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Department of Radiology

at Brigham and Women's Faulkner Hospital

Diagnostic Radiology

Diagnostic Radiology uses X-rays to produce images of the bones and internal organs of the body. Radiation from X-rays is absorbed differently by the tissues of the body. When the X-rays pass through the body, these differences are captured on a special plate. The plate is placed behind the patient. For example, bone absorbs more radiation than soft tissue. This is why bone will show up white on the image. X-rays are often the first choice of referring physicians when a patient has a condition requiring medical imaging. X-rays are very important in diagnosing fractures and other anomalies of bones. X-rays diagnose disease processes in the chest, abdomen and pelvis areas.

Types of Diagnostic Radiology Exams and How to Prepare:

Upper GI (Upper Gastrointestinal Series; UGI)

An upper GI is a radiographic (X-ray) examination that visualizes the structures of the upper gastrointestinal (GI) tract (the esophagus, stomach and duodenum). A small bowel follow-through may be done immediately after an upper GI to look at the rest of the small intestine. An upper GI is used to:

  • Diagnose gastrointestinal reflux.
  • Diagnose the causes of persistent nausea, vomiting, abdominal pain and/or chest pain.
  • Diagnose the cause of bleeding from the upper gastrointestinal tract.
  • Detect inflammation, ulcers and abnormal growths of the esophagus, stomach and duodenum.

Preparation: No food or drink after midnight the day of procedure.

After Care: Resume normal diet and drink plenty of water. For most patients with normal bowel habits, the passage of barium in the form of “white stools” will present no problem. Patients with a history of constipation may use a mild laxative such as Milk of Magnesia.

Small Bowel Follow-Through (Small-Bowel Series; SBFT)

A small-bowel follow-through is a radiographic (X-ray) examination that visualizes the structures of the small intestine from the distal duodenum/duodenojejunal junction (just passed the stomach) to the ileocecal valve (just before the large intestine begins). A small-bowel follow-through is used to:

  • Evaluate symptoms of abdominal pain or diarrhea.
  • Diagnose inflammatory bowel disease (including Crohn’s disease).

Preparation: No food or drink after midnight the day of procedure.

After Care: Resume normal diet and drink plenty of water. For most patients with normal bowel habits, the passage of barium in the form of “white stools” will present no problem. Patients with a history of constipation may use a mild laxative such as Milk of Magnesia.

Barium Swallow (BS)

A barium swallow is a radiographic (X-ray) examination of the upper gastrointestinal (GI) tract, specifically the pharynx (back of mouth and throat) and the esophagus. A barium swallow is used to:

  • Evaluate narrowing or irritation of the esophagus.
  • Diagnose disorders of swallowing (dysphagia - difficulty swallowing).
  • Evaluate spasms of the esophagus or pharynx.

Preparation: No food or drink after midnight the day of procedure.

After Care: Resume normal diet and drink plenty of water. For most patients with normal bowel habits, the passage of barium in the form of “white stools” will present no problem. Patients with a history of constipation may use a mild laxative such as Milk of Magnesia.

Modified Barium Swallow (MBS)

A modified barium swallow is a radiographic (X-ray) examination used to image the swallowing process. This exam is performed by the Speech Language Pathologist (SLP), along with the radiologist to determine whether food or liquid is entering a person’s lungs when swallowing, also known as aspiration. A modified barium swallow is used to:

  • Diagnose disorders of swallowing such as dysphagia and/or aspiration.

Evaluate spasms of the esophagus or pharynx.

Preparation: None.

After Care: Resume normal diet and drink plenty of water. For most patients with normal bowel habits, the passage of barium in the form of “white stools” will present no problem. Patients with a history of constipation may use a mild laxative such as Milk of Magnesia.

