Fluoroscopy Basics Anatomy

GI Tract Anatomy

Esophagus | Stomach | Duodenum | Small Intestine | Colon | Rectum

GU Anatomy

Kidneys | Ureters | Bladder | Urethra

Musculoskeletal And Spinal Anatomy

Joints | Synovial Cavities | Spinal Canal | Nerve Roots

Vascular Anatomy

Arterial Trees | Venous Systems | Major Branch Points


Fluoroscopy Procedures

Esophagram

Barium Swallow

Patient Drinks Barium | Upright And Recumbent Views | Spot Fluoro To Evaluate Motility And Aspiration


Upper GI Series

Stomach And Duodenum

Single Or Double Contrast | RAO And PA Projections | Fluoro To Follow Barium Through Duodenum


Barium Enema

Colon Evaluation

Retrograde Contrast Introduction | Single Or Double Contrast | AP Obliques And Lateral Spot Images


VCUG

Voiding Cystourethrogram

Catheterize Bladder | Fill With Contrast | Fluoro During Voiding | Evaluate Reflux And Urethral Anatomy


Cystogram

Bladder Filling Study

Contrast Instilled Via Catheter | AP And Oblique Views | Evaluate Bladder Contour And Extravasation


Myelogram

Spinal Canal Study

Contrast Into Subarachnoid Space | Fluoro Guided Injection | AP And Oblique Spot Images With CT Correlation Often Performed


Arthrogram

Joint Contrast Study

Contrast Injected Into Joint Under Fluoro | Evaluate Labral Or Rotator Cuff Tears | May Combine With MRI


Swallow Study With FEES Correlation

Functional Assessment

Dynamic Fluoro To Assess Swallowing Phases | Use Multiple Consistencies Of Contrast | Coordinate With Speech Pathology When Available


Technique And Safety

Radiation Safety

ALARA And Shielding

Use Lowest Reasonable Fluoro Time | Collimate To Area Of Interest | Use Pulsed Fluoroscopy | Lead Shielding For Staff And Patient When Appropriate


Contrast Management

Allergy And Renal Considerations

Screen For Iodinated Contrast Allergy | Check Renal Function For IV Contrast | Use Water Soluble Contrast For Suspected Perforation


Patient Preparation

NPO And Bowel Prep

NPO For Upper GI And Swallow Studies | Bowel Prep As Indicated For Barium Enema | Explain Procedure And Obtain Consent


Infection Control

Aseptic Technique For Catheterizations

Use Sterile Technique For VCUG Cystogram And Myelogram | Proper Disposal Of Contrast And Contaminated Materials


Equipment And Imaging Tips

Image Intensifier And Flat Panel

Detector Types

Flat Panel Detectors Provide Improved Image Quality And Lower Dose | Ensure Proper Detector Positioning For Optimal Field Of View


Pulsed Fluoroscopy

Reduce Dose

Use Pulsed Mode When Possible | Adjust Pulse Rate To Balance Motion And Dose | Use Last Image Hold For Documentation


Spot Imaging And Digital Subtraction

Enhance Visualization

Acquire High Quality Spot Images For Documentation | Use Subtraction For Vascular Studies To Remove Background Anatomy


Terminology

Fluoroscopy

Real Time X Ray Imaging | Used For Dynamic And Interventional Studies

Single Contrast

Contrast Agent Only | Useful For Contour And Motility Studies

Double Contrast

Contrast Plus Air | Enhances Mucosal Detail In GI Studies

VCUG

Voiding Cystourethrogram | Fluoro During Voiding To Evaluate Reflux

Myelogram

Contrast In Subarachnoid Space | Evaluates Spinal Canal And Nerve Root Compression