Radiology

What is it?

Radiology is the medical specialty that uses images obtained from the implementation of ionizing radiation, ultrasound or electromagnetism to diagnose conditions, even to treat them minimally invasively.

Services

Computerized Tomography (CT scan)

What a CT scan is.

CT scan is a non-invasive examination that uses special x-ray equipment to take pictures of the internal structures of the body. CT scans are better than conventional X-rays for bone, soft tissue and blood vessel sample exams. The tomograph takes pictures or "cuts" that show only a few layers of body tissue at once. By taking pictures in this way, health professionals can see and find better any problem in your body. A CT scan usually takes 15 to 30 minutes. The X-rays used on it usually have no side effects neither leave any radiation in a patient's body.

What happens during the CT scan?

The tomograph is a machine with a tunnel in the middle. You will lie down on a table that will slide in and out of that round-shaped hole. During the study, the technician will sit behind a window but can see and hear you, and can also talk to you at all times. You may be asked to wear a hospital gown and remove all jewelry or metal accessories. A support point or straps will be used to immobilize the body parts that will be examined. Special lights can be used to ensure that it is in the proper position. You may be asked to hold your breath for a few seconds during the scan. You must remain still during the exam because, if you move, the CT images may become unclear. Your doctormay order a light sedation if you have claustrophobia (fear to closed spaces), if you have difficulty staying still or if you have chronic pain.

A contrast medium may be used to get better visualization of images in some body parts. You may need to drink it about an hour before making the CT scan; this time may be required so the contrast material covers all the stomach and bowels. It can also be injected.

How should I prepare for the tomography?

You should inform the technician about any medication you are taking and indicate if you have allergies, especially to the contrast. Also notify the technician about any recent illness or other conditions and indicate if you have a history of heart disease, asthma, diabetes, and kidney failure or thyroid problems. Any of these conditions may increase the risk of an unusual adverse effect. Women should always inform the health professional if they believe they could be pregnant, since in this state they should not undergo a CT scan due to the exposure of the woman and the fetus to X-rays, which can cause defects in the formation of the fetus.

Registration

Please arrive 30 minutes before the scheduled appointment, if any type of CT scan is to be performed. In case that you are going to have an Abdominal CT scan, you must be in the hospital one hour previous to the exam.

Feeding

Your last meal and intake of liquids such as water, black coffee or tea, apple juice, soda or broth should be six hours before the exam. You can take your medications at the usual times with water. Follow any other instructions given by our health professional.

Clothing and jewelry

Do not wear jewelry: rings, earrings, necklaces or watches. You should wear comfortable clothes that do not have metal clasps. Remove any objects that may interfere with CT images such as glasses, dentures or hair clips. Our team may also ask you to remove hearing aids and removable dental pieces.

Creatinine levels ( blood test)

It is necessary within 30 days prior to CT scan for the following people:

Patients who are 60 years old or older.
Patients suffering from diabetes, whether insulin dependent or not.
Patients with a history of renal failure, renal masses or single kidney.

If you have this blood test done in another health institution, it is your responsibility to obtain a copy of the results and bring them to the appointment.

Diabetic patients

If you are a diabetic patient who takes any medication containing metformin (Glucophage, Glucovance, Metaglip, Actoplus, Prandimet, Kombiglyze, Janumet, Avandamet, Fortamet and Riomet) and have an exam that requires contrast (CT, intravenous pyelogram or arthrography) DO NOT take your medications the day before the test neither until 48 hours after the study. You must have a follow up with your doctor for a blood test and to receive instructions on when you can resume taking your medications normally.

Results of computed tomography

The radiologist will make a report of the findings displayed on the tomography. If you are hospitalized or your treating doctor is part of the Pablo Tobón Uribe Hospital they can see the report in your electronical medical record. If you come as an outpatient, the result will be delivered within 24 working hours after the tomography.

Image assisted therapies

Information for patients who require the following image-assisted therapies

Body interventionism.
Neuro-interventionism.
Percutaneous pain therapies.
Hemodynamics and electrophysiology.

This kind of diagnostic and therapeutic tests use different equipment as a guide to get real visualization time of various vascular organs or structures. These are minimally invasive procedures, since the designated site is accessed using small needles or catheters through an incision, smaller than 5 millimeters.

