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This is the complete lecture note for RAD603 Radiology Procedures and Results Interpretation. You can read it online below, open it in the full viewer, or download the PDF for offline study. It pairs with the course's video lectures, so you can read and watch together.
la-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS
la-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS Course code: RAD 603 Course title: Radiology Procedures and Results Interpretation Course credit load: 2 Units Series 1: Contrast Studies: Technique and Indications • Part 1.1: Barium Swallow, Meal, and Follow-Through o Sub Part 1.1.1: Technique of barium swallow o Sub Part 1.1.2: Technique of barium meal and follow-through o Sub Part 1.1.3: Indications for barium swallow, meal, and follow-through • Part 1.2: Barium Enema o Sub Part 1.2.1: Technique of barium enema o Sub Part 1.2.2: Single-contrast versus double-contrast barium enema o Sub Part 1.2.3: Indications for barium enema • Part 1.3: Intravenous Urography and Hysterosalpingography o Sub Part 1.3.1: Technique of intravenous urography (IVU) o Sub Part 1.3.2: Technique of hysterosalpingography (HSG) o Sub Part 1.3.3: Indications for IVU and HSG • Part 1.4: Micturating Cysto-Urethrography and Retrograde Urethrography o Sub Part 1.4.1: Technique of micturating cysto-urethrography (MCUG) o Sub Part 1.4.2: Technique of retrograde urethrography (RUG) o Sub Part 1.4.3: Indications for MCUG and RUG Introduction Fluoroscopic contrast studies remain a genuinely essential practical skill in everyday radiologic practice, providing dynamic, functional information about the gastrointestinal, urinary, and genital tracts that cross-sectional imaging alone cannot always fully replicate. This opening Series establishes the practical technique and clinical indications for the core barium and contrast studies performed in radiologic practice, from barium swallow through to retrograde urethrography.
la-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS The aim of this Series is to equip you with a thorough, practical understanding of the technique and indications for barium swallow, meal and follow-through, barium enema, intravenous urography, hysterosalpingography, micturating cysto-urethrography, and retrograde urethrography. This Series begins with barium swallow, meal, and follow-through, before turning to barium enema. We then examine intravenous urography and hysterosalpingography, concluding with micturating cysto-urethrography and retrograde urethrography. Series Learning Outcomes At the end of this Series, you should be able to: • SLO 1.1: demonstrate the technique of barium swallow, and barium meal and follow-through • SLO 1.2: list the indications for barium swallow, meal, and follow-through • SLO 1.3: demonstrate the technique of barium enema and distinguish single-contrast from double-contrast technique • SLO 1.4: list the indications for barium enema • SLO 1.5: demonstrate the technique of intravenous urography (IVU) • SLO 1.6: demonstrate the technique of hysterosalpingography (HSG) and list the indications for IVU and HSG • SLO 1.7: demonstrate the technique of micturating cysto-urethrography (MCUG) and retrograde urethrography (RUG), and • SLO 1.8: list the indications for MCUG and RUG. 1.1 Barium Swallow, Meal, and Follow-Through 1.1.1 technique of barium swallow A dynamic fluoroscopic assessment of swallowing and the oesophagus A barium swallow requires the patient to swallow barium sulphate suspension while under continuous fluoroscopic observation, discussed in relation to fluoroscopy principles in an earlier related course, with spot radiographic images obtained in multiple projections to assess the pharynx and oesophagus during active swallowing.
la-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS The examination typically assesses the oral and pharyngeal phases of swallowing, particularly relevant to suspected aspiration risk, and the oesophageal phase, evaluating peristaltic motility and luminal calibre throughout the length of the oesophagus, with the patient generally imaged in both erect and prone or recumbent positions. Fill in the blank: A barium swallow requires the patient to swallow barium sulphate suspension while under continuous fluoroscopic ________. 1.1.2 technique of barium meal and follow-through A barium meal extends the barium swallow examination to include detailed assessment of the stomach and duodenum, discussed further in relation to peptic ulcer disease in the next Series of this course, generally using a combination of barium suspension and, in the double-contrast technique, an effervescent agent producing gaseous distension to improve mucosal detail. A barium follow-through extends the examination further, obtaining sequential radiographs at timed intervals as barium progresses through the small bowel, assessing small bowel calibre, mucosal pattern, and transit time, with the patient generally repositioned and compression applied to separate overlapping bowel loops for optimal visualisation. Fill in the blank: A barium follow-through obtains sequential radiographs at timed intervals as barium progresses through the ________. 1.1.3 indications for barium swallow, meal, and follow-through Barium swallow is generally indicated for suspected dysphagia, discussed in relation to swallowing dysfunction in an earlier related course, or suspected oesophageal structural abnormality, such as stricture or motility disorder, providing valuable dynamic functional information complementary to endoscopic assessment. Barium meal and follow-through is generally indicated for suspected peptic ulcer disease, discussed further in the next Series of this course, gastric outlet obstruction, or small bowel pathology, including suspected small bowel obstruction or inflammatory bowel disease, particularly where cross-sectional imaging is unavailable or insufficiently conclusive. Fill in the blank: Barium meal and follow-through is generally indicated for suspected peptic ulcer disease, gastric outlet obstruction, or ________ bowel pathology.