Barium Enema (Lower Gastrointestinal Series; BE)

A barium enema is a radiographic (X-ray) examination of your lower digestive tract, which includes the large intestine (colon) and rectum. Barium is introduced via enema into the colon so that it can be seen on X-ray images. A barium enema is used to:

Preparation: Your doctor will provide specific instructions for a bowel preparation (medications or agents you take to cleanse the colon prior to the exam) and dietary restrictions to follow the night before the procedure.

After Care: Resume normal diet and drink plenty of water. For most patients with normal bowel habits, the passage of barium in the form of “white stools” will present no problem. Patients with a history of constipation may use a mild laxative such as Milk of Magnesia.

Cystogram

A cystogram is radiographic (X-ray) examination of your bladder and urethra. A thin flexible tube (catheter) is inserted through your urethra into your bladder. Contrast is introduced into your bladder through the catheter while fluoroscopic X-rays are taken with the contrast material in your bladder. A cystogram is used to:

  • Detect structural problems of the bladder and urethra.
  • Determine the cause of repeated urinary tract infections or urinary incontinence.

Preparation: None

Frequently Asked Questions About Diagnostic Radiology

Are X-rays safe?

X-ray studies involve radiation. Special care will be taken to shield your body. Lead aprons are used to shield patients from radiation. Shielding protects the reproductive organs, which are sensitive to radiation. Other sensitive areas are the thyroid gland and the eyes. If you are having a fluoroscopic procedure radiologists wear thyroid shields and lead glasses.

X-ray detectors only need minimal amounts of radiation to produce a detailed image. The radiation is highly controlled and targeted. Brigham and Women’s Faulkner Hospital follows the ALARA rule, which is to keep radiation dose As Low As Reasonably Achievable. ALARA is not only a sound safety principle, but it is a regulatory requirement for all radiation safety programs.

Who is performing my X-ray? Who is reading my X-ray?

A Radiologic Technologist will perform your exam. All X-ray technologists at Brigham and Women’s Faulkner Hospital have passed a certification exam in diagnostic radiography given by the American Registry of Radiologic Technologists and are licensed by the Massachusetts Department of Public Health’s Radiation Control Program.

Results for your exam are generally available for your provider to view on the same day of your exam, and are also available in Mass General Brigham’s Patient Gateway. Your completed exam will be read by a board-certified radiologist. A radiologist is a physician trained to diagnose conditions seen on medical imaging studies. The radiologist will send the report to your ordering provider.

What should I expect when having an X-ray?

Most X-ray exams take very little time to complete. The radiologic technologist will greet you and escort you to the exam room. You may be asked to change into a hospital gown for your X-ray. You will be asked to remove any metal from your body such as eyeglasses or jewelry.

Depending on the body part being imaged, you may be standing, sitting or lying down on an X-ray table for the exam. The technologist will step into a control room adjacent to the x-ray room to take the image. The technologist may give you specific breathing instructions, such as holding your breath in or out, at the time the X-ray is taken. Holding your breath is important because motion of the lungs during regular breathing can blur the images. The technologist will provide instructions and assist you with positioning the body part of your exam.

The technologist will come back into the room. Sometimes, additional images are taken in different positions. This allows for imaging from different viewpoints. Some positions may be difficult to hold if you are in pain. The technologist will work with you to the best of your ability to minimize discomfort during your exam.

When should I expect to have the results of my X-ray exam?

X-ray exams are interpreted by a board-certified radiologist. A detailed report will be sent to your ordering provider usually within 48 hours of the completion of your exam. Results are available in Mass General Brigham’s Patient Gateway.

Where do I check in for my X-ray? Do I need an order? Do I need an appointment?

Most x-ray requests are “walk-in” appointments between 7 am and 9 pm and require an order, but do not need to be scheduled. Enter the hospital and proceed to the front desk of Radiology on the first floor to check-in for your exam.

For patients with orthopedic appointments requiring x-rays, please report to suite 5L on the 5th floor.

If you are checking in for a fluoroscopy study such as an Upper GI, Barium Swallow or Barium Enema, proceed to the 1st floor Radiology Department front desk.

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