Radiology is a branch of science that provides the diagnosis and treatment of diseases using various imaging methods, and it was started to be used in 1895 by W. Conrad Röntgen with the discovery of X-rays. X-rays started to be used in the Ottoman Empire about 2 years after its discovery, and Turkish physicians used x-rays in war surgery for the first time in the world. A year later, the first X-ray book in Turkish was published by Captain Dr. Esat Fevzi under the name 'Röntgen Ray'. In our country, new devices and diagnostic methods have been added to the adventure that started with the x-ray film, which is usually named after its discoverer, with the emergence of technological developments over time.

Today, x-ray devices that obtain images using X-rays, computerized tomography (CT), mammography, fluoroscopy and angiography devices, ultrasonography (US) working with sound waves and magnetic resonance imaging (MRI) devices that work with a large magnet and radio waves are widely used in the diagnosis of diseases. used as. While the images obtained with these devices enable the detection and diagnosis of diseases (Diagnostic Radiology), it is also possible to perform some therapeutic procedures (Interventional Radiology) with the help of these devices. Interventional radiology is a rapidly advancing branch of medicine and is the therapeutic part of radiology. Interventional radiologists perform imaging-guided minimally invasive treatments and assist other clinical branches in many aspects.

Radiology Department Imaging Devices:

Magnetic Resonance Imaging
Multislice Computed Tomography
Digital X-Ray
Ultrasonography and Doppler Ultrasonography
Digital Mammography
Digital Scope
Bone Densitometer
PACS (Image storage and communication system)
Panoramic X-Ray

MAGNETIC RESONANCE IMAGING (MRI):

It is the conversion of energy reflections sent by radiofrequency (RF) waves from living body parts in the magnetic field created with the help of magnets into images with the help of a computer. The image is formed according to the density and movement of the hydrogen (H+) atoms in the tissue. There is a 1,5-Tesla GE SIGNA explorer in our department. With this device, shooting is done 24 hours a day, 7 days a week.

MRI does not contain radiation and there is no known harm to the patient. The duration of MRI examination varies according to the region examined, the number of regions, and the preliminary diagnosis, and it takes 5 minutes. with 45 min. varies between In addition, in some cases, contrast material is given from the vein during the examination in order to improve the image quality and clarify the existing lesion in some cases.

Because MRI has the highest soft tissue resolution, it is especially used for imaging soft tissues. It is frequently used in sports injuries, in the detection of disorders such as musculoskeletal system, especially meniscus damage, herniated disc, and in the evaluation of neurological diseases. In addition to MRI techniques such as brain, neck, spine, thorax, abdomen, musculoskeletal, which are frequently used in routine, advanced MRI examinations such as cardiac MRI, prostate MRI, diffusion MRI, perfusion MRI, functional MRI and MR spectroscopy can be performed. With MR angiography, it is possible to visualize the body vessels with or without contrast material. Cardiac MRI is an imaging method that reveals the structure of the pericardium, heart chambers, valves, heart muscle, large arteries coming out of the heart, and some coronary artery diseases very easily and without the need for any medication or procedure.

MRI has no proven harm on living organisms so far. This includes pregnant women. However, MRI is not recommended in the first trimester of pregnancy, when organ development occurs. In case of absolute medical necessity, the patient can be informed and the shooting can be done. No extra preparation is required for MRI. The patient is required to fill out and sign a medical history form prior to MRI. In addition, before entering the MRI room, watch, credit cards, mobile phones, keys, necklaces, earrings, metal items, etc., which may be affected by the magnetic field. It is obligatory to remove the materials and leave them in the locker rooms.

The patient must remain still during the examination, since the slightest movement in MRI causes distortion in the MR images.

The most important disadvantage is that it cannot be examined in the presence of a pacemaker, neurostimulator, cochlear implant, magnetic foreign bodies in the eye and old ferromagnetic intracranial aneurysm clips due to its strong magnetic field. It is vital that people who have magnets or foreign objects in their body, carry metal prostheses, use pacemakers, or have had a gunshot injury inform the MRI technician about this before the examination. Patients with claustrophobia cannot enter the tunnel of the MRI device. With the help of MRI compatible anesthesia devices, safe and high-quality shooting can be performed in patients with phobia of enclosed spaces, small children and infants, and patients who cannot remain still in the shooting room.