Most of the procedures performed in the interventionism unit can be done as outpatient or with minimal hospitalization. Usually they are done with minimal hospital stay, with minimal sedation or only with local anesthesia. The pain and recovery time are significantly less compared to other therapeutic alternatives.

The most commonly used systems to guide these procedures are highly sophisticated X-ray and tomography equipment; they emit ionizing radiation, which allows to visualize any body structure. Our Hospital has all the radiological protection tools, in that way optimal procedures can be performed with the minimum possible radiation dose. Ultrasound also allows a large number of interventions to be guided in a practical and simple manner, making it harmless to the patient.

In many cases it may be necessary to use contrast to have a better visualization of different body structures. They rarely produce allergies but, in case it occurs, they can consist of a rash or an outbreak in the skin and rarely respiratory distress, swelling or loss of consciousness.

It is important to inform the image service staff if you have a history of allergies to contrast, fish or asthma.

Hemodynamics and electrophysiology

This specialty is responsible for diagnosing and/or treating diseases that affect the heart, among them the most frequent are coronary heart disease, arrhythmias and congenital heart defects. The heart is accessed using thin catheters, which are usually inserted from the arm or inguinal region, and small devices such as stents, balloons or occluders can be released for the treatment of various pathologies.

Neurointerventionism

With small catheters, the circulation of the brain and neck can be directly assessed; as to provide characterization and treatment for patients with cerebral hemorrhage as in the case of aneurysms, vascular malformations or trauma. When there is an occlusion of a vessel that produces cerebral stroke, different techniques can be offered to restore circulation and, if done early, it can even minimize the consequences of stroke.

Percutaneous pain therapy

This kind of procedures are aimed as an alternative treatment for chronic pain caused by degenerative disease, usually spine disease and pain associated with cancer. These minimally invasive procedures usually produce highly effective short and long-term results that significantly improve the life quality of these patients.

Body interventionism

These treatments are aimed ata large number of pathologies that affect the trunk (chest, abdomen, and pelvis) and extremities. The objective of using these techniques is the diagnosis and treatment of peripheral arterial and venous occlusive disease, and congenital or acquired lesions of the aorta and large vessels. Treatment of tumors by endovascular or percutaneous route as in the case of the liver, treatment of bile and urinary tract occlusion, and comprehensive treatment of the patient with cirrhosis and portal hypertension.

General recommendations

Before the study

Arrive one hour before the exam with the previously authorized medical order and the laboratory and imaging tests related to the pathology that will be studied.
Most of the procedures require 6 hours fasting prior to the appointment if sedation is required, and 8 hours fasting If the procedure requires general anesthesia. Remember that for this last procedure, a previous evaluation by the anesthesiologist is required.
You must come with an adult companion, who knows your medical record and must be able to help you in the post-intervention recovery process.
If you suffer from allergies, are pregnant, or have pregnancy suspicions, you must inform the medical staff before the exam.
Wear comfortable clothes that are easy to remove.
Do not carry many accessories such as necklaces, earrings, watches, rings, and bracelets. Piercings should be removed if they are located near the area to be studied.
Clinical conditions such as diabetes, bleeding disorders, a history of coronary heart disease, or the use of anticoagulants or antiplatelet agents (Aspirin, Clopidogrel, among others) require special preparation and must be previously arranged with the unit's nursing staff.

During the study

Once you are in the radiology service, our nursing staff will perform a small safety questionnaire prior to the procedure.
Most of the time, a small peripheral vein is channeled for infusion of drugs or liquids.
Procedure rooms are cold and restricted access areas due to the technical conditions of the equipments. After the asepsis you will be covered with sheets and blankets that will warm you up.
It is important to know that the surfaces of these equipments are small and it is essential that they do not move, that is why it is important to follow the recommendations of the staff inside the room so that the images are clear and sharp. The machine where you will be lying can move in several directions, so you should not be scared.

After the study

If a catheter was inserted in the inguinal region, it will be necessary to remove it in the recovery room, where you will stay from three to six hours with your leg extended to avoid bruising or bleeding.
The nursing staff will explain you in detail the recommendations that you should follow once you leave our unit to go home, but generally speaking, you must remain in your home accompanied by a responsible adult from almost eight to twelve hours, watching for any abnormal symptoms such as bleeding, bruising, dizziness, palpitations, changes in color or temperature of the limbs or fever.

