FLUOROSCOPY

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 HISTORY
Fluoroscopy's origins and radiography's origins  can both be traced back
to 8 November 1895, when Wilhelm Röntgen, or in English script
Roentgen, noticed a barium platinocyanide screen fluorescing as a
result of being exposed to what he would later call X-rays Within months
of this discovery, the first crude fluoroscopes were created. 
fluoroscopes were simply thin cardboard screens that had been coated
on the inside with a layer of fluorescent metal salt, attached to a funnel-
shaped cardboard eyeshade which excluded room light with a viewing
eyepiece which the user held up to his eye.
 COATED CARDBOARD
SCREENS
"EARLY
FLUOROSCOPES”
What is fluoroscopy?...
• 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 it like viewing 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.
 Now lets talk about how images are obtained..

• 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.
This is the fluoroscopy unit I was talking
about
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 difference in the appearance of radiographs vs. fluoroscopic images is in the use of contrast.
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, CNS, joints, uterus, and the urinary tract.

The image here shows barium which has been swallowed and is traveling down the esophagus into the stomach.
Barium is very dense, absorbing much of the incident x-ray beam and so appears white on the film. 
 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.
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.
Joint motion can be observed fluoroscopically. This allows
assessment of the range of motion of a joint, and will display any
limitations of motion. Joint subluxations can sometimes be
detected by having the patient perform certain maneuvers,
• Arteriography is performed to look for areas of narrowing (stenosis), occlusions,
aneurysms, traumatic injuries, blood clots, and anomalies of blood vessels.
• In order to perform arteriography, a catheter has to be placed into the blood vessel of
interest and iodinated contrast is injected through the catheter. Fluoroscopy is used to
guide placement of the catheter in the blood vessel as well as to observe the flowing blood
and contrast.
Venograms are used primarily to determine the patency of veins, to look for blood clots, and to look for
areas of narrowing.
• GUIDANCE FOR INTERVENTIONAL PROCEDURES
• Example: Fluoroscopically guided fallopian tube recannalization
• Blocked fallopian tubes is one cause of infertility. The tubes can
be opened up again or "recanalized" through a relatively minor
intervention. Under fluoroscopic guidance
This is how fluoroscopy was done back in early 20th
century ,imagine wearing these goggles today..
 RESOURCES
https://www.dartmouth.edu/~anatomy/HAE/Radiology_Intro/rad_index.html

https://en.wikipedia.org/wiki/Fluoroscopy