la-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS Figure 1.1: Diagram illustrating fluoroscopic barium swallow technique showing the patient swallowing contrast while imaged in the erect oblique position. Pilot questions 1.1 1. Describe the basic technique of a barium swallow examination. (Linked to SLO 1.1) 2. Describe the additional structures assessed in a barium meal compared with a barium swallow. (Linked to SLO 1.1) 3. Describe the technique of a barium follow-through examination. (Linked to SLO 1.1) 4. List two indications for barium swallow. (Linked to SLO 1.2) 5. List two indications for barium meal and follow-through. (Linked to SLO 1.2) 1.2 Barium Enema 1.2.1 technique of barium enema Retrograde contrast instillation to assess the colon A barium enema involves retrograde instillation of barium suspension through a rectal catheter, discussed in relation to fluoroscopic technique earlier in this Series, under continuous
la-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS fluoroscopic monitoring, with the patient repositioned through multiple oblique and lateral projections to demonstrate the entire colon free of overlapping bowel loops. Adequate bowel preparation, generally involving dietary restriction and laxative administration in the days preceding the examination, is essential to remove residual faecal material that could otherwise obscure or mimic pathology, meaning careful patient instruction beforehand directly influences the diagnostic quality of the resulting examination. Fill in the blank: A barium enema involves retrograde instillation of barium suspension through a rectal catheter under continuous fluoroscopic ________. 1.2.2 single-contrast versus double-contrast barium enema Single-contrast barium enema uses barium suspension alone to opacify the colonic lumen, providing a relatively straightforward technique well suited to assessing gross structural abnormality, such as obstruction, but offering more limited mucosal detail. Double-contrast barium enema additionally introduces air or carbon dioxide following barium instillation, coating the colonic mucosa with a thin barium layer against a background of gaseous distension, considerably improving detection of subtle mucosal lesions such as polyps, discussed further in relation to colonic tumours in a later Series of this course. Fill in the blank: Double-contrast barium enema additionally introduces air or carbon dioxide following barium instillation, considerably improving detection of subtle mucosal lesions such as ________. 1.2.3 indications for barium enema Barium enema is generally indicated for suspected colonic structural abnormality, including diverticular disease, colonic stricture, or suspected colorectal tumour, discussed further in a later Series of this course, particularly where colonoscopy is unavailable, incomplete, or clinically contraindicated. Further indications include evaluation of suspected inflammatory bowel disease affecting the colon, and, in paediatric practice, assessment of suspected intussusception, where a therapeutic reduction may additionally be attempted under the same fluoroscopic contrast procedure. Fill in the blank: In paediatric practice, barium enema may be used for assessment of suspected intussusception, where a therapeutic reduction may additionally be attempted under the same fluoroscopic contrast ________.
la-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS Table 1.2: Comparing single-contrast and double-contrast barium enema. Feature Single-contrast barium enema Double-contrast barium enema Contrast used Barium suspension alone Barium plus air or carbon dioxide Mucosal detail Limited Considerably improved Best suited for Gross structural abnormality Subtle mucosal lesions such as polyps Pilot questions 1.2 1. Describe the basic technique of a barium enema examination. (Linked to SLO 1.3) 2. Explain why adequate bowel preparation is essential before barium enema. (Linked to SLO 1.3) 3. Distinguish single-contrast from double-contrast barium enema technique. (Linked to SLO 1.3) 4. Explain why double-contrast technique is preferred for detecting subtle mucosal lesions. (Linked to SLO 1.3) 5. List two indications for barium enema. (Linked to SLO 1.4) 1.3 Intravenous Urography and Hysterosalpingography 1.3.1 technique of intravenous urography (ivu) Sequential radiographs following intravenous contrast excretion Intravenous urography, discussed in relation to urinary tract imaging in an earlier related course, involves intravenous administration of iodinated contrast medium, discussed in relation to contrast principles in an earlier related course, followed by a series of timed radiographs as the contrast is excreted by the kidneys and progressively opacifies the collecting system, ureters, and bladder. A preliminary control radiograph is generally obtained before contrast administration to identify any radiopaque calculi or other
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