FAQ (Frequently Asked Questions)
What Kind of Test is That? - A Medical test was ordered for you. You were
more concerned about what your doctor might be looking for and too worried about
what the findings may be to inquire about the test itself.
Where can you find the answer to “What kind of test is that?” The staff at Manatee
Diagnostic Center welcomes patient questions and is happy to provide answers in
language that a layperson can understand. Angus Graham, Jr., MD, Medical Director,
provided the following answers about some commonly ordered tests.
1)
I’ve heard of a chest x-ray, and I know about x-rays for broken bones, but what is a UGI?
2)
My doctor ordered a BE. What should I expect?
3)
What is an IVP?
4)
What is an x-ray, an ultrasound, a CAT scan, and an MRI?
5)
Why can't I just have an MRI and be done with it?
6)
Why do I need an MRI?
7)
Why did my doctor order an MRI?
8)
My doctor didn’t order an MRI for me. Why not?
9)
What does an Ultrasound show?
10)
What is a CAT Scan?
11)
I just had a test. Why do I need another one?
12)
Links to further resources.
Question
I’ve heard of a chest x-ray, and I know about x-rays for broken bones, but what is a UGI?
Answer
The U in UGI stands for Upper, and the GI stands for Gastrointestinal. Your doctor
is asking that your upper gastrointestinal tract be examined. This tract starts
in the back of your mouth and includes the esophagus, the stomach, and the first
part of your intestinal tract, called the duodenum (where most ulcers occur).
Besides ulcers, your doctor is looking for cancer, polyps, inflammation or other
changes that may have occurred. Because these areas are not seen well with regular
x-rays, you will first be asked to swallow a barium solution that will coat the
lining of the areas being examined. The radiologist can then see these body parts
with the fluoroscope and can x-ray them. If the radiologist sees anything that looks
like a variation from the normal, he will take additional special x-ray views of
the areas in question.
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Question
My doctor ordered a BE. What should I expect?
Answer
The B is for Barium. The E is for Enema. Your doctor is asking that your colon be examined. Below the
upper gastrointestinal tract is the small intestine, which is quite long. The small
intestine then joins the colon, also called the large bowel. The colon/large bowel
ends with the rectum and anus. This part of your body also cannot he seen well with
an ordinary x-ray.
You must allow a tube to be inserted into the rectum so that a barium solution,
one that coats the lining of your colon, can be given as an enema. The solution
flows opposite to the usual flow of bowel movement and fills the entire colon. The
radiologist can then see and examine the colon from the anus / rectum region to
a point where the colon is joined to the end of the small intestine.
People frequently will have an urge to have a bowel movement during this test. This
must he resisted until the entire colon is filled, coated and x rays taken. Your
doctor wants the radiologist to see the entire colon, not just a part of it.
The radiologists will be looking for cancer, polyps, ulcers, diverticula, inflammation
and many other changes that can occur.
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Question
What is an IVP?
Answer
The IV is for Intravenous. This means that you will have an injection of fluid into
your vein. The P is of Pyelogram, a Greek word referring to a portion of the kidney.
The radiologist refers to the injected fluid as “contrast”, and it is used so that
urine will be visible on x-ray. The IV fluid containing contrast circulates in the
blood stream throughout the body, until it reaches the kidneys where it is removed
and put into the urine. During the 20 to 30 minutes following the injection of contrast,
x-rays will be taken and the kidneys, ureters, and urinary bladder can be seen.
The radiologist will be looking for any variation from normal such as cancer, kidney
stones, or obstruction of the flow of urine to the bladder.
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Question
What is an x-ray, an ultrasound, a CAT scan, and an MRI?
Answer
An X-ray is electromagnetic radiation capable of penetrating solids, used to photograph
and examine parts of the body, and the X signifies their unknown nature.
Ultrasound is sound with a frequency greater than 20,000 Hz, approximately the upper
limit of human hearing. It is used to photograph and examine parts of the body.
A CAT Scan, or C (Computerized) A (Axial) T (Tomography), uses a scanner x-ray machine
to take a cross section x-ray image of the body. It is also called a CT scan.
An MRI, or M (Magnetic) R (Resonance) I (Imaging), creates images of the body obtained
by using a high magnetic field and radio waves.
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Question
Why can't I just have an MRI and be done with it?
Answer
You hear about football players, ballerinas and other famous people having MRIs,
but you don’t hear about it when they have barium enemas. While it is true that
MRI is an indispensable breakthrough for diagnosing many things torn ligaments,
lumbar and cervical disc disease, brain tumors and hemorrhages in the head being
a few examples — it is not the best way to look for a stomach ulcer, gall stone,
cancer of the pancreas, and many other abdominal conditions.
Just as there is no universal cure-all, there is no universal test that does away
with the need for older, proven technology. MRI, CAT Scanning, Ultrasound, and x-ray
tests complement one another. Your doctor and radiologist work together to select
the test or tests that will provide the answers they seek on your behalf.
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Question
Why do I need an MRI?
