A barium enema is an X-ray procedure to examine the lower part of the gastro-intestinal tract (large bowel). Barium is a thick white chalky substance that shows up on an X-ray. Barium moves quickly through the gastrointestinal tract and is not easily absorbed by the body. This procedure allows a clear picture of the outline of the bowel and shows up any abnormalities. The test takes around 45 minutes. What to expect? A barium enema requires special preparation and it is important to carry out the instructions you are given, otherwise the procedure may not be carried out or give good enough results. The bowel must be clean and clear of faeces and gas before the examination. You will be sent special dietary instructions for the day before your examination, such as having clear fluids and then a specified prescriptive laxative must be taken. You should not eat or drink anything for 6 hours before your appointment. During the procedure, you will lie on your side upon an X-ray table. A well-lubricated tube is gently inserted into the rectum and barium and air is introduced into the colon. You will then be asked to move into a number of different positions, to ensure that the barium coats all the surfaces of the bowel. This helps to achieve a good examination. X-rays will be taken during the examination and you will be required to hold your breath for each X-ray taken. This examination is not a comfortable one; most people have a feeling of fullness of the bowel during the procedure, lower abdominal cramping and the urge to pass wind or a bowel motion. Sometimes intravenous medication is given to help relax the bowel and reduce the discomfort from the procedure. 230911PH

A biopsy involves a specially designed needle used to remove a small piece of tissue for examination under a microscope. The area being investigated will be numbed with a local anaesthetic before the tissue sample is taken. What to expect Liver, Kidney or Lung Biopsy You will be sent a form and asked to have a blood test one week before your biopsy. On the day of your biopsy, you will be admitted to the Radiology Department for about 5 hours and the actual procedure will be carried out in the Ultrasound Department. The biopsy only takes a few seconds, but you will be asked to remain resting on a bed in the Radiology Department for at least 4 hours. During this time, your blood pressure and pulse will be checked regularly. You will be allowed to go home in the afternoon but arrange for someone else to drive you home. Do not plan to do anything too energetic for the next 2 days. About one third of patients find they are a bit sore at the time of or soon after the biopsy and need some medication to help relieve the pain. Thyroid Biopsy (Fine Needle Aspiration) This procedure is carried out in the Ultrasound Department. The biopsy only takes a few seconds, but you will be asked to stay in the Radiology department for about 20 minutes after the procedure. Some patients are a bit sore at the time of the biopsy (aspiration) or soon afterwards and may need some Panadol to relieve the pain. CT Guided Needle Biopsy Before your biopsy appointment, you will be asked to have some blood tests at a laboratory. You will also be asked some questions about medicines you are taking and about any blood clotting problems that you may have. After the procedure is over, you may have to stay at the hospital for up to 2 hours. You should arrange for someone else to drive you home. 230911PH

You may have an ultrasound examination before a mammogram if you are young or presently breastfeeding and find a lump. This is because in these cases the breast tissue is denser and ultrasound will give more information than an x-ray. What to expect For this, you will lie on a bed with your breast exposed. The scanner head will be moved over your breast after a contact gel has been applied. At the same time the internal images will appear onto a TV screen and pictures are taken of these. 230911PH

This breast procedure is needed to clearly show which part of the breast tissue needs to be removed during your operation. What to expect The skin around the area is cleaned with a sterilising solution, then numbed with a local anaesthetic. A fine needle is then inserted into that area and the mammography machine is used to take films to check the position of the needle. Your breast will not be flattened as much as during a normal mammogram. A very fine wire with a hook on the end follows the length of the needle and remains in the breast until you have your operation. 230911PH

