INSIDE YOUR GUIDE TO MEDICAL IMAGING

WRITER: MARIANA DE JONGH, M.D.

My doctor has ordered an X-ray — or was it a CT scan? — or an MRI? — or was it an ultrasound? It’s hard to keep track. Medical imaging — this is the incredible science (and sometimes, the art) of looking within the human body without the doctor using a single blade or the patient shedding a single drop of blood. One of the major advances is that virtually all imaging studies are saved digitally on computers. Digital images can be viewed on-screen within minutes. A radiologist views and interprets the results and sends a report to your doctor, who then explains the results to you. If necessary, your imaging results can be made available to your doctor in minutes.

X-rays are the “old school” form of medical imaging. Accidentally discovered by German scientist Wilhelm Rontgen in 1895, X-rays are waves of electromagnetic energy, which behave in a very similar way to light rays. This painless test produces images of what is inside your body when the X-rays pass through tissue, which is low-density, and are blocked by denser material, like bone. For some types of X-ray tests, a contrast medium (such as iodine or barium) is introduced into your body to provide greater detail on the X-ray images.

Medical X-ray machines are often grouped into two categories: “hard” or “soft” X-rays. Soft X-rays, which operate at a relatively low frequency, are used to diagnose fractures, arthritis, osteoporosis, lung infections or conditions, enlarged heart, bowel obstructions, or swallowed items. The amount of radiation you are exposed to during a soft X-ray is so small that the risk of any damage to cells in your body is extremely low.

On the other hand, hard X-rays use very high frequencies designed to destroy molecules within specific cells. When hard X-rays are used, tissue is destroyed, which is why these are often used in radiotherapy, particularly for the treatment of cancer.

Ultrasound is a safe procedure that uses low-power, high frequency sound waves to produce relatively precise images of structures within your body. Ultrasound may be used, for example, to assess a fetus, diagnose gallbladder disease, evaluate flow in blood vessels, assess a breast lump, check your thyroid gland, study your heart, and diagnose some forms of infection. Ultrasound is also used as a therapeutic tool for treating musculoskeletal problems, kidney stones, and gall stones. The benefit of ultrasound images is that they capture internal movement in real time. Therefore, doctors can observe how blood flows through the vessels, how internal organs are working, or the physical health and progress of a fetus. There are no direct risks from a diagnostic ultrasound exam. It is non-ionizing radiation, so it does not have the same risks as X-rays or other types of ionizing radiation.

Computerized tomography (also called CT) combines a series of X-ray views taken from many different angles and computer processing to create cross-sectional images of the bones and soft tissues inside your body. Tomography originates from the Greek word “tomos,” meaning “slice” or “section,” and “graphia,” meaning “describing.” Therefore, looking at CT images is like looking down at single slices of bread from a loaf. Your doctor will be able to look at each of these slices individually or perform additional visualization to view your body from different angles, far more detailed than an X-ray. A CT scanner emits a series of narrow beams through the human body as it moves through an arc, unlike an X-ray machine which sends just one radiation beam. In some cases, CT images can be combined to create 3-D images. puted-tomography-ct-scan-of-the-body: CT scan; http://www.mayoclinic.com/health/

A CT scan can be used to visualize nearly all parts of the body and used to diagnose disorders of the muscle or bone; localize a tumor, blood clot, or infection; guide certain surgeries, biopsies, or treatment with radiation therapy; detect and subsequently monitor conditions such as heart disease, cancer and masses, lesions, or cyst of various organs such as the lung, liver, pancreas, and kidneys (among others); and detect internal injuries and/or internal bleeding.

SOURCE: Radiation-Emitting Products; http://www.fda.gov/Radiation-EmittingProducts/RadiationEmittingProductsandProcedures/MedicalImagin g/MedicalX-Rays/default.htm: X-ray machine; HYPERLINK “http://www.faqs.org/ health/topics/96/X-ray-machine.html#ixzz2Dzp5sZAA” http://www.faqs.org/health/topics/96/X-ray-machine.html#ixzz2Dzp5sZAA: What Is An Ultrasound?; http://ehealthmd.com/content/what-ultrasound: Ultrasound; http:// www.mayoclinic.com/health/ultrasound/MY00308: Computed Tomography (CT) Scan of the Body; http://www.webmd.com/a-to-z-guides/com ct-scan/MY00309: Magnetic Resonance Imaging (MRI);http://www.webmd.com/a-to-z-guides/magnetic-resonance-imaging-mri Radiation E xposure From Medical Diagnostic Imaging Procedures Health Physics Society Fact Sheet; http://hps.org/documents/meddiagimaging.pdf (Accessed December 4, 2012)

The Cumulative Effects Of Ionizing Radiation

When being subjected to any form of ionizing radiation in medical testing, no matter how low the dose and no matter what test is being performed, it is of importance to keep in mind that the effects of radiation exposure are considered to be cumulative. This means that even though you may be subjected to what is considered to be low doses of “soft” radiation, the damage done to the cells of the body add up as the number of procedures you are subjected to increases.

According to the Health Physics Society, the normal person is exposed to 300 millirems (mrem) of background radiation each year just through living on the Earth. The typical chest X-ray delivers only 4 mrem of radiation, so it is considered to be a very low dose of radiation. However, certain procedures such as an angioplasty heart study may deliver up to 5,700 mrem at one time. And health physicists also warn that different machines deliver different doses for the same type of test.

However, please remember that the HPS insists that the necessity of medical testing far outweighs any dangers from radiation exposure.

