| Question |
Answer |
| IV administered contrast is absorbed by the: |
liver |
| Biliary tract examinations are done to evaluate: |
liver function, patency of bile ducts, concentrating and emptying of the gallbladder |
| what kV range should be used for radiographic examinations of the billiary system? |
70-80 kVp |
| oral cholecystography (OCG) is done to evaluate: |
eval for symptoms persistent with gallbladder disease |
| what are the contraindications for an OCG? |
pt. with vomiting, diarrhea, pyloric obstruction, malabsorption, jaundice or liver dysfunction, hypersensitivity to iodinated contrast |
| pt. prep for an OCG |
lo fat diet, no laxatives prev 24 hours, no food after oral contrast |
| contrast administration for OCG |
single dose given 2-3 hours post evening meal on night prior to exam, 3g telepaque (4-6 tablets). Absorption in 10-12 hours. |
| Pt. position for an OCG scout and why |
prone to place the biliary structures closer to the IR |
| PA gallbladder IR sizes |
10X12 LW for scout, 8X10 for subsequent exposures |
| PA gallbladder pt. position (prone) |
center R abdomen to IR, pt. turns head to rest L cheek on pillow (may need to center 2-4” inf. To loc. Of gallbladder when prone) |
| PA gallbladder pt. position (upright) |
center gallbladder to IR CR perpendicular, patient holds on expiration |
| what is demonstrated on a PA gallbladder? |
opacified gallbladder, entire gallbladder and cystic duct, short scale of contrast, no motion, adequate technique |
| pt position LAO gallbladder |
pt. rotated 15-40 degrees, (thin pt. needs more rotation) perp. CR, center to gallbladder. |
| what is demonstrated on an LAO gallbladder? |
opacified gallbladder free from superimposition and foreshortening, entire gallbladder and cystic duct, short scale of contrast, no motion |
| lateral gallbladder is done right to: |
differentiate gallstones form renal calliculi, separate the gallbladder form the vertebral column (thin pt.) long axis of gallbladder parallel to IR |
| a R lateral gallbladder demonstrates what: |
opacified gallbladder free from superimposition or forshortening, entire gallbladder and cystic duct, short scale of contrast and no motion |
| AP R lat. Decub gallbladder pt. position |
pt. R lat. Recumbent, elevated 2-3 inches on support to center gallbladder to film. |
| AP R lat. Decub gallbladder demonstrates: |
stratification of gallstones, stones heavier that bile are not visualized, entire gallbladder and cystic duct, short scale of contrast, no motion |
| Operative cholangiography is done for |
bile-duct patency, sphincter of oddi function, presence of calculi, intraluminal neoplasms, stricture or dilation of ducts |
| C-arm placement for operative cholangiography |
(pt. RPO w/ 15-20 degree rotation) PA over R side of abdomen below inferior ribs ensure no overlap of vertebrae (may need to rotate c-arm) |
| Structures shown in operative cholangiography |
biliary system full of contrast, hepatic branches, pancreatic duct, no extravasation, contrast emptying into duodenum, retained gallstones |
| Where is a “t-tube” placed? |
in the common bile duct |
| Why would a pt. need a T-tube placed? |
assess to biliary drainage, patency, stones, strictures |
| What images are taken with a T-tube placement? |
AP scout, RPO, lateral. |
mr. charles11