A mammogram is a special type of x-ray used only for the breast. Mammography can be used either to look for very early breast cancer in women without breast symptoms (screening) or to examine women who do have breast symptoms (diagnostic). If you are having a mammogram because you have found a lump, it is important to remember that most breast lumps are not cancer, but the only way to be certain is to have it tested. What to expect? Tell the radiographer if you are, or think you may be, pregnant. Do not use talcum powder or underarm deodorant on the day of your examination as these can show up on the pictures. If you get severe breast pain connected with your menstrual cycle, it is better to make your appointment for the week after your period. You will need to undress from the waist up and a gown will be provided. One of your breasts will be positioned between two plastic plates that will flatten the breast slightly. This lasts only a few seconds and cannot do any permanent damage to your breast. The flatter the breast, the better the quality of the picture, making it easier for the radiologist to read. Most women find that this is a bit uncomfortable, but not painful. Generally two x-rays are taken of each breast. It is also useful to compare the results with earlier examinations and you should take any previous mammography results with you. The mammograms are looked at by radiologists who then send a report to your doctor. This process usually takes about a week. Sometimes, after a mammogram, you may be asked to have an ultrasound as well if the radiologist wants to find out more about a lump or a dense area of tissue in the breast (see Breast Ultrasound). 230911PH

Your mammogram has shown an area of tissue that needs to be examined more closely. During this procedure, a needle is inserted into the breast and a small amount of tissue will be taken out for examination under a microscope. The images from the mammography machine are used to make sure that the samples are taken from the correct area. What to expect Local anaesthetic is used so that the area around the biopsy site will be numb. You will either lie down on the bed or sit on a chair during the procedure, which will take about one hour. You will be able to drive home afterwards but do not plan to do anything too energetic that day. The results will take about one week to come back from the laboratory to the breast specialist. 230911PH

Your breast ultrasound has shown an area of tissue that needs to be examined more closely. During this procedure, a needle is inserted into the breast and a small amount of tissue will be taken out for examination under a microscope. The ultrasound machine is used to show the exact location of the area to be sampled. What to expect Local anaesthetic is used so that the area around the biopsy site will be numb. You will lie down on the bed during the procedure, which will take about 45 minutes. You will be able to drive home afterwards but do not plan to do anything too energetic that day. The results will take about one week to come back from the laboratory to the breast specialist. 230911PH

This is a special x-ray examination which, with the help of a computer, produces cross-wise picture slices of your body. These pictures are displayed on a TV screen. CT is used to view all body structures but especially soft tissue such as body organs (heart, lungs, liver etc.). What to expect? You will be asked to remove all metal objects from the area to be scanned. You will lie down on a narrow padded moveable table that will be slid into the scanner, through a circular opening. You will feel nothing while the scan is in progress, but some people can feel slightly claustrophobic or closed in, whilst inside the scanner. You will be asked to remain still and hold your breath on command. There are staff present, they will not necessarily remain in the room, but will speak with you via an intercom system and will be viewing the procedure constantly through a windowed control room, from where they will run the scanner. If you are having a scan of your stomach and intestines (CT abdomen), you may have to take a special liquid to drink beforehand to give a clearer picture. If you are having a scan of your bowel (CT colonography), you will be sent detailed instructions on what you should eat and drink the day before the examination. Some procedures will require a Contrast medium to be injected into a vein usually on the inside of your elbow or the back of your hand. Contrast medium is a colourless dye that makes the image of the CT scan clearer. Before you are given the injection, you will be asked some questions to make sure that it is safe for you and asked to sign a form agreeing to receive the dye. The scan time will vary depending on the type of examination required, but as a rule it will take around 30 minutes. Children Because the patient must lie completely still for their scan, we sometimes give children under 5 years a general anaesthetic so that they sleep throughout the procedure. If your child is given a general anaesthetic it will mean that your child will not be able to eat for 6 hours before coming to the hospital. After the procedure, you will need to wait at the hospital until your child is properly awake before going home. It may be a good idea to bring a favourite toy or book and a bottle, if necessary, for when your child wakes up. 270215TMS

This is a special type of x-ray to examine your uterus. We cannot do this test if you are pregnant or even if there is a chance that you may be pregnant. You will need to contact us and arrange an appointment date depending on the timing of your menstrual cycle. 230911PH

