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	FAQs

	MRI What is an MRI scan? MRI stands for Magnetic Resonance Imaging. An MRI scanner uses a magnetic field and radio waves to build up detailed pictures of various parts of the body from the signals that are sent out from the water molecules in the body. Computer systems help with this but no x-rays are used. Why am I having an MRI scan? MRI scans are investigations that can be used to help doctors to make a diagnosis or assess the effects of treatment. Your doctor will recommend an MRI scan based on the type of disease you have and the reason for the scan. Who can have an MRI scan? Your doctor will decide if an MRI scan would be helpful in your case. However, some people aren't able to have this scan, for example if: You have a heart pacemaker You have had any of the valves in your heart replaced by metal ones You have aneurysm clips in your brain You have ever done any welding or metal work without wearing goggles, or have ever had metal fragments removed from your eyes Please contact the MRI department if you think you may be pregnant. MRI scans may not be advisable in early pregnancy, unless there are special circumstances. The radiographers, who carry out the scan, will ask you some questions. You will also be required to fill in a questionnaire about your health and medical history, and you may be asked to sign a consent form. What preparation will I need? Usually there is no special preparation for an MRI scan. You may eat and drink normally before and after the scan, unless you have been told otherwise. The only exception is an MRCP(Magnetic resonance cholangio-pancreatography) which may require 4-6 hours of fasting prior to the study. An injection of contrast medium (dye) may be given into a vein. This is not always necessary, but can provide the scan with extra information. As with all medication, a very small number of patients may be allergic to contrast medium. Please inform the radiographer if you have any allergies. A child under the age of seven will probably require a sedative before the MRI exam. The sedative will be administered at the MRI Center before the scan, so plan to arrive approximately one hour before the child's scheduled appointment. Sedation is often more effective if a child is tired and, in the case of an infant, hungry. If possible, do not let your child nap before the exam, and bring a bottle to feed your infant after sedation. Young children should be kept up late the night prior to the exam and awakened early in the morning on the day of their exam. What happens when I come for the scan? When you come for your appointment it is advisable to wear clothing without metal fastenings. Alternatively we can provide a hospital gown or pyjamas. You will not be allowed to take or wear anything metallic or with magnetic strips into the scan room,. You may wear your spectacles, they will be taken off immediately before your scan. A locker is provided for your valuables. You must give the key to a radiographer or to the person accompanying you, as it is magnetic. Who will I see when I have my scan? As well as meeting reception staff, you will also meet radiographers who are trained to carry out the scans. You may also see a radiologist (a specialist doctor who is trained to interpret the results and carry out some of the more complex examinations). Does the scan hurt? No, the scan isn't painful. However, you will have to lie still for up to one hour on a table which is quite hard. You may sometimes be asked not to swallow for some time when the scan is going on.You might also be asked to hold your breath for some special studies. The radiographers will do their best to make you comfortable. If you have any pain or discomfort that could lead to difficulties with the scan, please tell the radiographer before your scan. What happens during the scan? The scanner produces a variety of loud noises, which are produced by magnetic coils that switch on and off during the scan. These coils measure the signal coming from your body in order to make the images. Because these coils are switched on and off rapidly, they vibrate and cause the noise you hear. Ear defenders or earplugs will help reduce this. Although the scanner is open at both ends, some people may find this claustrophobic. If you are worried about this, please speak to the radiographer before you come for your scan. During the scan, the radiographer will be able to see you from the control room and you can talk to each other through an intercom. Our new generation state of the art MRI scanner takes quite a short time for most studies and is also wider and less noisier than conventional MR machines. A friend or relative is allowed to accompany you into the MR room during your scan. How long will the scan take? Scans can take between twenty minutes and an hour. If your scan is going to take longer, you will be told this when your appointment is made. What happens afterwards? You may leave