COMPUTERIZED TOMOGRAPHY (CT):

Computed tomography is a radiological diagnostic method for creating a cross-sectional image of the examined area of ​​the body using x-rays. CT is based on x-rays. Two- and three-dimensional images of the internal structure of a body region are obtained by taking many two-dimensional X-ray images from different angles. During the CT examination, the patient lies on the table of the CT device without moving. While the X-ray source performs a 360-degree rotation around the patient to be examined, the part of the x-ray beam passing through the body is detected by the detectors, and the data obtained are processed with the help of a computer and images are created. The created digital images can be viewed on the computer screen. In addition, the images can be transferred to film or CD as well as permanently stored in the PACS to be brought back to the computer screen when necessary. Depending on the type of examination to be performed, the patient may be asked to drink contrast material as well as injecting contrast material through the arm veins. Contrast materials may cause allergic reactions in some people because they contain iodine. Before the examination, the patient should inform the technician or radiologist whether he has ever had an allergic reaction to such substances and, if any, his allergy to other substances.

Since CT X-ray is used, there is a risk of radiation. Since X-rays may harm the unborn baby, patients with suspected pregnancy should inform the technician about this before starting the examination. For patient safety, new technology (multislice multi-section) devices are obtained by minimizing the radiation dose as much as possible.

With the multi-section CT devices offered by the developing technology, the speed of the examination has increased and the section thickness of the images created by the device has become thinner. In a single breath-hold time of 15-20 seconds, the whole body region is displayed in 0.5 mm slices; Sections in different plans, 3D anatomy and detail can be revealed by processing the sections taken continuously on the computer. Thanks to the increase in the examination speed, the breath-holding time is shortened in examinations that require breath-holding, such as the abdomen and lungs. It is one of the most widely used diagnostic methods in radiology due to its easy accessibility and short examination time.

It is preferred in trauma patients, especially in fractures and organ injuries, since it can display the entire region of the body in a multi-sectional manner in a short time. Before starting treatment in patients with stroke, the presence of cerebral hemorrhage is determined by CT. It provides invaluable information in showing pulmonary vascular occlusion in rapidly developing respiratory problems, revealing sudden developing circulatory system problems and showing the cause of abdominal pain such as appendicitis (gold standard method in adult patients) and in the diagnosis of complications developing after surgery.

Lung cancer is the most common cancer and the most common cause of death. Lung tomography is a very effective and valuable diagnostic method in revealing the presence of the tumor and its relationship with the surrounding structures, lymph node enlargement, and the spread of the tumor to other organs. In types such as colon, stomach, and pancreatic cancer, the presence of cancer and its spread to nearby and distant organs can be easily detected with CT. Information about the spread and stage of cancer helps doctors to guide the treatment for cancer. It is increasingly used as an alternative to patient-disturbing procedures such as virtual endoscopy with CT and colonoscopy with virtual colonoscopy.

With the coronary CT angiography multi-slice CT device, the heart vessels can be visualized without any prior preparation, without a catheter, and in only one breath holding time. Coronary CT Angiography is a new and groundbreaking diagnostic method in the field of imaging, as it can be performed more easily and faster than classical angiography and can be performed without blood and pain.

X-RAY:

These are examinations made using X-rays. There are two digital x-ray machines in our hospital. The images taken are digital and can be viewed instantly in the outpatient clinic via the PACS system in DICOM format in our hospital.

Chest X-ray and telecardiography: Lung, heart and other chest structures are evaluated.

Vertebra X-rays: It is taken to evaluate the spinal bone structures.

Bone and joint radiographs: These were examinations to evaluate bones and joints in conditions such as bone fractures, masses or rheumatic diseases.

Extremity X-rays: It is requested to evaluate the arm and leg bones.

Head X-rays: Often taken in trauma patients to evaluate the skull and facial bones.

Paranasal sinus radiographs: It is the examination applied for the evaluation of sinus structures and the diagnosis of sinusitis.

Direct urinary system graphy: It is used to evaluate urinary system stones.

Standing direct abdominal X-ray: It is the first examination to diagnose bowel obstruction and perforation.

FLUOROSCOPY:

Fluoroscopy, also called scopy, is a medical imaging technique used to take real-time (live) images of the patient with the help of a device called fluoroscope. X-ray is used.

ULTRASOUND (US):

Sound waves are used for ultrasound, not X-rays. High-frequency (2-15 MHz) sound waves are emitted from the mobile part of the device (probe) that the human ear cannot hear. These waves are reflected back as they pass through mediums of varying densities inside the body. These back reflections are collected by the part we call the probe and sent to the computer of the device and made into an image. Since sound waves do not contain X-rays, there is no radiation effect. Since it has no known harmful effects on humans, it can be safely repeated (in case harmful effects can be detected in the future), provided that it is not excessive. Since the application is easy and harmless, it is frequently applied in the imaging of internal organs and in the diagnosis of diseases.

