Radiology

Examinations and Interventional Procedures Performed in Our Department

• Computed Tomography (CT)
• Ultrasonography (USG) and Color Doppler USG
• Interventional Procedures
  • a) Fine-needle aspiration biopsies (THYROID)
  • b) Tru-cut needle biopsies (BREAST)
  • c) Liver mass and diffuse liver biopsies
  • d) Breast cyst aspiration
• Contrast Examinations (Esophagus, stomach, duodenum, gallbladder and biliary tracts, small and large intestines, kidneys and urinary tracts, bladder, and reproductive system)
• Digital Tomosynthesis Mammography
• Bone Densitometry (Outsourced Service)
• Magnetic Resonance Imaging (MRI) (Outsourced Service)
• Direct Radiographic Examinations

The Radiology department has the technical equipment and experienced medical staff to meet all diagnostic and therapeutic demands of patients and doctors. The staff shows maximum care to ensure that patients are comfortable during procedures.

Radiologists have the knowledge and experience to perform not only diagnostic procedures such as general radiology, computed tomography, digital tomosynthesis mammography, digital fluoroscopy, magnetic resonance imaging, ultrasonography (USG), color Doppler ultrasonography (USG), and angiography but also therapeutic interventional procedures.

The radiology department has the technological infrastructure to carry out “Teleradiology” applications. “Teleradiology” applications provide the transfer of digital images between different health centers via the internet and enable information exchange and consultation between doctors. The PACS system, which enables teleradiology and digital archiving in our radiology department, has been put into practice since 2009. All radiographic examinations can be stored digitally thanks to this system and can be sent to workstations in film reading rooms via the intranet and evaluated from monitors without being printed on any film.

Ultrasonography (USG) and Doppler Ultrasonography

Vascular structures and blood flow can be evaluated in detail with color Doppler ultrasonography (USG). Upper and lower extremity arterial and venous system color Doppler ultrasonography (USG), portal Doppler, carotid and vertebral artery Doppler, orbital and scrotal Doppler, gynecological and obstetric Doppler, renal artery Doppler, and graft evaluation are among the examinations performed. These examinations are performed by highly experienced doctors. Unconditional patient satisfaction is one of the main principles of the department, and patients applying for examination can get an appointment on the same day, and the appointment waiting time is kept as short as possible.

Digital Tomosynthesis Mammography

Digital Tomosynthesis Mammography is a special examination performed using X-rays in the diagnosis of breast cancer and other benign breast diseases. Digital Tomosynthesis Mammography services include screening examinations of asymptomatic patients, diagnostic examinations of women with symptomatic breast diseases, stereotaxic preoperative breast marking, and consultations.

The technological features of the devices allow optimal magnification and compression techniques with minimum radiation dose. In the department, which provides accurate and fast diagnostic services for screening and diagnostic digital tomosynthesis mammography examinations, breast marking under ultrasonography (USG) guidance, fine-needle aspiration, and biopsies are also successfully performed.

Interventional Procedures Performed in the Clinic

Interventional radiology is a rapidly developing branch of medicine, and procedures that can help surgical treatment or even eliminate the need for surgery in some diseases (such as cystic diseases and abscesses of the liver and kidney) are performed using minimal interventional techniques. Interventional radiologists reach the target using fine needles and catheters with the help of fluoroscopy and other imaging modalities, without the need for surgical incision and general anesthesia, and can treat diseases and have C-arm fluoroscopy devices. Currently, all non-vascular interventional procedures (such as biliary drainage, abscess drainage, percutaneous nephrostomy, and needle biopsies for organs, gastrointestinal and genitourinary interventional procedures) can be performed in our hospital, and vascular interventional procedures will be possible in the near future.

Computed Tomography (CT)

Computed tomography is a radiological diagnostic method aimed at creating a cross-sectional image of the examined part of the body using x-rays. With this method, the overlap (superposition) in classical radiograms has been eliminated. Its images are much more detailed than X-rays.

