Radiology Department Selayang Hospital

Introduction The Diagnostic Imaging Department provides a wide range of diagnostic imaging services: including CT scanning, Mammography, MRI scanning, Ultrasound scanning, Angiography & Interventional Procedures, Fluoroscopy and General Radiography. The department operates on the paperless and filmless concept using the Radiology Information System (RIS) and Picture Archiving and Communication System (PACS).These systems are fully integrated with the Hospital Information System (HIS) and Electronic Medical Record (EMR). Fully integrated system has resulted in reduction of patients waiting time, rapid access of images and reports by clinicians, and a more efficient workflow. The department provides inpatient and outpatient services  with a total radiological examination of about 125,000 per year.   Vision & Mission Vision: To fulfill the needs of the customer and remain the foremost fully digital radiology department in Malaysia. Missions: To provide high quality diagnostic and interventional radiology services in an efficient and cost effective manner To use appropriate sophisticated  and up to date technology To take into consideration the needs, comfort and convenience of the patient To work as a team towards providing the highest quality of care for our patient To continue updating our knowledge thus ensuring the best radiological management for our patients   Services The department provides diagnostic and interventional services for patients of all age group and disciplines. Mobile services are provided for the critically ill and non-ambulatory patient. Emergency radiology services are provided 24 hours a day. Diagnostic Imaging services: General radiography (Computed Radiography & Direct Digital System) Computerised Tomography (CT) Magnetic Resonance Imaging (MRI) Mammography (Full Field Digital Mammography) Ultrasonography Fluoroscopy Angiography Mobile services: General Radiography including Forensic Radiography Ultrasonography. Mobile C-Arm Image Intensifier. Interventional Radiology Services: Biopsy Drainage Stent insertion Radio-frequency ablation Chemo-embolisation Percutaneous  ablative injections Fistuloplasty   For our patients Locations: The Main Department : 2nd floor. Emergency Unit : 2nd Floor Specialist Clinic Unit : 4th Floor On your arrival our personnel at the reception counter will direct you to the relevant examination room. Examinations requiring special patient preparation: Ultrasound – Hepatobiliary System / Urinary System, CT, and MRI scans Special procedures, angiography and interventional examinations Most gastro-intestinal (GI) and urinary tract examinations including intravenous urogram (IVU), studies of the esophagus (barium swallow), stomach (barium meal) and colon (barium enema) Mammography (breast imaging) To ensure successful examination it is important that you follow any instructions about examinations requiring special patient preparation that are given and discussed with you at the time when the appointment is made. Useful things to bring / have with you: Reading materials, puzzles / crosswords, pen and paper. Belongings and valuables: Please avoid bringing valuables to the department. Please keep your belongings and valuables (if any) with you at all time. Clothing: You may be asked to change to our examination gown for your examination. Hand Washing And Scrub: Hand washing facilities and alcohol rub are available and encouraged for patient and visitor use. Our Personnel: Different types of personnel are involved in performing imaging procedures: Radiologist Medical Officers Radiographer Nurse We can provide an area of quiet and privacy for mothers who need to breast-feed. The department has a water dispenser available for patients and visitors. Toilets are available for both patients and visitors in our waiting area.   Opening Hours Monday to Friday 7.30 am to 5:00 pm Saturdays, Sundays & Public Holidays Closed An on-call service is provided 24 hours each day for urgent and emergency procedures. Enquiries: Contact Telephone Numbers: General Enquiries: +6 03 61203233 ext 2134 & 2135 MRI Enquiries &  Appointments +6 03 61203233 ext 2234 Ultrasound Enquiries & Appointments: +6 03 61203233 ext 2151 Angiography & Interventional Procedures Enquiries & Appointments: +6 03 61203233 ext 2161 Mammography Enquiries & Appointments: +6 03 61203233 ext 2155 All Other Appointments: +6 03 61203233 ext 2134 & 2135 We want to make your stay in our department comfortable. Please bear with us if there is a short delay. We might be waiting for an imaging procedure on another patient to be completed. Please do not hesitate to ask any questions if you think you have waiting for too long. Our personnel are committed to provide the highest attainable standard of care. We strive to continually improve our service and value feedback: Please address your feedback to: Head of Department, Department of Diagnostic Imaging, Selayang Hospital, 68100 BATU CAVES. Tel : +6 03 6126 3444 Fax : +6 03 61370857 E-Mail :   daudis@sel.moh.gov.my source:  http://hselayang.moh.gov.my/

Special Examination Description:

Mammography

 

       Mammography is the process of using low-energy X-rays (usually around 30 kVp) to examine the human breast and is used as a diagnostic and a screening tool. The goal of mammography is the early detection of breast cancer, typically through detection of characteristic masses and/or microcalcifications.

       Like all X-rays, mammograms use doses of ionizing radiation to create images. Radiologists then analyze the images for any abnormal findings. It is normal to use lower-energy X-rays (typically Mo-K) than those used for radiography of bones. Ultrasound, ductography, positron emission mammography (PEM), and magnetic resonance imaging (MRI) are adjuncts to mammography. Ultrasound is typically used for further evaluation of masses found on mammography or palpable masses not seen on mammograms. Ductograms are still used in some institutions for evaluation of bloody nipple discharge when the mammogram is non-diagnostic. MRI can be useful for further evaluation of questionable findings as well as for screening pre-surgical evaluation in patients with known breast cancer to detect any additional lesions that might change the surgical approach, for instance from breast-conserving lumpectomy to mastectomy. New procedures, not yet approved for use in the general public, including breast tomosynthesis, may offer benefits in years to come.