Magnetic resonance

What an MRI is

Magnetic Resonance Imaging (MRI) is a diagnostic test used to obtain images from the inside of the body. It is based on the processing of radio waves that pass through the patient, which is subjected to a powerful magnetic field. Unlike CT scan or simple X-rays, MRI does not use ionizing radiation. It allows us to obtain very detailed images of the body in two and three dimensions, and from any perspective (transversal, sagittal and coronal). It can provide information about pathologies that are not seen with other imaging techniques like ultrasound or CT scan. It is also used when other imaging tests are contraindicated, for example in the case of iodinated contrast allergy used in CT scan.

What happens during the MRI study?

The equipment used to perform the test has a cylindrical shape, and inside there is a table that can be moved in which the patient lies, usually face up; the table enters in the cylinder and remains there throughout the test.

Inside the resonator, your arms, head and chest will be held with straps to prevent movement. An object called antenna will be placed on the anatomical part to be studied, this will be in charge of receiving the signals emitted by the patient's body and transmitting them to a computer where the image will be generated.

Inside the machine you will hear the noise of a fan and feel air moving. You will also hear a rattling noise while the images are being taken. Sometimes headphones are provided, in which you can listen to music to reduce noise and can be used to relax.

During the procedure a technologist will be watching you from an adjoining room and will tell you not to move. Sometimes you can also tell by him not to breathe or swallow for a few seconds. You can contact the medical technologist if you consider it necessary, using a bell that you will have in your hand.

MRI is a very safe test. The magnetic field that is applied has no detrimental effect on the organism. Sometimes you can feel something cold with the introduction of contrast; fortunately, allergic reactions to contrast used for MRI are very rare. It can be a bit annoying to remain still for a long time at the table and may feel some claustrophobia.

How should I prepare for resonance?

These are the recommendations that you may consider when undergoing a nuclear magnetic resonance (MRI):

Duration: The test is performed in about 30 to 60 minutes, although sometimes it may take longer.
Entry: The test can be done as outpatient attention.
You do not need to be accompanied, although it can be helpful if it makes you feel more relaxed. In case the test produces a lot of anxiety, or if the patient cannot be still inside the resonator, a relaxing medication is usually given, in that case there will be necessary to be accompanied by someone who can take you home.
Medications: You should not stop taking medication for hypertension, diabetes or cholesterol.
Documents: You must sign the informed consent since it is a document that explains what the test is about and its possible risks.
Arrive 30 minutes before the appointment, and schedule between an hour and a half and three hours for the exam duration.

Remember to bring previous studies (X-rays, CT, ultrasound, PET or scintigraphy) related to the area to be studied.

Objects that may interfere with the study

Staples for aneurysms.
Artificial limbs or joints, or prostheses such as an artificial knee joint.
Bullets or machine gun fragments.
Cochlear implant (ear).
Pacemaker
Implanted Cardiac Defibrillator.
Implanted spinal
Insulin bomb.
Metal fragments or pieces in the eyes.
Medicine patch (“transdermal patch” or skin patch such as nicotine, nitroglycerin, or birth control patches. Some of them may contain metal).
Some cloves, plates or metal screws or surgery clips. Commonly these objects will not be a problem during resonance.
Creatinine levels in blood test: it is a laboratory test requested for people who require contrast tests. They will be requested in the following cases:
Patients older than 60 years.
Hypertensive or diabetic patients, insulin-dependent or not.
Patients with a renal failure background, renal cyst or who have only one kidney.
Hospitalized patients regardless of age and underlying pathology.

Feeding: You will be asked not to eat or drink anything six to eight hours before the test, in case the study is carried out with contrast to better visualize the body images on the resonance or if you should be given any sedation during the study.

Metal: Do not wear jewelry, including rings, piercings, earrings, necklace or watch. Our team will ask you to please take off clothes that may have buttons, zippers or any other metallic object.

MRI Results: The images from an MRI can be seen immediately; nevertheless, its interpretation requires a detailed and careful evaluation from the radiologist. The specialist will make a written report that may be delivered to you three (3) working days after having the test, with the resulting images.

