Tests

18-20 Week Screening Pregnancy Ultrasound

What are the generally accepted indications for 18-20 week screening pregnancy ultrasound? Ultrasound at 18–20 weeks of gestation has become a routine screening procedure in pregnancy, and is ideal for assessing gestational age, foetal number, foetal viability and placental location, and if medically required, foetal gender. It is also valuable in detecting abnormalities in amniotic... View Article

Amniocentesis

What are the prerequisites for having an amniocentesis done? The following women can be referred for amniocentesis: over 36 years of age; past history of a child with an abnormality; those who have had an abnormality in their foetus or unborn baby identified on an ultrasound scan; personal or family history of a chromosomal abnormality... View Article

Angiography

Mr Jackie Yu A/Prof John Cockburn What are the common indications for angiography? This InsideRadiology item deals with the large number of treatment procedures that use catheter angiography requiring the ‘direct’ injection of contrast into a diseased artery or vein. This is in contrast to diagnostic angiography (which is obtained by ‘indirect’ imaging techniques) such... View Article

Arthrogram

What are the prerequisites for having an arthrogram done? Generally the patient should have had at least a plain X-ray of the joint and often an ultrasound, CT scan or MRI. Arthrography (like any test) should only be performed when the additional information obtained has the potential to alter the treatment or provide additional prognostic... View Article

Bone Mineral Density Scan (Bone Densitometry or DXA Scan)

Dr Elke Hendrich What are the generally accepted indications for a BMD scan? The following indicate an increased risk for bone loss (osteoporosis) and might require BMD assessment to confirm osteoporosis.1 Although BMD scanning can be carried out for any of these risk factors, only some satisfy Medicare re batable indications, as specified in the MBS... View Article

Breast MRI

Dr Donna Taylor A/Prof Liz Wylie What are the prerequisites for having a breast MRI done? Ideally MRI should be scheduled for days 6-12 of the menstrual cycle unless there is a clinical urgency to have the procedure performed as soon as possible (e.g. known breast cancer awaiting treatment). Ideally, breast MRI should not be... View Article

Chorionic Villous Sampling

Dr Monica Pahuja What are the generally accepted indications for chorionic villous sampling? Chorionic villous sampling (CVS) is usually carried out between 11 and 14 weeks of gestation (but can be carried out up until full term in selected cases), and involves either transabdominal or transcervical aspiration or biopsy of placental villi. Previously, only amniocentesis was... View Article

Computed Tomography (CT)

Mr Jason McKenzie Prof Stacy Goergen What are the prerequisites for having computed tomography done? Before referring a patient for a CT scan, it is important that you are certain that a CT scan is the best test to confirm or exclude the condition(s) you suspect. If you are not certain, contact a radiologist and... View Article

Coronary Artery Calcium Scoring

Dr Charles Lott What are the prerequisites for having coronary artery calcium scoring done? Coronary artery calcium scores are of most use in those patients at intermediate risk for cardiovascular disease, where the result will either lower or raise the risk profile and provide a change in management. Those at low risk (such as an... View Article

CT Colonography

Dr Helen Moore Prof Parm Naidoo What are the generally accepted indications for a CT colonography? Screening for bowel cancer in people who are considered to have no increased risk of developing bowel cancer. Failed or incomplete conventional colonoscopy. When colonoscopy is relatively contraindicated because of significant medical conditions. Note: Individuals at higher risk of... View Article

CT Coronary Angiography (CTCA)

What is computed tomography coronary angiography (CTCA)? Angiography is the X-ray imaging of blood vessels using X-ray contrast agents injected into the bloodstream. CTCA uses computed tomography (CT) scanning to take images (angiograms) of the coronary arteries. It requires the use of rapid CT scanning techniques, and can only be carried out in centers where... View Article

Diagnostic Mammography

Dr Helen Frazer A/Prof Liz Wylie What are the prerequisites for having diagnostic mammography done? Diagnostic mammography is performed in symptomatic patients, that is patients who have signs or symptoms of breast cancer such as a palpable lump, nipple discharge, skin changes etc. What are the absolute contraindications for diagnostic mammography? There are no absolute... View Article

Dual Energy CT Scan

Dr John Coucher What is a dual energy CT? Dual energy CT scans are a relatively new form of CT scanning that use separate X-ray energies to make images. Images can be generated: by the simultaneous use of two X-ray tubes (‘dual source’); by using an X-ray detector with separate layers to detect two different... View Article

Foetal MRI

Dr Michelle Fink Prof Stacy Goergen What are the prerequisites for having a foetal MRI done? Foetal MRI may complement ultrasound examination when detailed evaluation is required of intracranial and intrathoracic structures. It is also valuable when planning ante- or early postnatal surgical foetal intervention (e.g. in spina bifida, congenital diaphragmatic hernias, neck masses obstructing... View Article