the department as soon as your scan is finished. You may go to the toilet and eat and drink as usual. There are no side effects to the MRI scan itself. CT What is a CT Scan? A CT (Computerized Tomography) scan uses x-rays to produce images of the body. The images are produced from a block of data which the scanner acquires in one breath. These are turned into cross sectional images, like slices in a loaf of bread. Why am I having a CT scan? CT scans are investigations that can be used to help doctors to make a diagnosis or assess the effects of treatment. Your doctor will recommend a CT scan based on the type of disease you have and the information needed. Who can have a CT scan? CT scans use x-rays to produce the images and the X-ray dose for each scan is kept to a minimum for your safety. However, you should not have a CT scan if there is a possibility that you are pregnant. Please intimate the staff before your scan, if you think you may be pregnant. Are there any risks involved with having a CT scan? CT scanners use x-rays at the lowest practical dose. The benefits of having a CT scan outweigh the risk of exposure to radiation, as the information obtained from the scan will contribute to your treatment. During the scan an injection of fluid (contrast medium) is often given into a vein in your arm or hand. This helps to provide clearer images. Though this dye is usually free of any side effects,very occasionally, someone can have an allergic reaction to the injection of contrast medium. This is more common in dehydrated patients and those who have asthma or allergy to other drugs. Please inform the staff at the reception and also in the CT scanning department if you fall into any of these groups so that special precautions can be taken, such as administration of pre-medicative drugs, which will prevent any allergic reaction. In the unlikely event that you do have an allergic reaction, staff working in the CT scanning are trained to manage this situation. Please note that you will be handed a consent form before the scanning, explaining the risks involved in the language of your choice. You are required to sign this form after reading and understanding it. Please feel free to clarify any doubts that you might have from the staff before signing the consent form. What preparation will I need? The preparation depends on which part of the body is to be scanned and these are covered below. You may be asked to undress and put on a hospital gown. For some scans, you may be able to wear your own clothes if they have no metal in them. You will also be asked to remove jewellery as metal can interfere with the clearness of the picture. For all scans requiring injection of dye(intravenous contrast) you will be asked not to eat or drink anything for 4 hours before your appointment time. For scans of the abdomen and/or pelvic area you will be asked to drink up to a litre or more of fluid before the scan. This fluid may taste slightly bitter due to the dye added to it. The dye is usually mixed with fruit juice to make it more palatable. This will help to identify your stomach and bowel clearly on the scans. For some female patients having pelvic scans, a tampon may be inserted into the vagina (front passage). How long does the scan take? The scan itself will take between 5-15 minutes, depending on the number of pictures taken and the complexity of the scan. Generally you should expect to be in the CT Scanning department for about 11/2 - 2 hours. Occasionally we will be asked to scan a patient urgently which may result in a small delay but we will keep you informed should this happen. We do ask you to arrive on time for your appointment, your delay may result in the disruption in the service to others and you may have to rebook your appointment. If you are going to be late or can't keep your appointment, please let us know as soon as possible. What happens during the scan? The scanner looks like a large doughnut. You will be asked to lie on a cushioned table, which will move slowly through the scanner to allow pictures to be taken at different angles. The machine makes a noise while working. During the scan an injection of fluid (contrast medium) is often given into a vein in your arm or hand. This helps to provide clearer images. A cannula (small tube) will be put into a vein before you go into the scan room or a small needle will be inserted into a vein during the scan. You may experience a warm or flushing sensation during the injection, an occasional metallic or tingling taste in the mouth. These side effects usually last for only a few moments. For some scans, you may be asked to hold your breath or to stop swallowing for short periods. A member of the scanning team will give you instructions about your breathing and let you know what is happening at each stage of the scan. The staff will be able to hear you, so please say if you have any discomfort. Some people may find having a CT scan a bit claustrophobic. If you are worried