The written report includes information about the used technique, and if there was necessary to use contrast or not, . The kind of finding may vary in accordance to the pathology and the studied organ.

Conventional radiology, mammography and special studies

What an X-ray is

An X-ray is an image of internal body structures produced by exposure to a controlled source of X-rays and that is recorded on a photographic film or on a digital system such as a CD or hard disk that can then be viewed on a computer.

Is there any risk?

There are risks associated with X-rays, but a simple X-ray uses a small amount of radiation equivalent to what we all receive from the atmosphere for a period of two or three days.

Patients who are or may be pregnant should inform the radiologist, who will try to suggest another diagnostic test that replaces X-rays. If necessary, this test will cover the abdomen or pelvis with a lead apron since the fetus is more radiation sensitive

Do I need any special preparation?

No. However, please notify the radiology department if you have had a similar radiograph recently.

Can a family member or friend accompany me?

Yes, the patient may be with a companion; but, for safety reasons, it is possible that the companion may not be in the exam room, except in very special circumstances or in the case of small children.

How is the process?

When you arrive at the radiology department go to the reception, an imaging technician will explain the procedure for your examination.

If you have to undress for the procedure you will be taken to a private cubicle where you will be asked to put on a gown that will be provided. You can store your clothes and personal items in a locket.

You will be taken to the X-ray room and your X-ray will be taken on a table or standing on your back in a frame and, although the technician will go behind a screen, you will be seen and heard at all times.

You will be asked to remain still and, at times, to take a deep breath and hold your breath for a few seconds.

Will it be uncomfortable?

It won't.

How much time will it take?

The process of taking X-rays takes only a few seconds, but the technician may need to take additional X-rays in different positions. The process will not last more than 5 to 10 minutes.

Are there any side effects?

There are not..

When will I get the results?

The film will be examined after your visit and a written report on the result will be available within a maximum of three working days.

Special situations

Mammography: it is a radiological study similar to those described above, but with the particularity of being a specific projection for the evaluation of the breasts and with a different x-ray equipment.

For this study it is necessary that the breasts are placed on a surface and compressed to make it easier to identify tumors or calcifications. This may cause a little discomfort but it will only last a few seconds. The entire exam is done by a highly trained nurse or imaging technician for this purpose.

It is normal to take 4 X-rays initially but, depending on the diagnosis or the findings within the exam, additional projections may be taken on the same day or later.

The day of the exam it is important not to use deodorant or creams in the chest area because these products can be detected by the X-ray and cause confusion.

Radiological studies with contrast: sometimes it is necessary to use contrast to highlight certain structures such as the gastrointestinal or genitourinary tract. This contrast can be administered orally as in the case of barium used in explorations of the gastrointestinal tract; rectally when the colon is examined; intravenously in the case of the study of the kidneys or through the vagina or penis when the objective is the examination of the bladder or urethra.

Oral, rectal or transurethral contrast usually have no side effects and are well tolerated.

Intravenous contrast can rarely produce allergies that manifest with itching or skin rash and rarely with respiratory distress, swelling or loss of consciousness.

It is important to communicate to the image service staff if you have a history of allergies to contrasts, fish or asthma.

Molecular image (nuclear medicine, pet-ct and radio 22):

What is a PET-CT?

It is a diagnostic imaging method in which PET (Positron Emission Tomography) and CT (Computarized Tomography) images are sequentially obtained in the same PET-CT scan.

To obtain the metabolic or functional image (PET), the intravenous administration of a radiopharmaceutical is required, in addition, you must rest for one hour must and pass to the tomograph for the detection of radiation and the acquisition of morphological image.

The most commonly used radiopharmaceutical is 18F-FDG, a natural glucose analog found in fruits and cereals. To date, no allergic reaction or unwanted effect of this radiopharmaceutical has been described.

The patient injected with the radiopharmaceutical will emit ionizing radiation. Pregnant women and children under 10 years of age should not try to be near during the next 24 hours after the test.

In some cases it will be necessary to administer radiological contrast, after signing an informed consent.

