Slideshow of MUDr. Lubicia Oktábcová's Lecture TOP CT Examination Methods
CT department has been a part of Affidea Praha since 2001.
At the end of 2008 a new CT scanner LightSpeed VCT was installed in Affidea. In mid-January 2010 it was upgraded into LightSpeed VCT XTe - a CT scanner with a lot of advantages for both indicating physicians and patients. Thanks to ASIR technology it is possible to perform all CT examinations with a radiation dose reduced by 40-50% compared to standard devices. Affidea was the first medical center in the Czech Republic to implement this iterative algorithm to reduce the radiation load into routine operation. There were added other computational programs that allow similar examination of both coronary arteries and can also help significantly to diagnose and qualify pulmonary emphysema. The machine is also equipped with the possibility to assess the value of calcium score of coronary arteries.
This latest generation of CT machines allows the physicians of Affidea Praha to improve and accelerate diagnostics and also dynamically expand the examination spectrum according to the clinical requirements. For our patients it means not only the guarantee of perfects diagnosis, but also improvement of comfort during the examination, reduction of radiation load and last but not least, it enables shorter time of examination. Thanks to the connection with the e-Pacs system we are able to send the scans online to the inpatient hospital departments using this system.
Our experienced team provides CT examinations in a series of multicenter clinical trials, including teaching hospitals.
Contrast agents are used to highlight certain areas of organs, vessels and tissues. Thanks to the increased visibility of individual structures it is easier for the physician to make a diagnosis.
The output represent very thin sections going through the scanned area /0,6 mm/ which are processed in a special computer in all spatial levels. They enable to provide more information about the examined area.
An integral part is the possibility of processing a basic data file into virtual reality. The final “endoscopic” evaluation is common for CT colonoscopy where the current technical possibilities improve and simplify this difficult diagnosis. It is possible to perform CT bronchoscopy in the same way.
Three-dimensional data processing along with virtual reality are a perfect alternative for diagnostic imaging of the vascular system. Currently this method along with Doppler vessel examination becomes the number one method of choice for non-invasive diagnostic imaging of the vascular system. In addition to the examination of the brain vessels also the aortic arch and extracranial carotid arteries as well as thoracic and abdominal aorta including visceral arteries and of course the image of the vasculature of lower limbs. The main benefit of non-invasion compared to e.g. DSA has further potential in the possibility of more complex evaluation of vascular pathologies (visualization of atheromatous or aterosclerotic structures, exact views of aneurysms, etc.). The only thing left for these diagnostic options is to get more known within the professionals, so that they can be used more for the benefit of our patients.
The example of new trends in CT diagnostics can be a dental programme for preoperative assessment before dental procedure or surgery.
“Sixty-four-sliced machine” with the rotation speed of an X-ray of 360 degrees in 0.35 sec enables getting image data on sub-milimetre level in high resolution and quality. The high technical level has of course its reasons. The common denominator of a perfect image is mostly the patient who benefits from that. A dominant indicator is the speed of the image when during one turn of the X-ray we get data from 40 mm area which is covered by 64 detectors which enables not only a dynamic or functional study of a heart or brain, but also an examination of large body areas. In 10-15 secs it is possible to perform so-called whole body examination of a thorax or abdomen. For patients in severe condition it is a significant chance to get a large number of information quickly and efficiently, which can ultimately lead to a significant influence in treatment. Sub-milimetre slices are a pre-requisite for perfect three-dimensional data processing which is an essential part of the evaluation of the basic examination which provides us with dimensional image of the organs and pathological processes.
CT angiography is a non-invasive method when the application of iodinated contrast agent into a peripheral vein (usually cubital) displays arterial or venous bloodstream of the desired localization.
GE 64 slice scan provides speed and high quality examination.
Preparation:
The patient is hungry 4 hours before the examination. The only absolute contraindication when this examination cannot be performed is an allergy to the contrast agent. Significantly reduced kidney function can also be limiting.
Indication:
All conditions with suspected disorder of blood supply of the organs (brain, kidneys) or limb arteries or on the other hand when assessing the vascularization of pathological formations or vein wall (aneurysm).
This examination is carried out at the request of a physician according to their specifications.
Length of the Examination:
The actual examination takes a few seconds. After application of the contrast agent into the bloodstream the CT scan quickly records the flow of this substance in the required location. In case of assessing the arteries it records blood flow in the location in question.
Examined areas:
It is possible to examine: arterial bloodstream incranial, extracranial with aortic arch, aortic arch and upper limbs arteries, also thoracic + abdominal aorta + pelvic vessels, arteries leaving abdominal aorta (e.g. renal artery), abdominal aorta + pelvic vascular bed + vessels of lower limbs.
