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Radiology

Department of Radiology Services and Interventional Procedures:

Computed Tomography (CT)

Ultrasonography (US) 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 Studies (Esophagus, stomach, duodenum, gallbladder and bile ducts, small and large intestines, kidneys and urinary tract, bladder and reproductive system)

Mammography

Bone Densitometry (Service Procurement)

Magnetic Resonance Imaging (MRI) (Service Procurement)

Direct Radiographic Examinations

The Radiology department is equipped with the technical infrastructure to meet all diagnostic and treatment requests of patients and doctors. The staff takes maximum care to ensure the comfort of patients during procedures.

Radiologists possess expertise in general radiology, computed tomography, mammography, digital fluoroscopy, magnetic resonance imaging, ultrasonography, color Doppler ultrasonography, angiography, not only for diagnostic procedures but also for therapeutic interventional procedures. The department has implemented “Teleradiology” applications since 2009, allowing digital image transfer between different health centers, facilitating information exchange and consultation among doctors.

Ultrasonography (US) and Doppler Ultrasonography

Vascular structures and blood flow are evaluated in detail using color Doppler ultrasonography. Doppler ultrasonography is performed for upper and lower extremity arterial and venous systems, portal Doppler, carotid and vertebral artery Doppler, orbital and scrotal Doppler, gynecologic and obstetric Doppler, renal artery Doppler, and graft evaluations. These examinations are conducted by highly experienced doctors, emphasizing unconditional patient satisfaction. Patients seeking examinations can obtain same-day appointments, and the waiting time for appointments is kept as short as possible.

Mammography

Mammography is a specialized examination using X-rays for the diagnosis of breast cancer and other benign breast diseases. Mammography services include screening examinations for asymptomatic patients, diagnostic examinations for symptomatic breast diseases, stereotactic preoperative breast marking, and consultations.

The technological features of the devices allow optimal magnification and compression techniques with a minimum radiation dose. The department provides accurate and rapid diagnostic services for screening and diagnostic mammographic examinations, including ultrasound-guided breast marking, fine-needle aspiration, and biopsies.

Interventional Procedures

Interventional radiology is a rapidly evolving medical field that uses minimally invasive techniques to assist surgical treatment and even eliminate the need for surgery in some diseases (such as cystic diseases and abscesses of the liver and kidneys). Interventional radiologists use thin needles and catheters, assisted by fluoroscopy and other imaging modalities, to reach the target without the need for surgical incisions or general anesthesia, treating diseases. The hospital currently performs all non-vascular interventional procedures (biliary drainage, abscess drainage, percutaneous nephrostomy, and needle biopsies for gastrointestinal and genitourinary interventional procedures), and vascular interventional procedures will be available in the near future.

Computed Tomography (CT)

Computed tomography (CT) is a radiological diagnostic method that uses X-rays to create cross-sectional images of the examined area of the body. This method eliminates the superimposition seen in classical X-ray images. CT images are more detailed than those obtained by other imaging methods such as conventional radiography and ultrasonography.

Our hospital has a 32-detector CT device that can produce detailed cross-sectional images of any part of the body, such as the brain, spine, chest, abdomen, bones, and pelvis, through spiral or sequential scanning. Virtual endoscopic and angiographic examinations can also be performed. In addition to reducing the need for surgery and providing tissue diagnosis of lesions, biopsies and interventional procedures are performed under CT guidance.

CT is the result of the combination of X-rays and computer technology. To create a CT section, it is necessary to know the attenuation value of each point in the section plane. These values are determined by measuring X-rays passing through the section plane from all directions and processing them with powerful computers. The numerical values obtained are painted with corresponding gray tones to obtain sectional images. CT images are more detailed than X-rays.

There are two main reasons for this:

Imaging of a thin slice of the body: In traditional X-rays, structures in the dimension through which the X-rays pass overlap, making it challenging to select structures with subtle density differences. This issue is eliminated in CT scans, which visualize a thin slice of the body.

Direct measurement of X-ray absorption rates of tissues: In traditional X-rays, various factors such as the film, grid, and processing factors (time, temperature, chemicals) influence the detection of X-rays passing through tissues, hindering the reflection of tissue contrast in the image. CT eliminates these obstacles, creating images directly based on the X-ray attenuation values of tissues.

Therefore, CT images reflect tissue contrast much more sensitively. As the energy used in the method is X-rays, the meaning of the grayscale tones in the images is similar to that in traditional X-rays: Darker grayscale tones indicate areas where X-rays are absorbed less compared to lighter tones.

During the examination, the patient lies on the CT scanner table without moving. The table is manually or remotely positioned into the opening of the gantry, which is part of the CT device. The device is connected to a computer. While the X-ray source makes a 360-degree rotation around the patient to be examined, detectors arranged along the gantry or aperture detect the portion of the X-ray beam passing through the body. The collected data is processed by a computer, resulting in sequential cross-sectional images of the tissues. These images can be viewed on a computer screen, and if necessary, they can be stored on an optical disk for later retrieval or transferred to film.