about this, please speak to the radiographer before you come for your scan. During the scan, the radiographer and the doctor(radiologist) will be able to see you from the control room and you can talk to each other through an intercom. What happens afterwards? As soon as the scan is completed, you can get dressed. We may sometimes ask you to wait for an hour after your injection to make sure that you are feeling well before you leave the department. You may go to the toilet and you can eat and drink normally. It is safe for you to drive home. There are no side effects to having a CT scan. Very occasionally, someone will have an allergic reaction to the injection of contrast medium. Staff working in the CT scanning are trained to manage this situation if it arises. When will I know the results of my CT/MRI tests? Although the radiographer can see parts of your body on the screen, the images must be carefully interpreted by a radiologist who is an expert in this field. You may speak to the radiologist after the study and he may sometimes give you a provisional opinion to relieve anxiety but you should remember that the final films will need to be examined later, prior to a final report being issued. The radiologist will prepare the final report which you can collect along with the films. This may take from a few hours to 1-2 days and will be intimated to you either by the customer care executives or the radiographer. The reports are sometimes sent to your own doctor who will tell you the results and discuss them with you. ULTRASOUND What is an ultrasound scan? An ultrasound scan builds up pictures of organs and other areas inside the body from sound waves. These sound waves have a frequency beyond human hearing. An ultrasound scan is often used during pregnancy to obtain pictures of a baby in the womb. An ultrasound scan doesn't use x-rays and is entirely safe. The ultrasound waves are sent to and from the body by a small handheld sensor, which is similar to a microphone. The sensor is moved over the surface of the skin and it picks up the sound waves as they bounce off various organs within the body. A computer, which is linked to the sensor, turns the sound waves into pictures that are viewed on a television screen. Photographs of these pictures can be taken. Why am I having an ultrasound scan? Ultrasound scans are investigations that can be used to help doctors to make a diagnosis or assess the effects of treatment. Your doctor will recommend an ultrasound scan based on the type of disease you have and the information needed. Ultrasound can also be used to detect blood flow and whether there is any narrowing or blockage of blood vessels. These special kind of ultrasound examinations are called Doppler studies. What are the different types of ultrasound scans? There are several types of ultrasound scans. If you are to have one of these scans, the procedure will be explained to you before your appointment. Sometimes, doctors need to put a special ultrasound microphone inside the body to get a clearer picture. Special transducers have been developed to "look inside" the body. The following are some of the special ultrasound scans. Vaginal ultrasound A specially designed transducer (like a large tampon), is put into the vagina to look at the uterus (womb) and ovaries in women. Again although this may be uncomfortable, it shouldn't hurt. An ultrasound of the breast This examination is often used to investigate breast lumps, and is particularly good for detecting cysts(fluid-filled lumps). In older women, it is frequently used in combination with mammography. Guided biopsies / Fine Needle Aspirate (FNA) Other procedures, for example, biopsies, may be performed at the same time as the ultrasound. If the doctor performing the scan notices an area which looks unusual, in the breast or liver for example, s/he may want to take a biopsy or fine needle aspirate (FNA) - a sample of cells or tissue - from that area. With some biopsies, for example, a liver biopsy, you may need to stay in hospital overnight. If you have questions or there is anything you don't understand, please ask. Are there any risks? There are no known risks with ultrasound and it is considered to be very safe. What preparation will I need? You will be told if you need any special preparation before your scan. Scans of the upper abdomen usually require at least 4-6 hours of fasting. Overnight fasting may sometimes be required for better visualization of your gall bladder. Scanning of the pelvis requires you to have a full bladder. If your bladder is not full when you arrive for your scan, you will be asked by the sonology assistant to drink water and wait until your bladder is full. Clean drinking water is available in water dispensers placed in the waiting area. You can also bring your own drinking water if you want to. What happens when I come for the scan? When you arrive in the department you may be asked to undress and change into a hospital gown. You will then