ENGLISH FOR MEDICAL IMAGING - FLUOROSCOPY & ANGIOGRAPHY

Introduction
Fluoroscopy is a specialized x-ray technique which images moving structures and displays them in real
time on a television monitor. Fluoroscopic images look just like x-ray images, as they are obtained with a
similar technique.
The benefit of fluoroscopy is the ability to visualize dynamic processes as they are occurring; think of
fluoroscopy as a live x-ray movie. The downside of fluoroscopy, which is important to keep in mind, is the
relatively high radiation dose to the patient.
Angiography is the use of fluoroscopy to place catheters and other interventional devices into blood
vessels and image blood flow in vessels.

How Images Are Obtained

THE FLUOROSCOPY UNIT

The patient lies on a specialized
table between the x-ray generator
and the detector. The generator
produces an x-ray beam which travels
through the patient towards a
specialized detector called the image
intensifier.
The image intensifier absorbs the
transmitted x-rays and emits part of
the absorbed energy as light photons.
Through a sophisticated process, the
number of light photons emitted is
amplified and they are converted into
a digital image. This is then displayed
live on a TV monitor.
The physician observes the images
on the monitor live, as the study is
being performed.

Factors Affecting the Appearance

As fluoroscopy images are live images using x-rays, the same factors which affect the appearance of
radiographs will influence the fluoroscopic image, such as density, thickness and shape.
The main difference in the appearance of radiographs vs. fluoroscopic images is in the use of contrast.
Contrast agents are almost always used to highlight areas of interest and improve the diagnostic yield of
the study.
Contrast agents can be placed in many different cavities of the body to allow them to be seen, including
blood vessels, GI tract, biliary system, joints, uterus, and the urinary tract. What contrast agent is used will
affect the appearance as well. The next few pages show a few examples of fluoroscopy and contrast agent
appearance.
DISPLAY
Importantly, fluoroscopic images are digital images which can be displayed so that dense structures
appear white, like radiographs, or the images can be inverted so that dense structures appear black.

Indications for Use

Fluoroscopy is used to evaluate
dynamic processes and structures in
motion. It is used both in the diagnosis
and in the treatment of disease.
Diagnostic uses include evaluation of
swallowing function, study of the
gastrointestinal tract, motion of the
diaphragm and motion of joints,
evaluation of blood vessel patency and
size. Therapeutically, it is used in everyday
practice as guidance for a wide variety of
interventional procedures, performed by
radiologists and other specialists.

GASTROINTESTINAL TRACT
Fluoroscopy is invaluable in the
evaluation of the gastrointestinal tract.
Ingested barium is watched
fluoroscopically as it moves throughout
the gastrointestinal structures. Things that
can be observed fluoroscopically include
swallowing function, motility and
peristalsis of the esophagus, stomach,
small and large bowel, and the rapidity of
transit throughout these gastrointestinal
structures. The fold pattern, distensibility,
and caliber of these structures is also
observed.
Clinically, fluoroscopy of the GI tract allows diagnosis of obstructions, strictures, abnormal peristalsis,
bowel wall edema, and impaired swallowing function such as aspiration into the trachea. The image above
is an x-ray taken during ingestion of barium under fluoroscopic guidance. Note how well the fold pattern of
the small bowel loops is seen, outlined with barium.