CT has several advantages over other X-ray examinations. It provides clear visualization of the shapes and positions of organs, soft tissues, and bones. Moreover, CT examinations assist in better evaluating diseases, helping doctors differentiate between a simple cyst (a formation surrounded by fluid or semi-fluid material) and a solid tumor (a tissue mass formed due to rapid cell proliferation, tumor). Most importantly, CT, by creating more detailed images than direct radiographs, aids in assessing the spread of cancers. Information about cancer spread guides doctors in deciding on cancer treatments such as chemotherapy, radiotherapy, surgical treatment, or specific combinations. This helps protect healthy tissues from unnecessary interventions that may have serious side effects.

CT allows the evaluation of various sections of the body, such as the brain, which cannot be adequately assessed with conventional radiographs. It also enables the early and accurate diagnosis of many diseases compared to other imaging methods. Early detection of diseases leads to better treatment outcomes, and CT, with its superior features, helps doctors save many lives.

What Are the Most Common Uses of Computed Tomography?

CT is one of the best methods for examining the chest and abdominal organs. It is a preferred method for diagnosing diseases such as lung, paranasal sinus, liver, and pancreatic diseases. CT imaging also provides guidance for minimally invasive procedures, such as biopsies, for diagnostic or therapeutic purposes. CT is frequently used for diagnostic imaging of bone structures, including the hands, feet, shoulders, and other skeletal system structures, as well as for the diagnosis of spinal bone pathologies.

In trauma cases, rapid scanning and detailed imaging capabilities make CT a valuable tool for diagnosing brain, liver, spleen, kidney, and other internal organ injuries.

Additionally, CT is used in the diagnosis of vascular pathologies that could lead to stroke, gangrene, or kidney failure consequences.

How Should One Prepare for the Procedure?

For abdominal CT examinations to obtain better imaging of the intestines, patients are typically instructed to fast and use bowel-cleansing medications the night before the test. Moreover, in cases where a contrast agent is required through the vein, at least 2-4 hours of fasting is necessary to reduce the risk of nausea and vomiting.

Patients should arrive at the hospital at least 15 minutes before the appointment time to allow sufficient time for registration processes. If an abdominal or pelvic CT scan is to be performed, the patient should arrive at the hospital 1 hour and 30 minutes before the appointment time. In such cases, patients are asked to drink a contrast agent mixed with water, which helps improve the visibility of the intestines and aids the radiologist in evaluating the images.

Metal objects can affect image quality; therefore, it is recommended not to wear clothing with metal buttons or objects during the procedure. Depending on the body area to be examined, patients may be asked to remove metal objects such as earrings, jewelry, glasses, or dentures.

Female patients should inform the medical staff if they are pregnant or if there is a possibility of pregnancy.

Mothers who are breastfeeding are typically advised not to breastfeed for 24-48 hours after the use of intravenous contrast material.

How Is the Examination Conducted?

CT examinations can be performed with or without the use of a contrast agent, depending on the evaluated area. The contrast agent can be administered through the vein, orally, or rectally, based on the nature of the examination. Subsequently, the desired region is scanned using a tomography device.

If a contrast agent is administered through the vein, it is injected using a mechanical injector during the procedure. The patient is left alone in the CT room during the procedure, but the radiology staff can easily hear the patient’s voice in the control room if there are any complaints.

For pediatric patients, parents may accompany their children, provided they wear lead aprons.

Especially for children under six years of age, staying still during the examination can be challenging. Therefore, sedation, with or without medication, may be required.

The Use of Contrast Material in CT:

Contrast material, often given through the veins, is a commonly used substance in CT scans that allows the visualization of blood vessels under X-ray. Additionally, it is used to assess the nourishment of organs and differentiate between normal and diseased tissues (tumor, mass, infarction, etc.).

The contrast material can be administered through the vein (intravenous), orally (oral), or rectally (rectal), depending on the area to be examined and the evaluation to be performed. Two of these methods or, rarely, all three may be applied, or some patients may not receive any contrast material at all.

Before administering the contrast material through the vein, the patient is informed about the risk of contrast material allergy. If the person has previously had a reaction to the used contrast material, is regularly using medication for any allergens, or has diseases such as asthma, premedication with antiallergic drugs may be required. The recommended first choice for contrast material use in case of allergies is non-ionic contrast material. These types of contrast agents have density properties similar to physiological blood.

Before administering contrast material to a patient, blood creatinine levels should be checked to assess kidney function. The use of contrast material may be contraindicated in patients with severe kidney disease. In such cases, after risk assessment and providing solutions to accelerate the elimination of the contrast material, a decision is made on whether to use contrast material or to use alternative imaging methods.

During the administration of contrast material through the vein, patients may experience a temporary sensation of warmth (flushing), a metallic taste in the mouth, or a feeling of urinating. All these sensations typically last for seconds. In some cases, there may be a brief sensation of itching or nausea. If itching persists or a rash develops, these symptoms can be eliminated with medication. Rarely, difficulty in breathing and sudden swelling of the throat may occur. It is essential to inform the technologist if such symptoms occur during the examination. The use of non-ionic contrast material significantly reduces the occurrence of these symptoms. Breastfeeding mothers who have undergone the use of contrast material are advised not to breastfeed for 24-48 hours, as it may be harmful during this period.

Department Doctors

ahmet-peker

Spec. Dr. Ahmet Peker

Radiology