Since the ultrasound device does not transmit sound waves well, it cannot image organs and bone structures containing air or gas. Ultrasonography is most commonly used for examination of the liver, spleen, gallbladder, biliary tract, pancreas, kidney, bladder, uterus, ovaries and prostate in the abdomen. It is used as the first imaging method in the evaluation of gallbladder and biliary tract and genitourinary diseases, especially due to abdominal pain. The second most common usage area is pregnancy and gynecological diseases. Ultrasound is the best method used to understand whether the baby's development is normal during pregnancy. No proven side effects of ultrasound on the baby have been reported so far. Therefore, ultrasonography can be used safely during pregnancy. The most important disadvantage of ultrasound in pregnancy is that it cannot show all the baby abnormalities. Apart from this, it is a reliable diagnostic method in the evaluation of neck, thyroid gland, salivary glands, breast, muscles and joints, penis and testicles and superficial soft tissues.

There are 1 TOSHIBA xario and 1 Mindray DC 8 ultrasound and Doppler ultrasound devices in our department.

DOPPLER ULTRASOUND:

It can be mixed and almost all ultrasound devices in today's technology have Doppler features. No separate device is required for Doppler or color doppler. Color Doppler US is a new US technique that shows the presence, direction and velocity of blood flow in the vessels by color coding the blood flow. It is used in the diagnosis of artery and vein diseases and in the evaluation of the blood supply of the masses detected in the body. It is a reliable diagnostic method especially if it is easy to use and well done in the diagnosis of vascular diseases such as vascular occlusion and varicose veins.

MAMOGRAPHY:

Mammography is a type of X-ray film that uses X-rays. It is the most effective imaging method used in breast cancer screening. Breast cancer is the most common type of cancer in women and early diagnosis is very important. Early diagnosis of breast cancer is possible with mammography, which is performed to detect cancers that are too small to be detected by examination.

The American Cancer Institute, the World Health Organization and the Turkish Radiology Association recommend that women over the age of 40 have a mammogram every year. Routine mammography before the age of 40 is not recommended except for high-risk patients. Because of the dense breast tissue from the young-milk gland, a good image cannot be taken.

During the shooting, the nozzles must be compressed between the two plates on the device. In this way, the overlapping of the breast tissue is prevented and the appearance of the masses is ensured. While this compression improves the image quality, it also reduces the radiation dose to be exposed during the examination.

It is recommended that mammography be taken between the 7th and 14th days of menstruation, which is the period when breast swelling and tenderness are the least. Since residues such as sweat, perfume, deodorant, powder, etc. can give misleading results, it is recommended to take a shower before having a mammogram and not to use such substances.

BONE MINERALS DENSITY TEST (BONE DENCITOMETER =DXA ):

X-ray is a method used. The amount of radiation used is extremely low, one-tenth of a lung film. Minerals such as calcium and phosphorus constitute an important part of the bone structure. Bone densitometry scan is a test to measure bone mineral density and evaluate bone mineral density loss. The purpose of bone density (density) measurement methods is to determine the quantitative ratio of this mineral part of the bone. The more the loss of minerals in the bone, the lower the density is measured, in this case, it is interpreted as a decrease in bone mineral density, that is, osteoporosis has occurred. This test is used to diagnose osteoporosis, which develops as a result of calcium loss in the bones.

What is the Bone Mineral Density Test used for?

A bone mineral density test is often used to diagnose osteoporosis, which affects postmenopausal women but can occur rarely in men and children. With the bone mineral density test, the risk of developing fractures can also be evaluated.

Who is bone density measurement performed for?

Postmenopausal women.
Patients with diseases associated with loss of bone density.
Women at high risk for osteoporosis in the premenopausal period.
Women who have surgically entered menopause (both ovaries removed).
Women with postmenopausal risk factors.
Those with a family history of osteoporosis
2.5 cm per year.
For those with more stature
for those over 65.
For those on a calcium-poor diet.
Those who have decreased bone density in the X-ray.
For those who have to be inactive for more than 1 month.

No preparation is required for bone density measurement. Try not to eat foods containing calcium 24 hours in advance. Try to wear light and comfortable clothes that do not contain metal buttons or zippers. If you have recently (within the last 1 week) barium examination (taken by mouth), radioisotope scanning or contrast use in computed tomography, inform your doctor. In this case, you may be asked to wait 10 or 14 days for the bone densitometry examination.

If you are pregnant or likely to be pregnant, please inform your doctor or the relevant technician.

How often should bone density measurement be done?

Although it varies according to the degree of osteoporosis and the treatment given, spine and hip bone density measurements should be performed every 2 years in menopausal high-risk patients and every 5 years in low-risk patients. Depending on the severity of osteoporosis and the treatment applied, the frequency of recurrence will be indicated to you by your physician.