Before the test:

Decrease the consumption of carbohydrates (flour, bread, sugar), the diet should be based on protein (meat, fish) and vegetables from 12 hours before.
Do not perform activities that involve physical effort: exercise with bands, weights, aerobics, long walks; In general, rest 24 hours before.
Stay well hydrated, drink water frequently 24 hours before the procedure.
Women of childbearing age not hysterectomized should bring a negative pregnancy test valid for no more than 8 days.
Have approximately 6 hours for the entire procedure.
The patient must be accompanied by a responsible adult (the companion cannot be a pregnant woman).
The patient must present with comfortable clothes, without metals, cell phone or valuables.
Bring the request of the attending physician, a complete clinical summary and previous studies related to the current condition (CT, MRI, mammograms, ultrasound, PET or nuclear medicine, among others), these documents are essential.
Keep fasting for 4 hours and take your medications normally with water.
Diabetic patients can have dinner the night before and have breakfast as early as possible on the day of the exam and take their medications at normal times. The study can only be done 4 hours after the last dose of insulin.

Recommendations:

To carry out the PET-CT exam, the patient has been given a radiopharmaceutical, so the patient will be emitting radiation for a period of between 10 and 12 hours; in order to protect family members, companions and people who may be close to the patient, you must:

Return directly to your home once you leave the area where you had the exam.
Drink plenty of fluids for the rest of the day.
If there are children under 10 years of age or pregnant women in your home, you should not have direct contact with them until the next day.
Do not stay in public places like coffee shops, restaurants, banks, among others.
Try not to use public transport.

PET-CT results

The results will be delivered within 5 workingdays after the exam. In some cases, more time will be required to conduct additional case evaluations.

PET-CT / Hypoglucid Foods

Breakfast: drink with semi-skimmed milk, cheese or substitute, soda biscuit, toast, juice without sugar.
Mid-morning: portion of fruit.
Lunch: meat (fish, chicken, beef, pork), soup or cream, salad, sugar-free juice, semi-skimmed milk.
Mid-afternoon: sugar free jelly.
Dinner: meat (fish, chicken, beef, pork), soup or cream, salad, sugar-free juice, semi-skimmed milk.
Snack: semi-skimmed milk drink.

Food not allowed

Sugar, rice, bakery or pastry products, potatoes, bananas, cassava, oatmeal, granola, soft drinks, alcoholic beverages, honey, sweets, desserts,sugar cane.

Ultrasound

What is an ultrasound?

Ultrasound studies use sound waves that create images of the internal organs of the body. As the name implies, ultrasound waves are used, not X-rays as in other study techniques (CT - radiographs). These ultrasound waves can be used safely in all patients, including pregnant women, without side effects.

The most common uses of ultrasound are:

Find the cause of a pain or infection.
Check an inflamed area.
Check the internal structures of the abdomen and pelvis.
Examine breast tissue.
Guide needle

What is a Doppler study?

It is a study conducted with the same principles of conventional ultrasound. In this, vascular structures such as veins or arteries of the neck, limbs and abdomen are evaluated. In the Doppler evaluation, the flow of these vascular structures can be assessed, representing the speeds of this flow in red and blue colors on the monitor screen.

The most common uses of the Doppler study are:

Detect deep or superficial venous thrombosis in the upper or lower limbs.
Evaluate varicose veins (venous insufficiency).
Detect inflammation of the veins (phlebitis).
Assess the presence of thrombi or stenosis in arteries, especially in the neck and lower limbs.
Evaluate implant vascularization in transplanted patients (Examples: kidney, liver).
Evaluate alteration in scrotum such as varicocele, inflammation of the testicle or epididymis or testicular torsion.

Test preparation

Preparations are different for each study. You may be asked to take off your clothes from the area that will be studied and to dress with a hospital gown. You may be asked to be fasting for several hours before the study. For other tests, you may have to drink a specific amount of water before the study so that the bladder will be full. You will be informed about the requirements previous to the appointment.

How the study is done

Nursing staff will transfer you to the study room before starting. You will be asked to lie down on a stretcher, the study will be conducted by a radiologist, who will apply a cold gel on the skin that allows the transmission of sound waves. Later, an instrument called a transducer will slide over the studied zone and will be displaying images on a screen monitor. Sometimes the radiologist will ask you to take a breath to visualize some organs that are difficult to access.

To create images the device sends small pulses of sound waves to your body that bounce and return to the device and, depending on the time taken to return, transform this information into images. The device records changes of these waves when bouncing on the tissue.