be asked to lie on an examination couch. The lights from the room will be dimmed so that the pictures on the television screen can be seen more clearly. A gel will be applied to your skin in the area to be scanned, such as the abdomen. The gel allows the sound waves to pass into the body. The sensor can also move over the skin more easily. The gel will be wiped off at the end of the scan. An ultrasound scan of the pelvis There are two ways of scanning the pelvis. The first is through the abdomen. For this method a full bladder is essential to help produce good pictures. You will be asked to drink about a litre (nearly two pints) of any fluid, except alcohol, in the two hours before your appointment. You don't have to drink it all at once but you should try not to pass urine before the scan. The second method uses a specially designed transducer, which is inserted into the vagina. This technique provides better, more accurate pictures and avoids the discomfort of a full bladder. A guided biopsy A local anaesthetic will usually be injected to numb the area and prevent discomfort. Ultrasound guides doctors to the correct place by enabling them to "see" inside the body. Then the doctor uses a fine needle and syringe to draw off cells, fluid or tissue. The sample is sent to the laboratory for examination under a microscope. Breast Sonography Breast Sonography is a painless ultrasound procedure where the breasts are scanned with high frequency sound waves to produce pictures of the breast tissue. Ultrasound testing allows the radiologist to determine whether a lump is solid tissue or a fluid-filled cyst. Very dense breasts can often be seen better with ultrasound than with mammography. Exams for young patients and certain follow-up exams will be done primarily with ultrasound. As with the mammogram, your test results will be sent to your referring physician. Who will I see when I have my scan? As well as meeting reception staff, you will also see a radiologist (specialist doctor) and a sonology assistant. After a pregnancy scan, can I ask the radiologist to tell me the sex of the baby? NO! It is absolutely illegal for either the radiologist or the sonology assistant to divulge the sex of the baby and any queries in this regard will not be entertained in our centre. Please remember that by trying to ascertain the sex of the baby, you are as much liable to be prosecuted by the law as much as any doctor/staff engaging in such unethical practices. Before a pregnancy scan you will be required to read and sign a consent form in which you agree not to enquire about the sex of the baby. This form has to also be signed by the radiologist who performs the scan. Does the scan hurt? No, you only feel the gentle pressure of the sensor over your skin. If you are to have an internal scan any sensations you may feel will be explained to you. How long will the scan take? Most scans take between 10-30 minutes. However, it is not always possible to know how long a scan will take until scanning begins. What happens afterwards? As soon as the scan is completed you may get ready to go home or back to your hospital ward if you are an inpatient. The gel will be removed before you get dressed. You may go to the toilet and eat and drink as usual. There are no side effects to the ultrasound scan itself. Is it safe to drive home? Yes, it is. When will I know the results? The radiologist performing the ultrasound may sometimes explain his findings to you. Usually the radiologist will prepare a report which you can collect along with the pictures. This may take from a few hours to 1-2 days and will be intimated to you either by the customer care executives, the sonology assistant or the radiologist.The reports are sometimes sent to your own doctor who will tell you the results and discuss them with you. MAMMOGRAPHY What is Mammography? Mammography is a low-energy x-ray of the breast taken to detect breast disease. A mammogram can detect breast cancer up to two years before it can be felt. Early detection of cancer increases effective treatment options and the possibility of a cure. Mammography has been proven to detect cancer earlier than physical exam alone. We are equipped with mammography equipment of the latest technical standards. The low dose digital film used in our mammography department ensures that you will receive the highest quality examination at the lowest possible radiation level. The benefits of mammography outweigh the minimal risk of radiation exposure. How Should I Prepare For The Exam? Before scheduling a mammogram, we recommend that you discuss any new findings or problems in your breasts with your doctor. In addition, inform your doctor of any prior surgeries, hormone use, and family or personal history of breast cancer. Do not schedule your mammogram for the week before your period if your breasts are usually tender during this time. The best time is one week following your period. Also inform us if there is any possibility that you