Fluoroscopy
While routine radiography procedures still or static images,
fluoroscopy permits the viewing of dynamic images or xray images in motion.
Fluoroscopy is usually performed by radiologists who are assisted by
radiographers. Fluoroscopic procedure are a routine aspect of every
radiographer’s clinical education.
Fluoroscopic Equipment
A fluoroscope is an xray machine designed for direct viewing
of the xray image. Early fluoroscopes consisted simply of an xray tube mounted
under the xray table and a fluorescent screen mounted over the patient. The
physician watched the xray image on the screen while turning the patient into
the desired positions to view various anatomic areas. The fluoroscopic image
was very dim, dark adaptation was required, and the procedure was carried out
in a dark room.
Today’s equipment is far more sophisticated. Most
fluoroscopic units are properly called radiographic / fluoroscopic (R/F) units
because they can be used for both radiography and fluoroscopy. This is
convenient because most fluoroscopic examination also have a radiographic
component.
Spot Films
Spot Films are taken during fluoroscopy to record the image
as seen on the fluoroscope. Depending on the age of equipment, cassettes, roll
film, or digital systems may be used to record fluoroscopic images.
Fluoroscopic Tube
The fluoroscopic tube is used to expose spot films and
images areas of interest. After the fluoroscopic portion of the study is
completed, additional images may be taken using an overhead tube for comprehensive
visualization of the entire anatomic region.
Digital Fluoroscopy
The radiation required for a fluoroscopic study has been
greatly reduced by the use of the image intensifier. This electronic device is
in the form of a tower that fits over the fluoroscopic screen. Inside is a
series of photomultiplier tube that brighten and enhance the image formerly
seen by looking directly at the fluoroscopic screen.
The enhanced image is digitized or photographed by a video
monitor. A Computer or videotape recorder can be used to make a record of the
entire study.
Some towers can be removed from the fluoroscope and moved
away from the table when they are not needed. The fluoroscope and spot film
device can also be moved out of the way when the table is used for radiography.
The control console of an R/F unit is more complex than that
of a basic radiography unit. There may be separate mA and kVp settings for the
control of the radiographic (overhead) and fluoroscopic (under table) tubes,
and special settings for spot film radiography. A timer on the control advances
when the fluoroscope is on, and an alarm sounds after a preset period, usually
5 minutes.
Radiographer’s Duty in Fluoroscopy Examinations
For a fluoroscopy examination, the duties of the
radiographer include the following:
- Taking the patient’s history, including information on the success of dietary and/or bowel cleansing preparation
- Getting the patient gowned
- Explaining the procedure to the patient
- Taking and processing any required preliminary images
- Setting the control panel correctly for fluoroscopy and spot film radiography
- Positioning the patient for the start of the procedure
- Preparing the equipment for fluoroscopy
- Entering patient data into the computer for digital imaging, if applicable
- Loading the spot film device, if applicable
- Preparing contrast agents as needed
- Assisting the radiologist as needed. This may involve helping the patient assume various positions; assisting the patient and / or the radiologist with the contrast medium; changing spot film cassettes as needed; loading, unloading, and identifying roll films; or electronically managing digital images
- Taking follow up radiographs
- Providing post procedural care and instructions.
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