In 1895, the German physicist Wilhelm Conrad Röntgen, born in 1845, discovered that electromagnetic waves of a specific wavelength penetrate the body and are partly absorbed by the body. Using X-rays (or roentgen rays) as they were named after him; organs in the body can be photographed in a way similar to how objects are photographed with a camera. |
In conventional X-rays, an X-ray image is exposed on film - a method no longer used at DiagnoseZentrumUrania. Using its modern counterpart, digital X-rays, images are transformed into digital signals and processed by computer. Radiation exposure is significantly reduced in this procedure - by about a third or a half. |
The patient is "fluoroscoped" or transilluminated with X-rays in this examination so that the radiologist can view and assess the moving organs on the monitor. However, the procedure is used less frequently now. At DiagnoseZentrumUrania, for instance, examinations of the large intestine are commonly performed with the aid of computed tomography (CT) using a process known as virtual colonoscopy. A CT may also be performed for a lung examination instead of a fluoroscopy, if necessary. However, fluoroscopy still plays an important role in the examination of specific symptoms in the stomach and the esophagus as well as for the diagnosis of venous diseases. |
The harmfulness of X-rays depends on the quantity (dose) used. Technical advances made in the last 100 years have consistently reduced the dose. Today it is in a range that is considered nearly harmless. Of course, X-rays are used as sparingly as possible. However, they should be completely avoided during pregnancy - procedures like ultrasound and magnetic resonance imaging (MRI) are given preference in this setting. Each examination method has its specific strengths and advantages. Depending on individual needs, the physician falls back upon the least harmful and most informative procedure, which is often still a (digital) X-ray procedure.
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Breast cancer is the most common cancer in women. 8-10% of all women are affected by this cancer at least once in their lives. However, the disease can be treated very well - provided it is detected early. Regular early detection measures enhance the chances of cure. Mammography is the most important preventive examination for early detection of breast cancer.
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Palpation of the breast is very important. It is performed by the treating doctor, usually a gynaecologist, or even by the woman herself. However, one can only detect larger tumors with this method. Most tumors have grown for several years by this time. Mammography, on the other hand, is able to identify even small lumps at a stage when they are far from being palpable.
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This statement is often but, regrettably, not always true. The most common benign lump in the breast is a cyst (fluid content). Lumps consisting of tissue can be identified well with mammography. Some of them contain very small deposits of calcification (microcalcification), which are typical of specific types of cancer. Even the form and structure of the changes permits the examining radiologic technologist to distinguish between benign and malignant tumours. Currently, all lumps that are not obviously benign are further evaluated by performing a histological examination (tissue sample).
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Due to technical advancements, the radiation dose used for mammography has been progressively reduced in the last few years. Digital mammography in particular, which is performed at DiagnoseZentrumUrania, involves very low radiation exposure. In general the same is true for all X-ray examinations: a non-diagnosed malignant process is a much greater ordeal than the potential side effects of the examination.
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The patient places her breast on the X-ray table, where the breast is pressed as carefully as possible. The woman informs the technician when the pressure is too high and the assistant should stop applying pressure. Compression is required, but should not be painful. The greater the compression of the breast, the better the images will be, and the lower the radiation dose needed. Obviously, a degree of compression is chosen for the examination that the patient can tolerate without significant pain.
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ALL existing images and reports should be taken to every examination because tiny changes may only be identified by comparing the present images with earlier ones. Therefore, it is sensible to perform a basic mammography at the age of 35 years. |
The breast is examined using of special contrast materials with MRI. These accumulate more strongly in malignant tumours than in normal breast tissue. This procedure is only performed when the examiner is unable to achieve clear results using mammography and ultrasound.
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Digital mammography is conducted in a way similar to X-ray mammography. However, the images are not exposed on film but are transformed into data that can be stored on a detector plate. The diagnosis is made directly on the monitor, immediately after the images have been obtained. The examining radiologic technologist can target portions of the image, enlarge these, and evaluate them.
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Suspicious lesions and calcifications can be identified more easily using the digital mammography, while simultaneously reducing the required radiation dose considerably.
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The examining radiologic technologist had to take several partial images until now, especially when examining larger breasts. Thanks to the large detector plate, the classical views from above and obliquely from the side obtained with microdose mammography provide enough information. Due to the excellent quality of the digital images, fewer images are usually required, which leads to a reduced radiation dose.
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Literally, the word osteoporosis means "porous bone ". According to the WHO definition, osteoporosis (colloquially known as atrophy or disappearance of bone) is a skeletal disease marked by small bone mass and disordered microarchitecture of bone tissue, causing the bone to become fragile and increasing the risk of fracture. Typical fracture areas include the spine, the hip or the wrist. Although there are no exact figures on the total number of persons suffering from osteoporosis in Austria, currents estimates show that about 700,000 persons suffer from "bone atrophy," 80% of which are women. |
Bone densitometry is performed to examine osteoporosis (bone atrophy). The aim is to reliably identify the disease because a person is more prone to fractures in the presence of osteoporosis. The risk can be markedly reduced by early prevention and treatment of the disease.
Quantification of the calcium content of bone (also known as bone densitometry) is the foundation of any diagnosis of osteoporosis and is performed at DiagnoseZentrumUrania using DEXA (Dual-Energy X-Ray Absorptionmetry).
This examination method is especially common in the lumbar spine and femoral neck areas. It is defined by a high degree of precision that requires low doses of ionizing rays, is considered the gold standard (method of first choice), and enables the examining radiologic technologist to calculate the bone mineral content in the examined area.
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Like all living tissue, human bone undergoes continuous transformation. In other words, bone is consistently renewed. Sexual hormones (estrogen, testosterone) regulate this process as well as many other functions. Maximum bone mass is achieved at the age of about 20 or 25, before beginning to decline. The altered hormonal balance in advanced age leads to greater bone degeneration, hence permanent bone mass reduction begins and the bone load-bearing structure of bone is gradually weakened. The risk of fractures increases as a result of this process.
Natural and rapid loss of bone mass begins from menopause onward - between the ages of about 50 and 55. The drop in the female sexual hormone estrogen, as well as gestagen, accelerates bone loss in many women - a reduction of more than 3.5 to 8% per year - so that osteoporosis mainly (about 95%) occurs in women after the last spontaneous uterine bleeding, i.e., during menopause. It should be mentioned that osteoporosis also occurs in younger persons, both male and male as a result of other underlying diseases (secondary osteoporosis). A bone densitometry is indicated in the following persons:
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Since the quality of human bone is usually best around the age of 20 to 25 years, it would be advisable to perform the first preventive bone densitometry at the age of about 35. Regular checkup examinations should be performed from the age of 50 onward to prevent fractures on time and, depending on the risk of fracture, begin medication treatment to minimize the risk of fractures.
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Typical signs include fractures of the vertebrae, the femoral neck and the wrist.
Osteoporotic fractures often occur spontaneously when standing, running or sitting - in fact, even while one is sleeping. Even simple motions, for instance when you lift your shopping bag or take your grandchild into your arms, may cause a fracture. Every fracture increases the risk of further fractures.
Osteoporosis and vertebral fractures may cause a deformation of the spine (stooped posture), which may impair respiratory function and cause painful and problematic displacement of the inner organs.
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In addition to physical symptoms, osteoporosis frequently causes mental problems as well, such as uncertainty, stress or anxiety which, in turn, may trigger loss of self-esteem or depression. Exchanging your experiences with other patients suffering from osteoporosis will help you to deal with the disease and will contribute significantly to enhancing your quality of life. The Austrian Osteoporosis Self-Help service provides extensive information about the medical and psychological effects of the disease and is available to answer questions concerning prevention, care and treatment of patients. Active osteoporosis self-help groups http://www.osteoporose.cc/ currently exist in
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Yes, it is the same procedure.
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Vessels and soft tissues can be viewed especially clearly. Besides, superficial structures - those located directly below the skin, such as the thyroid gland, the female breast, lymph nodes, or testicles - can be seen very clearly. Organs of the abdominal cavity can also be viewed well - the liver, gall bladder, spleen, pancreas, kidneys, uterus, ovaries, bladder and prostate gland. Air and calcifications are not seen on ultrasound. Therefore, any bones, the lung, and those parts of the abdominal cavity that contain intestinal gases (gastrointestinal tract) cannot be visualised or can only be seen to a limited extent. |
Duplex ultrasound is a combined procedure involving conventional ultrasonography to visualise vessels and Doppler ultrasound, which enables the examiner to measure flow velocity in vessels. The Doppler effect of sound was discovered by the Austrian mathematician and physicist Christian Andreas Doppler (born in 1803 in Salzburg).
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First the patient is positioned appropriately, depending on the area to be examined. The doctor applies a layer of gel on the transducer. The purpose of the gel is to ensure better contact between the body and the transducer. Without this gel there would be a narrow strip of air between the transducer and the skin, and the strip of air would reflect the ultrasound waves. The area behind it - the organs to be examined - cannot be seen if this occurrs. Patients who are scheduled to undergo an examination of the abdominal cavity should have an empty stomach (fasting) since only a relatively small quantity of intestinal gases is present in this state. Intestinal gases are a significant interference. The doctor moves the transducer in various directions and angles over the patient's skin and this permits him to inspect and evaluate the organs and the tissue from various perspectives. The images are obtained in standard patterns whenever possible so that doctors who have not taken the images themselves can easily reconstruct the procedure. The gel is removed after the examination.
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In the 1960's EMI (Electric and Musical Industries in England) signed a contract with The Beatles and reaped significant profits from the success of this group. A highly talented technician by the name of Godfrey Hounsfield worked for the company. One day he received an unusual assignment: he was asked to invent something new in any area of research - with no concrete specifications. He started to look for novel methods to visualize the insides of the body. His idea was to send X-rays at various axes through the body, evaluate the results on the computer, and thus create tomograms with no superimposition. Using this method he visualized the brain of a pig for the first time 1968. The machine "scanned" for nine days and the computer calculated the 28,000 measurements for two hours. The first examination in a human being was conducted in 1971. For this discovery, Hounsfield was awarded the Nobel Prize for Medicine in 1979. No EMI CT devices exists on the market today - several years of research work apparently turned out to be highly expensive, but not lucrative endeavor for the company. The fact that the structures of various organs can be visualized with no superimposition is considered a special feature of computed tomography. For instance, the brain is fully surrounded by bone and could be visualized for the first time by the aid of this new procedure. All other organs of the body can also be viewed moer easily and accurately than with ordinary X-rays. |
The brain, all internal organs, the lungs and bones can be viewed especially clearly on CT.
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The density of contrast material (CM) differs from that of body tissue and therefore causes, as the name suggests, better contrast. When contrast material is injected, it is accumulated in organs that are more strongly supplied with blood. The liver, spleen, brain, etc. can be viewed with greater clarity. Most tumors and inflammations are also supplied more strongly with blood and therefore contrast clearly with their surroundings. In fact, some tumors are marked by a characteristic perfusion pattern (=blood supply) so that they can only be diagnosed by administering contrast material. Besides, in specific cases the application of contrast material enables the examiner to even distinguish between benign and malignant tumours. Joints and body cavities can also be viewed very well using CM. Since CM is excreted through the kidneys, the urinary tract and bladder are seen very clearly. Contrast material ingested in fluid form creates deposits on the walls of the intestinal tract, making these organs visible as well. |
Contrast material injected into the blood, body cavities, lymphatic tissue or other organs (liver, kidney) is excreted nearly completely through the kidneys within 15 to 30 minutes. Contrast material taken in fluid form does not react with the body in any way and is excreted naturally through the digestive system. Some contrast materials pass through the bile ducts - they reach the bile ducts through the liver and continue to the intestines from there. |
A CT without contrast material may be performed at any time except during pregnancy.