In case of a positive finding we perform analysis of stenosis, i.e. to determine the exact length and percentage of narrowing of the artery.
Possible Allergic Reactions:
Allergic reactions are rare. In Affidea, however, there is an erudite anesthesiologist present throughout the whole examination, just in case of an allergic reaction.
CT colonography is a diagnostic method using the options of a multi slice CT scan. It should be done in case of an incomplete result of a conventional colonoscopy because of an obstacle or significantly winding colon. It is also suitable when an optical colonoscopy is impossible when the patient is using medication that affects blood clotting or has a serious heart and lung disease, It can also be used advantageously with weakened or elder patients. The preparation is the same as for the standard colonoscopy. Gas is injected into the colon via rectum. There is no need to use tranquilizers, because the examination is well tolerated and is painless. The result is the description of the pathological structure, its size, character and distance from the rectum. Unlike standard colonoscopy, taking histological sample is not possible.
CT scan of coronary artery calcium score of the heart is a painless method of obtaining information about the presence, location and extent of the calcified plaque in coronary arteries – the arteries supplying in blood oxygen and nutrients into the heart muscle.
Calcified plaques are created in places with increased fat deposition and other substances under the inner wall of the artery which leads to coronary artery disease. People with this disease are at increased risk of cardiac events. Over time the further escalation of vascular plaques can narrow the arteries or close them completely and this way block the blood flow into the heart muscle. It may result in pain in the chest known as “angina” or even cardiac event. Since calcium is an indicator of atherosclerosis, its amount is detected on the heart CT scan by a valuable prognostic tool. The finding on heart CT scan is called calcium score. The full name of this examination is “coronary artery calcium score” (CACS).
The examination is performed in the same way as CT angiography. It is necessary to have special software that enables very complicated processes. The load on the patient is comparable with a standard contrast CT examination. This approach allows detailed evaluation of coronary arteries or bypasses. The suitability of the examination is determined by some parametres: low level of CT calcium score, lower and regular heart rate. The indication should always be consulted with the radiologist.
CT Dentascan as a part of our routine examinations is necessary before applying dental implant with the presumptive anatomical complication, or pathological processes of upper and lower jaw.
According to the results, the overwhelming majority of clients would in the future once again opt for CT colonography, since a significant contribution to the clients’ satisfaction was using automatic insufflator of carbon dioxide. Detailed explanation of colonography examination using insufflator can be viewed in the bachelor project of a radiology assistant from 2012 in the library of The College of Nursing in Prague.
Patients tolerate the gas very well during the examination and at the same time using a machine with back pressure valve reduces risk of perforation of the colon to the minimum.
We have been using this machine at CT department since summer 2011 and Affidea was the first medical facility in the Czech Republic that started to use this machine for virtual colonography.
Informed Consent of the Patient CT
Informed Consent of the Patient, Annex 1
CT Request Form
To make an appointment call phone number: 267 090 851. You need to have a request form filled by your indicating physician with the specification of the examination.
Ozone therapy belongs to mini-invasive percutaneous treatment methods. It uses bactericidal and virucidal effects of the ozone, which has a significant analgesic and anti-inflammatory effect and supports the immune system.
It is used with good results at various painful conditions of different etiology, fatigue syndromes and postoperative conditions.
The intradiscal application is gradually being phased out for a comparable benefit with periradicular application at higher load for the patient.
It is recommended to apply 10 – 15 ml mixture of ozone and oxygen in optimal concentration 27 ml per 1 ml of the mixture. According to the effect, 1-3 applications are usually performed with 1-3 month space between them.
The effect is usually 60-80%. Exact diagnosis is important for the best result, therefore a prior examination by a specialist is necessary, followed by CT or MRI examination.
There are virtually no contraindications. The method is performed after local anesthesia by the application of the mixture by a spinal needle into the required location under sterile conditions, with CT scan navigation.
Due to the use of ASIR method the radiation load at our workplace is low. After the performance the patient usually remains lying horizontally at the department for about 60 minutes. Complications are extremely rare and in compliance with the conditions they can be avoided. According to the literature, these can be epidural hematoma and abscesses.
Ozone therapy can also be used in treatment of painful joints when 2-5 ml of the mixture is applied in an intra-articular way according the size of the joint. The mixture can also be applied to the insertion of tendons at tensinosis and painful muscle spasms.
MUDr. L. Oktábcová's lecture on ozone therapy
To make an appointment call phone number:: 267 090 851 You need to have a request form filled by your indicating physician with the specification of the examination. (the above-mentioned requested ozone therapy).
Download the request form here.
Informed Consent of the Patient CT
Informed Consent of the Patient, Annex 1
Informed Consent with Selective Nerve Root Block CT (ozone)
Chief Physician
Physicians