FAQs

Plain X-Rays & Digital X-Rays Films

What are X-rays?
X-rays are electro-magnetic radiation, which are produced by special machines called X-ray machines. These cannot be seen, felt or heard.

How do X-rays work?
Different parts of the body behave differently with X-rays. Structures such as bone absorb X-rays, whereas air in the lungs lets all X-rays pass through. Thus, when X-rays pass through the body, when they come out, they have different strengths, depending on what parts of the body they have passed through. When these X-rays hit a film (like a photographic film), that film gets exposed depending upon this variation. Like a photographic film, this special film also needs to be developed, before we can see the final picture.

Where are X-rays useful?
X-rays have been used to look at all parts of the body. Specifically, they are required for the chest, all bones and joints and for the abdomen.

Are there any dangers?
Since, X-rays involve radiation, there is a theoretical risk, though none in practice. In women who are pregnant, X-rays should be performed only after weighing all risks and benefits.  

What are the dyes used with X-rays?
Sometimes, artifical dyes are used to improve our ability to see internal structures. These usually form part of a "procedure". The common dyes used are either barium containing (barium sulphate) or iodine containing. Barium sulphate is used for all barium examinations to study the stomach and intestines. Iodine containing dyes are usually injected in the veins to study the kidneys, during angiography, etc.

Are there any complications of the dye?
5% of patients may get nausea and redness of skin. Though severe reactions are known, these are very rare and uncommon. However, in patients show have a previous history of allergy, those who are asthmatics, those wich renal and cardiac failure, a special dye which is more expensive, but safer should be used, to prevent a reaction.

Who is qualified to report X-rays?
Only radiologists are trained to read X-rays and all X-rays should carry a radiologist's report. Other physicians and non-radiology centres may also perform X-rays, but they are usually not qualified. Before going for an X-ray, ask the centre, whether it will be done under the radiologist's supervision.

Are there any newer advances in X-rays?
X-rays are used in CT scanning (computed tomography). Digital radiography uses X-rays for directly producing images on a computer, bypassing the film - this is very helpful in emergency situations, such as the trauma centre or intensive care unit.  

What are Digital X-rays?
All images obtained using digital systems are digital x-rays. The commonest digital method used is the CR system that produces digital X-rays on a computer. See the accompanying picture for an idea of how this works.

What are the advantages of Digital X-rays?^*
Digital X-rays are superior to conventional X-rays in resolution and quality.

How much do X-rays cost?
A single X-ray costs Rs. 120. Procedures cost more as more X-rays are taken.

*Digital X-Ray facility starting shortly.

What is ultrasound?
Ultrasound is a technique which uses sound waves of high frequency to produce images.

How does ultrasound work?
Different parts in the body have a different response to high-frequency ultrasonic waves passed through them. When ultrasound waves are passed through the body, many tissues reflect sound waves partially and transmit the rest, which are then reflected back from deeper structures. The reflected waves are measured and depending on the time it takes for them to return, the depth of the echo is decided - the intensity decides the grayness of the area

Where is ultrasound useful?
Ultrasound is used in many parts of the body, specifically to look at the fetus, for other gynecological abnormalities and to look at the abdomen, orbits, thyroid gland, breast, testes, etc.

Are there any dangers?
There is no known danger to the use of ultrasound

Are there any dyes in ultrasound, as in X-rays?
As yet there are no "dyes", injected in routine ultrasound practice. Contrast media however are being evaluated for use in clinical trials.

How much does ultrasound cost?
Ultrasound examinations cost between Rs 300 and 600, depending on the area of the body examined

Who is qualified to do ultrasound?
Only radiologists trained in ultrasound should perform these investigations. In many situations, however, gynecologists also perform ultrasound examinations on their own patients - if adequately trained, this is acceptable.

Are there any newer advances in ultrasound?
Newer advances include the following

• Higher resolution scanning for small areas such as the superfical ligaments and tendons of the body
• Doppler - this allows examination of blood vessels
• 3D Ultrasound - this allow three dimensional studies of various parts of the body

Color Doppler

What is Color Doppler?
Color Doppler is a special ultrasound technique, which allows us to evaluate blood vessels.

What is the principle?
Using the Doppler principle of changing pitch with velocity, ultrasound waves that reflect from the red blood corpuscles in arteries and veins are evaluated for velocity and amplitude and color maps of the vessels can be generated.

Is special equipment required?
An ultrasound machine equipped with color Doppler facilities is required. These are now readily available at many centers.

What is its utility?
Color Doppler is very useful in evaluating the carotid arteries in the neck, the heart (echocardiography), the arteries and veins in the abdomen and the arteries and veins in the upper and lower limbs.

What is power Doppler?
It is a type of color Doppler.

Is any special preparation required?
No

What is the cost?
Between Rs 1000 and 2000.