       For the average woman, the U.S. Preventive Services Task Force recommended (2009) mammography every two years in women between the ages of 50 and 74. The European Cancer Observatory (2011) recommends mammography every 2–3 years between 50 and 69.These task force reports point out that in addition to unnecessary surgery and anxiety, the risks of more frequent mammograms include a small but significant increase in breast cancer induced by radiation.The Cochrane Collaboration (2011) concluded that mammograms reduce mortality from breast cancer by an absolute amount of 0.05% or a relative amount of 15%, but also result in unnecessary surgery and anxiety, resulting in their view that it is not clear whether mammography screening does more good or harm.They thus state that universal screening may not be reasonable.

       Mammography has a false-negative (missed cancer) rate of at least 10 percent. This is partly due to dense tissues obscuring the cancer and the fact that the appearance of cancer on mammograms has a large overlap with the appearance of normal tissues. A meta-analysis review of programs in countries with organized screening found 52% over-diagnosis.

Computerised Tomography

 

       Example of a CTPA, demonstrating a saddle embolus (dark horizontal line) occluding the pulmonary arteries (bright white triangle).

       X-ray computed tomography, also computed tomography (CT scan) or computed axial tomography (CAT scan), is a medical imaging procedure that utilizes computer-processed X-rays to produce tomographic images or 'slices' of specific areas of the body. These cross-sectional images are used for diagnostic and therapeutic purposes in various medical disciplines.Digital geometry processing is used to generate a three-dimensional image of the inside of an object from a large series of two-dimensional X-ray images taken around a single axis of rotation.

      Schematic representation of CT scanner

       CT produces a volume of data that can be manipulated, through a process known as "windowing", in order to demonstrate various bodily structures based on their ability to block the X-ray beam. Although historically the images generated were in the axial or transverse plane, perpendicular to the long axis of the body, modern scanners allow this volume of data to be reformatted in various planes or even as volumetric (3D) representations of structures. Although most common in medicine, CT is also used in other fields, such as nondestructive materials testing. Another example is archaeological uses such as imaging the contents of sarcophagi.

       Usage of CT has increased dramatically over the last two decades in many countries.An estimated 72 million scans were performed in the United States in 2007.It is estimated that 0.4% of current cancers in the United States are due to CTs performed in the past and that this may increase to as high as 1.5-2% with 2007 rates of CT usage;however, this estimate is disputed. Kidney problems following intravenous contrast agents may also be a concern in some types of studies.

Magnetic Resonance Imaging

 

       Magnetic resonance imaging (MRI), nuclear magnetic resonance imaging (NMRI), or magnetic resonance tomography (MRT) is a medical imaging technique used in radiology to visualize internal structures of the body in detail. MRI makes use of the property of nuclear magnetic resonance (NMR) to image nuclei of atoms inside the body.

       An MRI scanner is a device in which the patient lies within a large, powerful magnet where the magnetic field is used to align the magnetization of some atomic nuclei in the body, and radio frequency fields to systematically alter the alignment of this magnetization.^[1] This causes the nuclei to produce a rotating magnetic field detectable by the scanner—and this information is recorded to construct an image of the scanned area of the body.Magnetic field gradients cause nuclei at different locations to rotate at different speeds. By using gradients in different directions 2D images or 3D volumes can be obtained in any arbitrary orientation.

       MRI provides good contrast between the different soft tissues of the body, which makes it especially useful in imaging the brain, muscles, the heart, and cancers compared with other medical imaging techniques such as computed tomography (CT) or X-rays. Unlike CT scans or traditional X-rays, MRI does not use ionizing radiation.

Angiography

Angiogram showing a transverse projection of the vertebrobasilar and posterior cerebral circulation.

       Angiography or arteriography is a medical imaging technique used to visualize the inside, or lumen, of blood vessels and organs of the body, with particular interest in the arteries, veins and the heart chambers. This is traditionally done by injecting a radio-opaque contrast agent into the blood vessel and imaging using X-ray based techniques such as fluoroscopy.

       The word itself comes from the Greek words angeion, "vessel", and graphein, "to write" or "record". The film or image of the blood vessels is called an angiograph, or more commonly, an angiogram. Though the word itself can describe both an arteriogram and a venogram, in its everyday usage, the terms angiogram and arteriogram are often used synonymously, whereas the term venogram is used more precisely.

       The term angiography is strictly defined as based on projectional radiography; however, the term has been applied to newer vascular imaging techniques such as CT angiography and MR angiography. The term isotope angiography has also been used, although this more correctly is referred to as isotope perfusion scanning.

Ultrasonography

 

       Diagnostic sonography (ultrasonography) is an ultrasound-based diagnostic imaging technique used for visualizing subcutaneous body structures including tendons, muscles, joints, vessels and internal organs for possible pathology or lesions. Obstetric sonography is commonly used during pregnancy and is widely recognized by the public.

       In physics, the term "ultrasound" applies to all sound waves with a frequency above the audible range of normal human hearing, about 20 kHz. The frequencies used in diagnostic ultrasound are typically between 2 and 18 MHz.