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SPECIAL REQUIREMENTS

SPECIAL REQUIREMENTS TO CONSIDER WHEN COMING IN FOR RADIOGRAPHIC STUDIES AND OTHER PROCEDURES

 

X-rays are only taken on the basis of a physician’s referral.
 

X-rays, including X-ray contrast studies, are generally not performed on pregnant women and are only allowed if absolutely necessary.
 

A contraindication to intravenous X-rays with radiographic contrast (urography, computer tomography) is hypersensitivity to iodine, as the contrast material used for X-ray radiography contains iodine.
 

PREPARATIONS FOR THE PROCEDURE

 

X-ray radiography

No special preparations are required for X-rays (of lungs, bones etc). Clothing and jewellery and the like must be removed, depending on the X-ray site, before the procedure, as instructed by medical staff.
 

X-ray contrast studies of the digestive tract

You may not eat, drink or smoke in the 6 hours before the procedure.

 

Patients are given a barium sulphate suspension to drink during the procedure along with a powder that encourages gas formation (it’s important to resist the urge to belch as this would release the gas from the stomach). The procedure is then performed.
 

Intestinal tract

In the three days preceding the procedure, a diet low in foods that tend to cause gas should be followed, along with consumption of laxatives to purge the bowels. Do not eat or drink before the procedure.
 

You will be given 200-300 ml of barium contrast solution during the procedure. The movement of the radiographic contrast material through the body will be tracked by X-rays taken an hour apart until the material reaches the colon.

 

Irrigoscopy

On the day before the procedure, you will take preparations to liquefy the contents of the intestine (laxatives). On the day before the procedure, you will also drink 1.5-2 litres of fluid. If you suffer from chronic constipation, you may begin preparing the bowel already 2-3 days before the procedure.
 

On the night before and the morning of the procedure, you will receive an enema.
 

You may not eat solid food after noon the day before the procedure.
 
Twenty minutes before the procedure, you will be given preparations to relax the bowel. Under X-ray monitoring, the colon will be filled with 500 ml of barium sulphate suspension and then evacuated and air introduced into it. Images will be taken of all parts of the colon in different positions. The procedure lasts an average of 15-25 minutes.

 

Intravenous urography

Contraindications: pregnancy, decreased kidney function, hypersensitivity to contrast material.
 
Adults and children over the age of 12
 
You will follow a special diet for a few days before the procedure. Light soups and porridge are permitted. You should drink copious amounts of liquid, about 2 litres (preferably water and herbal teas). On the evening before the procedure, you will take a laxative (such as 4 tablets of bisacodyl, tablets are not to be chewed!) or other means of purging the bowels may be used after the mid-day meal (such as Fortrans or X-Prep as instructed). If necessary, you may undergo an enema.

 
Do not fast on the morning of the day of the procedure! Two to three hours before the procedure, you may drink water, tea, eat light food such as porridge and crackers. Do not consume foods that may cause gas or oily foods that are hard to digest. Also avoid carbonated beverages and alcohol. If you have constipation, you will need to eat liquefied food for 2-3 days.

 
During the procedure, a radiographic contrast agent will be injected into a vein, which may produce a feeling of warmth throughout your body. X-rays will be taken at short intervals in the kidney and bladder region. The procedure lasts 45 minutes to 1 hour.

 

Ultrasound

For ultrasound procedures directed at the joints, thyroids, mammary glands and testes, no special preparations are required.
 
If you are coming in for an ultrasound of the abdominal cavity, you may not eat anything for 6 hours prior. It is advisable to drink copious amounts of water before the procedure, including on the preceding days. If you have constipation or bloating, you should take preparations the night before and on the morning of the procedure to reduce the amount of intestinal gas (activated charcoal tablets, Espumisan). If there is a need for visualization of the bladder itself, you must come to the procedure with a full bladder – you can drink juice, water, tea (without honey or sugar).
 
If you are woman about to have a transabdominal pelvic ultrasound, you should drink up to 1.5 l of water an hour before the procedure. Conversely, if you are undergoing a transvaginal ultrasound, empty your bladder.
 
For men’s pelvic ultrasounds (prostate imaging), you should empty your bladder before the procedure if it is not intended to visualize the bladder as well. In case of bladder problems, you should come to the procedure with a full bladder!
 

Magnetic resonance imaging

Magnetic resonance imaging (MRIs) are not permitted for people with a heart pacemaker, metal particles in their eye, head or anywhere in the body, as this could cause life-threatening problems! A heart pacemaker could come to a halt in a strong magnetic field, and foreign metal objects (including, e.g., aneurysm clips if installed less than six months ago) may change position when exposed to a strong magnetic field and damage blood vessels, nerves etc. ) Metal implants installed in the last 20 years are not a contraindication for MRIs. MRIs are not discouraged during the first trimester of pregnancy.

 
When in the procedure room, leave jewellery and anything containing metal (hair clips etc), cell phones and wallets and pocketbooks and magnetic cards in the dressing area – cell phones and magnetic cards will otherwise be damaged, metal items will move when exposed to the extremely strong magnetic field and metal objects will cause shadows – artefacts in the image that reduce the MRI quality.

 

Computer tomography (CT or CAT scans)

A contraindication to CAT scans (including to CT with contrast) is pregnancy, as growing and developing foetus is sensitive to X-ray radiation, which could harm the foetus. Pregnant women may undergo CAT scans only in critical cases where the benefits clearly outweigh the potential harm from the radiation.

 
Another contraindication is iodine intolerance. The contrast substance in CT scans contains iodine, which could precipitate a strong, possible life-threatening reaction in the body in hypersensitive patients. Thus hyperthyroidism, therapeutic use of radioactive iodine and kidney insufficiency (except for dialysis patients) are contraindications as well.

 
No special preparations for CAT head scans is needed, but before entering the procedure room, you will be asked to remove jewellery (earrings, hair pins) and glasses as metal objects could leave artefacts that worsen the scan quality.
 
Nasal passages and ears do not require special preparation. Before entering the room, remove your jewellery (earrings and hair pins).
 
No special preparation is required for thyroid, bone and joint scans.
 
No special preparation is required for lung scans.
 
Before entering the procedure room, remove metal objects, jewellery, and clothing containing metal threads, buttons (neckpieces; for women, brassieres with underwire; over clothing with metal buttons and threads.
 
Upper and middle abdomen. Half an hour before the procedure, drink half a litre of water containing diluted contrast agent so that the digestive tract can be visualized.
 
Upper and middle abdomen, pelvis minor. An hour before the procedure, drink 800 ml of contrast agent solution so that the digestive tract can be visualized.
 
For procedures directed at the blood vessels (brain arteries, carotid arteries, pulmonary arteries, abdominal aorta, renal arteries), no special preparations are required.