CT can create a detailed cross-sectional image of any part of the body and can be used in the diagnosis of many diseases from soft tissue diseases to fractures. It is frequently used in cases that other imaging methods such as direct radiography and ultrasonography (USG) cannot clarify.

Our hospital has a CT device with 32-detector technology, and spiral or sequential scanning of any part of the body such as brain, vertebra, thorax, abdomen, bone, and pelvic structures, virtual endoscopic and angiographic examination can be performed. In addition, CT-guided biopsy and interventional procedures are also performed to reduce the need for surgery and for tissue diagnosis of lesions.

CT is the product of combining x-ray with computer technology. In order to create a CT section, it is necessary to know the x-ray attenuation value of each point in the section plane. These values are found by processing a large number of measurements made by passing x-rays from all directions around the section plane with powerful computers. These numerical values found are painted with the corresponding gray tones and section images are obtained. CT images are more detailed than X-rays.

There are two main reasons for this:

1. Imaging a thin slice of the body: In X-rays, structures in the dimension through which the x-ray passes overlap. For this reason, it becomes difficult to select structures whose density difference is not significant. This situation has been eliminated in CT, which images a thin body slice.
2. Direct measurement of x-ray absorption rates of tissues: Many factors such as film, intensifier, bath factors (duration, heat, chemicals) are effective in the detection of x-rays passing through tissues in X-rays. These factors prevent the contrast in the tissue from being reflected in the image. These obstacles have been eliminated in CT. Images are created directly with the x-ray attenuation values of the tissue.

Therefore, CT images reflect tissue contrast much more sensitively. Since the energy used by the method is x-ray, the meaning of gray tones in the images is as in X-ray: Dark gray tones show regions where x-rays are held less than light tones.

During the examination, the patient lies motionless on the table of the computed tomography device. The table is inserted into the opening of the device called the gantry, manually or by remote control. The device is connected to a computer. While the X-ray source performs a 360-degree rotation movement around the patient to be examined, the part of the x-ray beam passing through the body is detected by detectors lined along the cavity or gantry, and the data obtained is processed by a computer. As a result, successive cross-sectional images of the tissues are created. The created images can be monitored from the computer screen. In addition, images can be transferred to film or stored on an optical disk to be brought to the computer screen again when necessary.

Computed tomography has some advantages over other x-ray examinations. In particular, it shows the shape and placement of organs, soft tissues, and bones very clearly. In addition, CT examinations help doctors in the differential diagnosis of a simple cyst (a sac-like formation surrounded by fluid or semi-liquid substance) or a solid tumor (a tissue mass formed by the rapid proliferation of some cells, tumor), allowing better evaluation of diseases.

More importantly, CT helps in evaluating the spread of cancers by creating much more detailed images than direct radiograms. Information to be obtained about cancer spread helps doctors in deciding whether chemotherapy, radiotherapy, surgical treatment, or certain combinations of these will be used by guiding them about the treatment to be applied for cancer. Thus, healthy tissues are protected from unnecessary interventions of treatment methods that may have serious side effects, although they have many benefits.

CT makes it possible to evaluate many parts of the body, such as the brain, which cannot be shown with direct radiograms. It also provides the diagnosis of many diseases earlier and more accurately than other imaging methods. Since diseases are treated better when diagnosed early, CT helps doctors save many lives with these superior features.

What Are the Most Common Areas Where Computed Tomography Is Used? CT is one of the best methods for examining chest and abdominal organs. It is the preferred method for the diagnosis of many diseases, including lung, paranasal sinuses, liver, and pancreas diseases. Guidance for minimal invasive procedures for diagnostic or therapeutic purposes such as biopsy can be provided with CT imaging. CT is also a diagnostic method frequently used in bone imaging. It is also used in the diagnosis of hand, foot, shoulder, and other skeletal system structures and spine bone pathologies.