Doctors use the lowest dose of radiation possible. Newer machines and techniques may expose you to less radiation. Sometimes a contrast dye is used for CT scans to help highlight the areas of your body being examined. If a 3-D image of the abdomen is required, the patient may have to drink a barium meal. The barium appears white on the scan as it travels through the digestive system. Contrast material can enter your body in a variety of ways, including, orally, intravenously (IV), and/ or rectally. The main risks associated with CT are the possibility of an increased lifetime risk of cancer due to X-ray radiation exposure and possible allergic reactions or kidney failure due to the contrast that is sometimes used to improve visualization. Still, when medically indicated, CT scans have many benefits that generally outweigh potential risks.

Magnetic resonance imaging (MRI) is a technique that, unlike X-rays, uses a magnetic field and radio waves to create detailed images of the organs and tissues within your body.

Most MRI machines are large, tube-shaped magnets. When you lie down, a radio frequency is used to knock your hydrogen atoms out of line. You won’t feel a thing, but as they move back to their natural alignment, each hydrogen atom in your cells will emit a tiny electric signal. The MRI scanner has strong magnets that will detect the electric signal. A computer uses these signals to create a detailed image of your soft tissues. The MRI machine can also be used to produce 3-D images that may be viewed from many different angles. MRIs allow doctors to see structures inside joints like tissues or tendons and diagnose a variety of problems like brain aneurysms, multiple sclerosis, stroke, brain tumors, heart function, the extent of heart disease, and blockages of blood vessels; and diagnose and subsequently monitor tumors and other abnormalities of many organs such as the liver, kidneys, spleen, pancreas, uterus and ovaries, and bone and joint disorders such as arthritis, infection, or cancer. More recently, MRIs have been used in addition to mammography to detect breast cancer. When a doctor can see these structures inside they are able to correctly diagnose and treat the injury or disease much earlier.

Tell the technologist if you have any metal or electronic devices in your body, as they can be dangerous in an MRI.

It is also important to discuss any kidney or liver problems with your physician and the technologist. Problems with these organs may impose limitations on the use of injected contrast agents during your scan.

Now, back to your doctor visit — it is likely that medical imaging will continue to be a subject that is sometimes hard to grasp or comprehend. Particularly when you, as a patient, receive and read a written report of a study you had done. The degree of detail in each report and the many findings that can be labeled as “abnormal” can be overwhelming. Now that medical imaging has become so precise, a lot of these findings labeled “abnormal” end up being non-significant, variations of what is “normal” and something that we may need to keep an eye on but is by no means dangerous. Keep in mind, physicians complete many years of training to be able to describe to us what lies within our bodies and distinguish what is normal from what isn’t… sometimes with only a picture to go on.

What To Look For In A Lotion

WRITER: RUTH ANN BYRD

The skin is the body’s largest organ, with its intricate design providing a protective barrier for the entire body. Dry skin can develop tiny cracks that let in bacteria and compromise the skin’s ability to function properly. Unless you want to outlive your skin you must take care of it. Drinking lots of water and eating foods high in healthy fats containing essential fatty acids (flaxseed, fish oil, avocado) will nourish the skin from the inside just as daily application of moisturizers will condition and nourish the skin externally.

Do body lotions differ from facial lotions? The answer is yes: Facial skin differs from body skin. The face has more pores. It is thinner and more vascular. These characteristics make facial skin more reactive and sensitive to harsh chemicals. Body lotions are not generally formulated for use on the face, and vice versa.

So what does one look for in a body lotion? For the true story, you must read the ingredient list, not the catchy slogans on the front label. You will then see that the first three ingredients in basic drugstore variety body lotions are usually water, glycerin, and mineral oil in this order — regardless of the price tag. These economical ingredients help improve dry skin by sealing in moisture. The remaining ingredients are usually a combination of fragrance, additives, and preservatives to make the lotion smell, look, and feel better on the skin. Very few will be fragrance-free. Move on to the more expensive isle of the drugstore, and you will find “natural” lotions. These packages are usually an attractive shade of beige with green logos. The words “natural” on the label may mean anything or nothing at all. Although the implication is there, very rarely does “natural” mean there are any significant percentages of superior ingredients in the product. Again, read the ingredient list, not the label, and you will see.

The best (and most expensive) body lotions will be found in spas, health food stores, and physicians’ offices. These will contain ingredients such as lactic acid to dissolve dead skin cells, improve skin cells ability to maintain moisture levels, and promote collagen production. There are also special formulations to assist in firming the skin and some that may temporarily improve the appearance of cellulite. Other key ingredients to look for are vitamins A, B, C, and E, and oils from avocados, coconuts, olives, and shea butter. For best results, consult a skin care specialist. Organic ingredients are by far the healthiest choice when possible. Look for the USDA Organic seal as proof of true organic authenticity. Higherquality ingredients usually mean higher price tags, but this is usually offset by the need for less product per application due to less dilution.

Love the skin you are in. Be good to it, and it will thank you in the years to come.

For skin that glows, follow these simple steps when applying body lotion: Exfoliate daily with a dry body brush prior to bathing. Brush with long, gentle strokes toward the heart. This will direct the blood flow toward the heart, and allow the lymphatic system to clear toxins more effectively. After bathing, towel dry, and immediately massage in body lotion with twelve percent lactic acid. Apply extra lotion to very dry areas such as elbows and heels. Allow to dry thoroughly prior to dressing.

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