Who is qualified to perform color Doppler?
A qualified radiologist is the only one who should perform color Doppler examinations of the vessels in the body.

Echocardiography

What is echocardiography?
It is a method of studying the heart and the adjacent great vessels using ultrasound.

What is it used for?
Echocardiography is used to study the structure and function of the chambers of the heart, the integrity of the valves and the coverings of the heart.

Is any preparation required?
None.

Are there any dangers of echocardiography?
None.

How much does it cost?
Anywhere between Rs 600 and Rs 1200.

Does color Doppler help?
It allows better visualization of the vessels and the chambers of the heart

Who is qualified to perform echocardiograms?
Trained cardiologists and radiologists.

OPG & Cephalogram

What is OPG?
OPG stands for Orthopantomography. It is a special method for obtaining radiographs of the teeth-bearing jaws, both upper and lower.

How is it different from regular X-ray machines?
A regular X-ray machine cannot take detailed pictures of the jaw-bones. An OPG machine is specially constructed so that it rotates around the jaw-bones, thus giving us an extremely good idea about the structure of the jaw bones. Yes, x-rays are used, but the method is totally different.

In what situations are they needed?
OPG x-rays are usually asked for by dentists, whether they be general dentists, orthodontists, oral surgeons or prosthodontists/implantologists. Because OPGs give a bird-eye view of the teeth and the adjacent bones, they are useful in a wide-variety of conditions including infections, tumors, congenital abnormalities, pre-implant evaluation and trauma.

Are they any risks?
Just as with x-rays elsewhere in the body, if a lady thinks she might be pregnant, an OPG can be avoided. No other risks exist.

Is any dye injected?
No

How much time does it take to get OPGs done?
Around 10 minutes.

How much does it cost?
On an average, Rs 250.

What is a cephalogram?
It is an x-ray of the face, obtained so that accurate measurements of the face can be performed.

What is its use?
Oral surgeons, orthodontists and prosthodontists need cephalograms prior to planning surgeries and teeth manipulation.

How much time does it take?
On an average, 20 minutes.

How much does it cost?
 Rs 300

Barium Studies

Why are there different types of barium studies?
Depending on the area being examined, we have barium swallow, meal, meal-follow-through, enema and small bowel enema.

What are these?
Barium swallow is a study for the esophagus, barium meal for the stomach, barium meal follow-through for the small bowel, barium enema for the large bowel and small bowel enema for the small bowel. In swallow, meal and meal-follow-through examinations, the patient has to drink barium. In barium enema examinations, barium is injected using an enema tube. In small bowel enema examinations (enteroclysis), a tube is inserted from the nose to the duodenum and barium is injected.

How do barium examinations work?
Barium is an inert substance that coats the internal lining of the bowel and fills up its lumen. It is radio-opaque and thus seen very well on x-rays.

Is there any danger?
Barium by itself is an inert substance and completely harmless. However if it escapes into the abdominal or thoracic cavity through a perforation, it can cause severe inflammation. Thus barium studies should not be done in patients with suspected perforation.

What preparation is required?
For barium swallow, none. For barium meal, at least six hours fasting. For barium meal follow-through, overnight fasting with Dulcolax tablets for clearing the bowel. For small bowel and barium enema, overnight fasting with liquid diet the day before and aggressive clearing of the bowel with Dulcolax tablets the night before and in the morning.

How much time do they take?
From 15 minutes for a swallow to 2-3hours for barium meal follow-through examinations.

How much do these studies cost?
Between Rs 800 and Rs 2500.

Other Radiology Procedures

IVU (intravenous urography)
In this, a dye is injected intravenously and x-ray pictures of the kidneys, ureters and bladder are obtained. The dye is radio-opaque and seen well with x-rays. Overnight fasting and good preparation of the colon with Dulcolax are required. The cost is between Rs 1000 to 2500.

MCU (micturating cystourethrography)
Dye is introduced into the urinary bladder and the patient is asked to micturate/urinate. X-ray pictures are obtained during the act of micturition to assess the function and structure of the urinary bladder and urethra.

RGU (retrograde urethrography)
Dye is injected through the urethra from the glans penis and x-ray pictures are taken. This helps in assessing the urethra and the bladder base.

Fistulogram and sinusogram
In these studies, using a small catheter, iodinated dye is injected into the cutaneous sinus or fistula and x-rays are taken, which help in identifying the tract of the sinus or fistula.

Sialography
In this, the parotid duct is cannulated from the mouth and x-ray pictures of the parotid duct and gland are obtained.

Angiography, venography
The arteries are catheterized usually through the femoral artery and after injection of iodinated dye, x-rays are taken. If the same study is performed for the veins, we get venograms.

HSG (hysterosalpingography)
The cervix is cannulated and iodinated dye is injected into the cervical and uterine lumen. The Fallopian tubes are then well seen. This procedure is used to study the patency of the passage as well as other structural abnormalities.