CT is used in the diagnosis of brain, liver, spleen, kidneys, and other internal organ injuries by utilizing its features of being able to perform rapid scanning and providing detailed images in cases of trauma. It is also one of the methods used in the diagnosis of vascular pathologies that may lead to stroke, gangrene, or kidney failure results.

How to Prepare for the Procedure? In abdominal CT examinations, the patient is asked to stay hungry the night before the examination and use drugs that perform bowel cleaning similar to laxatives so that the intestines can be better imaged. In addition, in cases where radiological contrast media must be used intravenously, at least 2-4 hours of fasting is required against the risk of nausea-vomiting.

One should come to the hospital at least 15 minutes before the appointment time. This will provide the necessary time for registration procedures in the hospital. If a CT scan of the abdomen or pelvis (pelvic region) is to be performed, one should come to the hospital 1 hour and 30 minutes before the appointment time. The patient is asked to drink water mixed with contrast media, which is a liquid that shows the intestines more clearly and allows the radiologist to evaluate the films better. Depending on the pre-diagnoses considered in the patient and the examination requested, the patient may be asked to drink contrast media much earlier than the appointment time.

Metal objects affect image quality; therefore, it is recommended not to wear clothes containing metal buttons or objects. In addition, depending on the body region to be examined, the patient may be asked to remove metal objects such as earrings, jewelry, glasses, and dentures. Female patients should inform the doctor about whether they are pregnant or whether there is such a possibility. Mothers who are breastfeeding are asked not to breastfeed for 24-48 hours after the procedure in case of intravascular contrast media use.

How Is the Examination Performed? CT examination can be performed without giving contrast media or by giving contrast media according to the region evaluated. Contrast media can be given intravenously, orally, or rectally according to the characteristic of the examination. Subsequently, the desired region is scanned in the tomography device.

If the contrast media is to be given intravenously, the injection is made during the procedure through a mechanical injector. During the procedure, the patient remains alone in the tomography room, but if there is any complaint, the patient’s voice can be easily heard from the shooting room. Child patients can be accompanied by their mother or father provided that they wear a lead apron. Especially for children under six years of age, it may be difficult to remain motionless throughout the examination. For this reason, they may need to be in a sleep state with or without medication.

Use of Contrast Media in CT; Contrast media is a drug, mostly given through the vascular access, frequently used in tomography examinations, enabling the vessels to be imaged under x-ray. It is also used in the nutrition of organs and in the differentiation of normal tissue and diseased tissue (tumor, mass, infarct, etc.).

Contrast media can be given intravenously (intravenous), orally (oral), or rectally (rectal) according to the region to be examined and the evaluation to be made. While two or rarely three of these methods can be applied together, contrast media may not be given to some patients at all.

Before giving contrast media intravenously, the patient is informed for the purpose of detecting the risk of contrast media allergy. If a reaction has developed against the contrast media used before, if the person is using regular medication against any allergen, or if they have an allergic disease such as asthma, etc., premedication with antiallergic drugs may be required. Despite the allergy, the first choice is the use of non-ionic contrast media. This type of contrast media has similar density characteristics to physiological blood.

In patients who will use contrast media, blood creatinine level showing kidney functions should be checked before the examination and shooting should be done according to this result. Since the excretion of contrast media is from the kidneys, the use of contrast media may be inconvenient in those with serious kidney disease. In this case, after the risk assessment is made and solutions that will accelerate the excretion of the contrast media are provided, the use of contrast media is decided or alternative imaging methods are used.

During the administration of contrast media through the vascular access, temporary feeling of warmth (flushing), a metallic taste in the mouth, or a feeling of urinary incontinence may occur. All of these pass within seconds. In some cases, there may be a short-term feeling of itching or nausea. If the itching is long-term or if a rash occurs, these complaints can be eliminated with medication. Rarely, difficulty in breathing and sudden swelling in the throat may occur. You need to report this complaint to the technician who is shooting. These complaints occur very rarely after the use of non-ionic contrast media. If contrast media has been used in breastfeeding mothers, giving milk for 24-48 hours may be inconvenient. Milk should not be given during this period of time.