Answer
MRI is an acronym: M (Magnetic) R (Resonance) I (Imaging). This technology is obtained by using a high
magnetic field and radio waves. Instead of relying on x-rays, like other imaging
technologies do, MRI uses a powerful magnet. Some are approximately 30,000 times
stronger than the magnetic force of the earth.
During an exam, the patient lies inside the opening (the bore) of the magnet. The
hydrogen atoms in the patient’s body react to the magnetic field, the computer reads
signals from the atom formation and then it reconstructs data into detailed images
of the body’s interior.
MRI provides doctors an alternative way to “see” inside the human body.
For the diagnosis of many types of injuries and conditions MRI is the test of choice
because of its remarkable ability to provide answers to particular test medical
questions.
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Question
Why did my doctor order an MRI?
Answer
In many cases, the type of diagnostic information your doctor needs could
not be obtained any other way, except by performing a surgical procedure to gain
direct access to the tissues in question.
MRI is useful for evaluating lumbar and cervical disc disease. It is also very helpful
in evaluating brain tumor, hemorrhages in the head and brain trauma from accidents.
This test is often ordered to visualize torn ligaments in the wrist, knee or ankle,
to evaluate shoulder injuries, diagnose tendonitis or evaluate masses in the soft
tissues of the body.
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Question
My doctor didn’t order an MRI for me. Why not?
Answer
While it is true that MRI is an indispensable breakthrough for diagnosing many things,
it is not the best way to look for a stomach ulcer, gall stone, cancer of the pancreas,
and many other abdominal conditions. Also, your doctor may have other good reasons,
based upon your current or past health history, for not recommending this particular
test, Your doctor will be happy to explain his reasoning.
Just as there is no universal cure-all, there is no universal test that does away
with the need for older, proven technology. MRI, CAT Scanning, Ultrasound, and x
ray tests complement one another. Your doctor and radiologist work together to select
the test or tests that will provide the answers they seek on your behalf.
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Question
What does an Ultrasound show?
Answer
An Ultrasound allows us to see the soft tissues in your body. Sound waves bounce off
of things. You may be familiar with the use of sonar in submarines! The Ultrasound
machine converts the echoes (or bounces of sound waves) into pictures.
We can tell a lot about the contents of various parts of the body by using this
simple, easily tolerated test. Ultrasound does not show us your bone structure;
x-rays do that very well. The gall bladder is commonly evaluated with Ultrasound
as a first test. The sound waves not only bounce off of the gall bladder, showing
us its size and shape but also, some sound waves penetrate the gall bladder and
will bounce off of stones, if they are present. The liver is also well seen with
Ultrasound. We can detect the size and shape of some tumors and abscesses The radiologist
can measure the size of the bile ducts to look for enlargement caused by a tumor
or stone.
An Ultrasound test can detect an aneurysm of the aorta before it becomes life threatening.
An aneurysm is caused by a weakness in the wall of the aorta. Because the
aorta is well seen by Ultrasound, the abnormal swelling caused by the aneurysm can
be measured and a determination about surgical treatment can be made before a potentially
deadly rupture occurs.
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Question
What is a CAT Scan?
Answer
CAT Scan is a commonly used term that refers to Computed Axial Tomography. CAT or
CT Scanning was developed after Ultrasound and uses x-ray technology. CAT Scanning
is fast, patient friendly and has the unique ability to image a combination of soft
tissue, bone, and blood vessels. It is a multi use imaging system.
For many computed tomography examinations, patients may be asked to take a special
contrast agent (orally, rectally or via injection). CAT Scan contrasts are pharmaceutical
agents (liquids) and are sometimes referred to as “dye”. The contrast agent is used
to make specific organs, blood vessels and or tissue types stand out better to reveal
the presence of disease or injury.
A picture produced by CAT Scanning might be compared to cutting a loaf of bread
in half so that you can look at the cut surface. CAT Scanning of the abdomen shows
us many of the same things that Ultrasound can show, plus it allows us to see the
bones in the area, some of the ribs and the spine. However, the pancreas, for example,
is much better seen with CAT Scan than with Ultrasound and cannot be seen at all
with traditional x-ray.
Another example where the CAT Scan is useful is in visualizing the adrenal glands.
They are only an inch in size, but can be seen on almost every scan, giving us the
ability to detect tumors.
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Question
I just had a test. Why do I need another one?
Answer
The best way to answer this question is with a common example: Let’s assume you
are having a problem in your abdominal area and you may have just had an x-ray of
your abdomen or one of a number of other tests (UGI, IVP, BE) that are commonly
ordered.
The doctor may have suspected a stomach, colon, or kidney problem and decided to
order the must revealing test for their condition.
This first test may have come back negative or been inconclusive. Now, your doctor
wants you to have an Ultrasound or a CAT Scan. He may be expanding his investigation
for gallstones, liver or pancreas problems, an aneurysm or an abscess. These diagnoses
are often made after an Ultrasound or a CAT Scan. This is why your doctor has decided
to continue the testing process until he or she is able to make a definitive diagnosis
and start you on an appropriate treatment regimen.
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Links to further resources:
