Fluoroscopy
Norm of Fluoroscopy
Requires interpretation. Usually there is symmetric, synchronous pulmonary and diaphragmatic motion. Diaphragmatic excursion = 2–4 cm. Absence of calcification in the coronary arteries.
Usage of Fluoroscopy
Assessment of diaphragmatic function; localization of lung mass for percutaneous biopsy, mediastinal mass, pleural effusion, pleural lesion, and pulmonary disease; screening tool for detection of coronary artery disease; infrequent applications of fluoroscopy other than that of the chest include gastrointestinal imaging, venography, myelography, and genitourinary fluoroscopy.
Description of Fluoroscopy
A radiographic examination of pulmonary motion using a fluoroscopic screen containing calcium tungstate crystals, which fluoresce when struck by x-rays. When the x-ray passes through the body, dense areas allow less radiation to pass through onto the fluoroscopic screen than do less dense areas. The resulting pattern of light and dark areas aids in the diagnosis of pathophysiologic conditions. Fluoroscopy can reveal subtle nodular or parenchymal calcifications and coronary artery calcifications better than regular radiographs. The test takes about 5 minutes and includes less than 1 minute of x-ray exposure.
Professional Considerations of Fluoroscopy
Consent form IS required.
Risks
Radiation exposure, radiodermatitis, infection.
Contraindications
Pregnancy and during breast-feeding.
Precautions
During pregnancy, risks of cumulative radiation exposure to the fetus from this and other previous or future imaging studies must be weighed against the benefits of the procedure. Although formal limits for client exposure are relative to this risk: benefit comparison, the United States Nuclear Regulatory Commission requires that the cumulative dose equivalent to an embryo/fetus from occupational exposure not exceed 0.5 rem (5 mSv). Radiation dosage to the fetus isproportional to the distance of the anatomy studied from the abdomen and decreases as pregnancy progress. For pregnant clients, consult the radiologist/radiology department to obtain estimated fetal radiation exposure from this procedure.
Preparation
- The client should remove all upper body clothing, jewelry, and metal items.
- Just before beginning the procedure, take a “time out” to verify the correct client, procedure, and site.
Procedure
- The client stands with the chest between the x-ray tube and the fluoroscopic screen.
- Remove electrocardiographic monitoring leads and patches containing metal snaps and safety pins. Move invasive lines out of the fluoroscopic field if possible.
- Wear a lead apron if remaining in the room.
- Proceed with fluoroscopy. The client turns in different projections for the procedure.
Postprocedure Care
- None.
Client and Family Teaching
- Inform the client or family of the rationale for the test.
- The client must remove all jewelry or metal objects from the trunk of the body.
- The client must not be pregnant.
- Results will be available after examination of the procedure results by a radiologist.
- In women who are breast-feeding, formula should be substituted for breast milk for 1 or more days after the procedure.
Factors That Affect Results
- Metallic objects may interfere with the quality of films obtained by fluoroscopy.
Other Data
- A videotape of the film may be made for later examination.
- Fluoroscopy delivers more radiation than a chest radiograph does.