are pregnant. Do not wear deodorant, talcum powder, or lotion under your arms or on your breasts on the day of the exam. These can appear on the x-ray film as calcium spots. Describe any breast symptoms or problems to the technologist performing the exam. If possible, obtain prior mammograms and make them available to the radiologist at the time of the current exam. What Does The Mammography Equipment Look Like? A mammography unit is a rectangular box that houses the tube in which x-rays are produced. The unit is dedicated equipment because it is used exclusively for x-ray exam of the breast, with special accessories that allow only the breast to be exposed to the x-rays. Attached to the unit is a device that holds and compresses the breast and positions it so images can be obtained at different angles. How Does The Procedure Work? The breast is exposed to a small dose of radiation to produce an image of internal breast tissue. The images produced as a result of some of the x-rays being absorbed (attenuation) while others pass through the breast to expose the film. The exposed film is placed in a developing machine-producing images much like the negatives from a 35mm camera. What Is The Best Way To protect myself from breast cancer? Early detection is your best protection. Close to 90 percent of breast cancers can be detected early, when they are most treatable. All three of the following methods should be used. Monthly breast self-examination. Yearly physical examinations of your breasts by a physician Mammography according to the American Cancer Society guidelines: Baseline by age 40 Age 40-49 every 1 to 2 years Over age 50 - every year BONE MINERAL DENSITOMETRY What is DEXA? Dual-Energy X-Ray Absorptiometry (DEXA) is the most accurate and advanced test available for measuring bone mass with excellent resolution and reproducible precision. Mineral radiation (less than 1/20 of a chest x-ray) is used to determine the bone density of the spine, hip or wrist. A DEXA test is more sensitive than ordinary x-rays, more accurate than radiograms (radiographic absorptiometry) and can diagnose bone loss at an earlier stage. Safe and painless, the 10 minute DEXA scan is the most reliable test to determine even the earliest stages of bone loss associated with osteoporosis. What is Osteoporosis? Osteoporosis is a disease that reduces the strength of your bones, causing them to become brittle, less dense and considerably more prone to fractures. Osteoporosis affects more than 20 million women and 5 million men in this country, primarily over the age of 50. A woman's risk of an osteoporosis related injury, such as a hip fracture, is equal to the combined risk of developing breast, uterine and ovarian cancer. Not to be taken lightly, studies have proven that up to 20% of women who suffer a hip fracture will die within one year of the fracture.* Until recently, osteoporosis was often undiagnosed, progressing silently over the years, until a fracture occurred. With the development of DEXA, early diagnosis is possible and fractures associated with this disease can be prevented. It is apparent that early diagnosis, therapeutic interventions and use of bone density testing to diagnose and monitor osteoporosis have enabled physicians with technology and treatment options that were unavailable in the past. We now have the tools to not only identify, but to overcome osteoporosis. What are the Risk Factors of Osteoporosis? In the years following menopause, women will naturally experience bone loss because of a decrease in estrogen. Most will have no symptoms, even while the disease progresses. These factors add to your risk of developing osteoporosis. Age Caucasian or Asian Descent Thin or Small Build Previous Fracture Family History of Osteoporosis Early Menopause Smoking Inactive Lifestyle Certain Medications (including steroids & thyroid hormones) Alcohol Abuse Inadequate Calcium Intake Why Physicians Request a DEXA Exam? To determine your actual bone density and fracture risk To reveal early signs of bone loss with the fewest false positive or false negative results To diagnose low bone mass that may signal the need for treatment What preparation will I need for a DEXA exam? Wear comfortable clothing such as a sweat suit - no metal zippers, buttons or buckles. Typical DEXA exams are completely painless and only take 10 minutes to perform. A brief history is required which may include: Family history of osteoporosis Radiographic findings of osteoporosis Recent fractures Post menopause or early menopause What if I can't keep my appointment? If you can't keep your appointment, please contact the respective department straight away. If you are admitted to hospital before your appointment, please tell the ward staff that you have an appointment booked. Where can I get Help? The entire CLUMAX staff will be happy to answer any questions you may have. Please clarify any doubts at the time of your appointment or telephone the department at any time.