Magnetic Resonance Imaging (MRI)

Mr Richard McIntyre Prof Stacy Goergen What are the generally accepted indications for magnetic resonance imaging (MRI)? Magnetic resonance imaging is increasingly being used for diagnosis and follow up. The wide range of indications can be grouped under: Brain – indications include stroke, temporal lobe epilepsy, infection, inflammation, tumour, multiple sclerosis (MS), dementia, post-trauma, metabolic disorders,... View Article

MRI Heart (Cardiac MRI)

Dr Brett Lorraine Dr Charles Lott What is cardiac MRI? Cardiovascular magnetic resonance (CMR) is an advanced form of magnetic resonance imaging utilising electrocardiogram gating to avoid cardiac motion blurring. Its main use is in assessment of anatomy, function and viability of the heart, but it is also useful in detecting ischaemia and infarction, and... View Article

Myelogram

Prof Mark Khangure Dr Jason Wenderoth What are the generally accepted indications for a myelogram? Myelography is becoming less common with the introduction of high quality magnetic resonance imaging (MRI). However, two indications remain for a myelogram In patients who require imaging as a result of a clinical diagnosis of nerve root, thecal sac or... View Article

Nuchal Translucency Scan

What are the generally accepted indications for first trimester screening (nuchal translucency scan)? All women who are pregnant are recommended to have a screening ultrasound at around 11 weeks gestation. (See below: NHMRC Guidelines). In addition to screening for foetal genetic abnormalities (e.g. Down syndrome), other indications include: confirming viability; dating and confirming due date;... View Article

Plain Radiography/X-rays

What are the prerequisites for having plain radiography/X-rays done? A signed request from a referring clinician with appropriate and relevant clinical details. What are the absolute contraindications for plain radiography/X-rays? None. A plain X-ray is a low dose examination that is cheap and readily available. The small risk must be weighed up against the benefit.... View Article

Radiation Risk of Medical Imaging During Pregnancy

Which radiology tests are absolutely contraindicated during pregnancy? No radiological examination is absolutely contraindicated during pregnancy. As there are no dose limits in the medical use of ionising radiation, the risk of the procedure must be weighed against the risk to the patient and her foetus if she does not have the procedure. Which radiology... View Article

Radiation Risk of Medical Imaging for Adults and Children

What are the generally accepted indications for a medical imaging procedure? An appropriate imaging procedure is justified if it changes patient management or treatment, or confirms or excludes the presence of disease. The type of imaging procedure, as to whether ionising radiation is involved, will be determined by the presenting clinical problem. For further information... View Article

Saline Infusion Sonohysterography (SIS)

What are the prerequisites for having a SIS done? There are no prerequisites. It is a good test to assess the endometrium for those patients who have persistent endometrial thickening, suspicion of polyps, and assessment of post menopausal endometrium, patients taking tamoxifen, or those with possible Asherman’s Syndrome. What are the absolute contraindications for a... View Article

Screening Mammography

What are the benefits of screening mammography? Eight randomized controlled trials dating from the 1970s have shown that mammographic screening for breast cancer reduces the mortality from breast cancer by over 20%.1 Participation in BreastScreen Australia has been shown by case–controlled studies to be associated with a reduction in mortality from breast cancer of over... View Article

Transvaginal Ultrasound

What are the prerequisites for having a transvaginal ultrasound done? There are many reasons for which transvaginal ultrasound may be a useful examination: pelvic pain; all gynaecological symptoms; assessment of endometrium; presence of polyps or fibroids; assessment for suspected polycystic ovaries; ovarian cysts or tumours; screening for ovarian cancer; assessment of early pregnancy (dating); possible... View Article

Traumatic Vascular Injury – Head & Neck

What is the incidence of traumatic vascular injury of the head & neck? The incidence of blunt cerebrovascular injury (BCVI) varies depending on the criteria used and the sensitivity of the diagnostic test applied. Those using catheter angiography with fairly liberal criteria such as Biffl et al.1 described an alarming incidence of 1.07% for blunt... View Article

Ultrasound

What are the prerequisites for having an ultrasound done? If you are referring a patient for an ultrasound examination, it would be valuable to include: A concise, relevant clinical history, as this will improve the efficacy of any diagnostic imaging test. Relevant recent pathology or imaging results. What are the absolute contraindications for an ultrasound?... View Article

Urethrogram

What are the generally accepted indications for a urethrogram? A urethrogram is a procedure used to show the location and characteristics of a clinically suspected urethral stricture, which is most often a result of trauma, surgery, prolonged catheterisation or radiation therapy. Those men with poor urinary stream, not thought to be a result of prostatomegaly,... View Article