination of the uterus and tubes by introducing contrast material into the uterus. The method is called “hysterosalpingography”. It is performed 7 to 10 days after the patient’s last menstrual period. Before the examination, the patient must take painkiller tablets and antibiotics prescribed by the doctor. No other preparation is required.
HOW IS THE EXAMINATION DONE?
A thin tube is inserted into the uterus and the passage of the iodised contrast material from the uterus to the tubes and abdominal cavity is monitored. Radiograms are taken at certain intervals during this passage. All procedures are completed in about 10 minutes. Sedoanalgesia is performed by the anaesthesiologist.