In this procedure, phenol is injected into nerves in the back to help relieve pain and increase blood flow to the skin of the leg. The CT machine is used to make sure the injection is in exactly the right place. What to expect You will be admitted to the hospital and asked to sign a consent form saying that you agree to have the procedure. You are not able to eat or drink anything for 4 hours before the procedure. You will need to change into a hospital gown (but can stay in your own underwear) and will then be taken on a bed to the CT Department where the procedure will be carried out. You will be given an injection of a local anaesthetic and asked to lie still on your side for 15-20 minutes until the procedure is finished. For 3 hours after the procedure, a nurse will check your blood pressure and pulse regularly. You might have to stay in hospital overnight, but if you are allowed to go home you must have someone drive you home and stay with you. 230911PH

What is MRI? Magnetic Resonance Imaging (MRI) is a unique way of showing structures in the body using a strong magnetic field and harmless low energy radio waves. No x-rays are used. What Happens During the Scan? You lie on a special table which moves into the tunnel of the machine. You need to keep very still during the examination. The scan can take from 30 minutes to an hour. At times the machine makes loud knocking noises. Some people find the tunnel in the machine confining. Please inform staff at the time of your booking if you know you are very claustrophobic (uncomfortable in small spaces). Is Any Special Preparation Necessary? All loose metal objects, safety pins, hairclips, watches and credit cards must be left outside the scan room. Lockers are provided. Patients will be required to complete a questionnaire to ensure it is safe for you to go into the MRI machine. If you answer "yes" to any questions it is very important that you inform staff at the time you make your appointment. Where Procedure is Performed The MRI scanner is situated at the end of the CT corridor in the Middlemore Galbraith Block. The hours of service are 8.30am - 5pm. 230911PH

This procedure involves the insertion of a needle into the affected place in the body, then radio-frequency waves are directed at a very small area to destroy the target cells. What to expect You will be admitted to the hospital for this procedure which will be carried out in the CT Department. Because this procedure can be painful and because it is very important to stay completely still, you will be given a general anaesthetic so that you are asleep throughout the procedure. This means that you cannot eat or drink for 6 hours beforehand. You will need to bring with you what you need to stay in the hospital overnight and arrange for someone else to drive you home the next day. 230911PH

In ultrasound, a beam of sound at a very high frequency (that cannot be heard) is sent into the body from a small vibrating crystal in a hand-held scanner head. When the beam meets a surface between tissues of different density, echoes of the sound beam are sent back into the scanner head. The time between sending the sound and receiving the echo back is fed into a computer, which in turn creates an image that is projected on a television screen. Ultrasound is a very safe type of imaging; this is why it is so widely used during pregnancy. Doppler Ultrasound A Doppler study is a noninvasive test that can be used to evaluate blood flow by bouncing high-frequency sound waves (ultrasound) off red blood cells. The Doppler Effect is a change in the frequency of sound waves caused by moving objects. A Doppler study can estimate how fast blood flows by measuring the rate of change in its pitch (frequency). A Doppler study can help diagnose blood clots, heart and leg valve problems and blocked or narrowed arteries. What to expect? Please come to the reception desk of the Radiology Department 15 minutes before your appointment. You will be sent detailed instructions if you need to do anything to prepare for your examination (e.g. not drink or eat for 6 hours before for a stomach examination or drink a certain amount of fluid 90 minutes before for a pelvic examination). Your examination will usually last between 1 and 2 hours. After lying down, the area to be examined will be exposed. Generally a contact gel will be used between the scanner head and skin. The scanner head is then pressed against your skin and moved around and over the area to be examined. At the same time the internal images will appear on a screen. 230911PH

An X-ray is a high frequency, high energy wave form. It cannot be seen with the naked eye, but can be picked up on a photographic plate. Although you may think of an X-ray as a picture of bones, a trained observer can also see air spaces, like the lungs (which look black) and fluid (which looks white, but not as white as bones). What to expect? You will be asked to remove all metal objects from the area to be x-rayed. You will be asked to remain still in a specific position and hold your breath on command. There are staff present, they will not necessarily remain in the room, but will speak with you via an intercom system and will be viewing the procedure constantly through a windowed control room. The examination time will vary depending on the type of examination required, but as a rule it will take around 30 minutes. 230911PH