48 Questions
What is the recommended imaging technique to demonstrate the biliary system, according to the text?
Ultrasound imaging
What is the purpose of taking plain radiographs of the biliary system, according to the text?
To demonstrate opacities in the region of the gallbladder and biliary tree
What is the recommended patient preparation for biliary system imaging, according to the text?
Taking laxatives and a diet to clear overlying faeces and bowel gas
What is the purpose of immobilization in radiography?
To prevent motion artifacts
What is the recommended kilovoltage for this radiographic image?
70 kVp
What is the position of the patient for this radiographic image?
Prone
What is the purpose of collimation in radiography?
To improve the sharpness of the image
What is the recommended mAs for this radiographic image?
Short exposure time with high mA
What position should the patient be in during the procedure?
Supine
What should be done with the T-tube prior to insertion?
It should be raised and tapped to remove air bubbles
What is the purpose of obtaining an early filling image?
To assess the patency of the biliary tree
What should be done for immunosuppressed patients prior to the procedure?
Prophylactic dose of broad spectrum antibiotic
What is the purpose of the control image of the RUQ?
To assess the patency of the biliary tree
What is the purpose of taking a laxative for two days prior to the examination days in this technique?
To evaluate the laxative preparation
What is the purpose of the single control radiograph of the whole abdomen or the right side of the abdomen in this technique?
To judge the exposure for the second part of the examination
How long before the examination should the patient take the oral contrast (Biloptin)?
14 hours
What substance is used as the oral contrast in this technique?
Iodine-containing substance (Biloptin)
What should the patient avoid prior to the examination in this technique?
Smelling food
What is a potential complication of persistent biliary fistula according to the text?
Biliary peritonitis
What is the consequence of not treating a biliary fistula?
Gastric ulceration
What is the treatment for cholangitis according to the text?
Antibiotics
What is the cause of biliary peritonitis according to the text?
Leakage of bile into the peritoneal cavity
What is the consequence of delayed treatment of cholangitis according to the text?
Hepatic necrosis
What is the recommended direction of the vertical central ray for imaging in the described procedure?
Directed to a point 7.5 cm to the right of the spinous processes
What is the recommended position for the patient's respiration for the described procedure?
Arrested respiration after full expiration
What is the primary purpose of an Oral Cholecystogram (O.C.G)?
To examine the gall bladder, billiary and cystic duct
What is a contraindication for an Oral Cholecystogram (O.C.G)?
Abnormality in oesophagus
What is the recommended number of views of the entire biliary tree that should be recorded by spot film during injection of contrast medium to the duodenum?
At least 2 views
What are some indications for imaging an Oral Cholecystogram (O.C.G)?
Lazy gallbladder, atonic GB, GB stone, multiple diverticulum of the GB
What should be done if the intrahepatic ducts do not fill during injection of contrast medium to the duodenum?
The patient should be tilted trendelenburg and further contrast injected
What position should the patient be in to fill the left hepatic duct during injection of contrast medium to the duodenum?
Left side
What should be checked for 24 hours if the T-tube is removed after the procedure?
The patient's wound for bile leakage
What should the patient be warned to advise of post procedure?
Any itching or rash
What is the ideal position for the patient during the typical film sequence for gall bladder imaging?
Left anterior oblique position
What is the purpose of the fatty meal given to the patient during the imaging process?
To provide contrast for the images
What is the recommended time frame for the patient to take the tablets before the examination?
4 hours before the examination
Which image projection best demonstrates the gall bladder in the first two films?
LAO position image
What is the main reason for imaging the gall bladder region?
To detect gallstones or other gall bladder issues
What is a common complication associated with the administration of SAR?
Urticarial skin reactions
What is the purpose of a T-tube cholangiogram?
To inject contrast medium into the biliary tree
When is a T-tube most commonly inserted?
During a cholecystectomy operation
What is the main function of the T-tube in a cholangiogram procedure?
To allow injection of contrast medium into the biliary tree
What is a rare complication associated with the administration of SAR?
Vasodilation
What is the main indication for performing a cholangiography procedure?
To diagnose obstructive jaundice
What is a contraindication for cholangiography procedure?
Contrast or iodine allergy
What is the preparation step required before performing a cholangiography procedure?
Patient identification
What is a possible complication of cholangiography procedure?
Contrast-induced nephropathy
What is the contraindication related to barium study for cholangiography procedure?
Barium study within last 3 days
Study Notes
Biliary System Imaging
- Recommended imaging technique to demonstrate the biliary system: Oral Cholecystogram (O.C.G)
- Purpose of taking plain radiographs of the biliary system: To identify abnormalities in the system
Patient Preparation
- Recommended patient preparation: 2-day laxative preparation to cleanse the bowel, avoiding food and drinks 12 hours prior to the examination
- Patient should take the oral contrast (Biloptin) 2 hours before the examination
Radiographic Image
- Recommended kilovoltage: Not specified
- Recommended patient position: Erect or supine position, depending on the procedure
- Purpose of collimation: To reduce scattered radiation and improve image quality
- Recommended mAs: Not specified
T-tube Cholangiogram
- Purpose of the T-tube: To drain bile from the common bile duct
- T-tube is most commonly inserted: After a surgical procedure
- Main function of the T-tube: To drain bile and allow for cholangiography
- Prior to insertion: The T-tube should be flushed and checked for patency
Immobilization and Collimation
- Purpose of immobilization: To reduce patient movement and improve image quality
- Purpose of collimation: To reduce scattered radiation and improve image quality
Procedure
- Patient position during the procedure: Erect or supine position, depending on the procedure
- Recommended direction of the vertical central ray: Not specified
- Recommended patient respiration: Held breath during the exposure
Indications and Contraindications
- Primary purpose of an Oral Cholecystogram (O.C.G): To evaluate the gallbladder and bile ducts
- Contraindication for an Oral Cholecystogram (O.C.G): Liver or gallbladder disease
- Indications for imaging an Oral Cholecystogram (O.C.G): Suspected gallbladder disease or obstruction
- Contraindication for cholangiography procedure: Barium study, liver or gallbladder disease
Complications
- Possible complication of cholangiography procedure: Biliary fistula or peritonitis
- Rare complication associated with the administration of SAR: Anaphylaxis
- Common complication associated with the administration of SAR: Nausea and vomiting
Treatment
- Treatment for cholangitis: Antibiotics and drainage
- Consequence of delayed treatment of cholangitis: Sepsis and death
- Treatment for biliary fistula: Drainage and surgical repair
Test Your Knowledge on Biliary Tree Imaging Techniques: Learn about the essential steps and tips for successful imaging of the biliary tree. This quiz covers important aspects such as contrast injection, patient positioning, and imaging views. Sharpen your skills and enhance your expertise in biliary tree imaging with this informative quiz.
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