Contrast material should not be injected:
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Radiation exposure is extremely low. It is similar to the radiation level of X-rays or fluoroscopy. As a matter of principle fear of exposure to a high dose of radiation shouldn't be reason to avoid having an examination. An incorrect diagnosis can be more harmful to a patient. Even in daily life we are exposed to low radiation doses, which do not harm us in any way. The opposite is true: A low radiation dose is used as treatment (e.g. at the spas in Bad Gastein) and we are even exposed to small doses during flights. Radiation exposure during a transatlantic flight is approximately the same as that of a lung X-ray. Modern devices are built to be much safer than earlier ones and technical advances continue to reduce the radiation exposure levels of CT and digital X-rays.
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No. That is magnetic resonance imaging (MRI). A computed tomography scanner also has a tunnel but it is much shorter - just about 50 cm. The body is nearly completely unconstrained so claustrophobia is not an issue during this procedure.
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No. They are synonyms. The procedure is based on a very strong magnetic field in which the spinning movement in the nucleus of the atom is altered. The former term refers to the magnetic field while the latter term refers to the processes in the nucleus of the atom.
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MRI is one of the most recent "imaging procedures". It is based on a very strong magnetic field in which the protons in the nucleus of the hydrogen atom are oriented differently when exposed to a specific signal. When this signal stops, they "jump back" to their original pathway. These tiny movements in the atomic range can be measured and used for imaging purposes.
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This term refers to the strength of the magnet used. The stronger the magnet, the faster one obtains images of highest quality. 1 Tesla is approximately 20,000 times the magnetic pull of the earth. Such magnets are difficult to manufacture. The quantity of electricity needed to operate them is about the same as that needed to run a small power plant. The magnet has to be persistently cooled with helium, a liquid inert gas, to 4 Kelvin (-269° centigrade), which is nearly equal to the lowest temperature in outer space.
The physicist Nikola Tesla who discovered magnetic field strength was born in 1856 in Serbia, studied in Graz, and lived and worked in the USA until 1943.
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The scanners most commonly used for medical purposes function with 1.0 and 3.0 Tesla. Stronger scanners (up to 7 Tesla) are exclusively used for research purposes.
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No other procedure is as accurate as MRI when it comes to assessing soft tissue, especially the brain, bone marrow, vessels and joint cartilage. Even changes just a few millimeters in size can be identified with this method.
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About 16,000 scanners are currently being used for medical purposes. However, only around 600 3.0 Tesla scanners are available around the world today. One of these is at DiagnoseZentrumUrania. Austria is one of the leading countries in the world in terms of technical equipment (next to the USA, Japan and Switzerland) as well as the quality of health care.
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Dental fillings, joint prostheses, plates and screws after fractures may interfere with imaging, but there is no risk for the patient. The examination can usually be performed without any concerns, even if patients have artificial heart valves. Please also read our information on the subject in: Implant and MRI Information.
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The use of this procedure is not advisable for patients with cardiac pacemakers. Metal or shell splinters as well as metal clips with a large quantity of iron, e.g. those used earlier during operations on cerebral vessels, may well be sources of danger. Dental prostheses, other fixed braces or artificial hip joints, however, are safe. Caution is advised in cases of tattoos with dyes or pigments that contain iron because they tend to become hot. In any case, the medical staff should be notified of the presence of metal parts in the body BEFORE the examination.
The magnetic field destroys bioelectrical implants (such as insulin pumps in patients with diabetes, prostheses in the inner ear). Metal objects of any type, including magnetized cards or electronic devices, should not be brought into the examination room because they might not only be damaged, but also damage the Magnetic Resonance Imaging scanner. |
Patients may experience muscle twitches or a mild warming of tissue during the examination. These reactions are no cause for concern. The procedure can usually be used without risk even in children and pregnant women in the last trimester of pregnancy. In some cases, scanners with a lower field strength may be used for pregnant women. The noise in the scanner is often found to be unpleasant. Ear protection, ear plugs or headphones with music help in such cases. |
Just a few people (about 1%) feel intimidated by this type of examination. They find it helpful to be accompanied by family members or friends. Accompanying persons are asked to be quiet and calm to avoid hindering the examination. Our staff observes the patient through a window during the entire procedure; the patient can also speak to our medical staff at any time. Patients can also request attendance by pressing an alarm button. If necessary we administer an anxiolytic agent (to reduce anxiety) - you should not drive a vehicle after you receive such medication!
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