For certain studies, the radiologist will place the device in a hole of your body, such as the vagina or rectum. These studies may cause some discomfort but are generally well-tolerated and do not cause pain.

Several images will be taken from different positions using the device, observed by the doctor during the study, and stored in the computer. When the study is finished, the gel is cleaned from your body and you can get dressed.

Ultrasound and Doppler results

The radiologist will make a report about the findings displayed on the ultrasound. If you are hospitalized, or your treating doctor is part of the Pablo Tobón Uribe Hospital, he can see the report in your Electronical Medical Record. The result will be delivered within 60 minutes after the ultrasound.

Radium 223 Dichloride

What is Radium 223 Dichloride?

Radium 223 Dichloride is a radiopharmaceutical that acts as a therapeutic agent that emits alpha particles.

How Radium 223 Dichloride works

It is introduced on the bone and absorbed by the areas in which there is cancer. Once it's in the bone, it causes the death of some nearby bone cancer cells, reducing pain and increasing the life quality of patients.

Who can undergo this procedure?

Male patients, diagnosed with castration-resistant prostate adenocarcinoma (medical or surgical treatments that reduce testosterone levels), with symptomatic bone metastases and who do not have visceral metastases (in locations other than bone, such as liver, lung, brain, etc.)

Treatment and administration

Intravenous treatment that lasts approximately one minute. It consists of 6 doses: one dose every 4 weeks, for a total duration of approximately 6 months. The dose administered is indicated by the nuclear doctor.

Expected Effects

Pain reduction.
Delay in the appearance of other skeletal events such as fractures.
Increase in life quality.
Survival time p

Expected adverse effects of Radium 223

Most people do not experience all the following radiopharmaceutical side effects, these are usually predictable in terms of their appearance, duration, and severity and will improve when the treatment ends.

Bone pain, mainly in the days after the radiopharmaceutical injection.
Diarrhea
Sickness
Vomit.
Anemia: Low hemoglobin levels.
Neutropenia: Low levels of white blood cells (specially neutrophils).
Thrombocytopenia: Decreased platelet count.

Plethysmography

Plethysmography is a non-invasive study that is used to recognize the arteries’ condition. Generally, it is used to check the blood flow on arms and legs arteries, in order to evaluate the function of the arteries and rule out any obstruction or narrowness disease. In addition, it helps to clarify the cause for possible vascular diseases.

This study should be done for people with diseases such as hardening of the arteries (atherosclerosis) and diabetic people.

Preparation

No smoking on exam day.
Take rest.

Process

You should lie down on a stretcher for approximately 45 minutes.
Several bracelets will be installed on your arms or legs, which will measure your blood pressure.

Then, a device called a plethysmograph will measure the blood volume in arms or legs, as the case may be, before and after the bracelets are inflated.

Specialists

Radiologists

Carlos Mario Gonzales Vásquez
Claudia Montoya Giraldo
Andrés Valencia Delgado
Beatriz Molinares Arévalo
César Andrés Ortega Toscano
Marta Claudia Sánchez Correa
Juan Esteban López Amaya
Catalina Cuervo Valencia
Vanessa García Gómez

Osteomuscular radiologists

Catalina Mejía Gómez
Mauricio Estrada Castrillón

Pediatric radiologists

Lina Marcela Cadavid Álvarez
Jorge Alberto Ochoa Gaviria

Interventional radiologists

Sergio Álvarez Vallejo
Santiago Echeverry Isaza
José Miguel Hidalgo Oviedo
Emilio Sanín Pérez

Neurointerventional radiologists

Andrés Ignacio Arbeláez Medina
Gabriel Jaime Ortiz Piza

Breast specialist radiologist

William Quiceno Calderón

Nuclear medicine specialist

Mónica Alexandra Vidal Gonzales
Alejandro Delgado Quijano

Request an appointment

For national patients

To request an appointment (4) 360 47 88

For more information (4) 445 90 00

For international patients

Link to request an appointment https://tphptu.teleperformance.co/TPCO/ChatHptuV5/CHATV5_Inicio.aspx?URL=74922ee129189199d3dd3f7971f387a29dfbbdced55d4df4

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Attention time

Attention 24/7 as inpatient and outpatient. We are located at Tower B, 2^nd Floor.