In today's imaging practice, when it comes to the examination of private parts such as the chest, pelvis, breast, and urethra, it is bound to encounter more embarrassing situations. The author briefly discusses several common problems encountered during imaging examination.
Asked to undress? Remove artifact interference and improve the clarity of your images
Radiology is a set of clinical diagnosis and treatment as one of the auxiliary departments, but also an indispensable department of medical institutions, now most of the clinical diagnosis urgently need to rely on the imaging department of examination, and imaging department each examination has exquisite, and has strict standards. For example, if you want to take off your clothes in the imaging department, let's tell you in detail.
For example, after a woman took an X-ray chest x-ray, she was surprised and confused, and could not calm down for a long time. Why was she asked to take off her bra? Isn't an X-ray that can penetrate clothes? It should be noted here that these are purely the requirements of image inspection technology, that is, to remove artifact interference and improve the clarity of the image. As patients, you should believe that the doctor is abiding by professional ethics and actively cooperating with the doctor's examination. Of course, medical staff should also pay attention to protecting the privacy of patients, avoiding the occurrence of embarrassment, and should also consider the patient's feelings and avoid using cold and inappropriate words such as "undressing".
The picture above is a normal x-ray of a chest orthopedic film. This is the standard image taken removed from the bra, and we see no foreign bodies in the lung field. Both lungs, heart and bones can be clearly displayed.
The above figure does not remove the metal foreign body outside the body. In contrast to the first one, we see the red arrow being a necklace worn around the neck, and the yellow arrow referring to the clasp and underwire of the bra. These foreign bodies just overlap with the bone and lung tissue we are looking at, and if there is a lesion in these areas, these foreign bodies outside the body will obscure the lesion, resulting in missed diagnosis and misdiagnosis.
Not all female patients have to undress and untie their belts for radiology. Instead, which part of the film requires that there are no foreign bodies such as metal in that part.
The picture above is a flat abdomen, in the words of ordinary people, it is an X-ray film of the stomach. We can see that the yellow arrow on the film refers to the steel rim of the bra, and the red arrow refers to the button behind it. At this time, the button overlaps with the thoracic spine, if there is something wrong with this bone, it may not be able to see it, resulting in missed diagnosis, and the gain is not worth the loss.
At work, it is often encountered that female patients are asked to take off their bras in the computer room and do not understand. Not only did it delay the inspection time, but it also caused unnecessary misunderstandings. For this situation, the department with more comprehensive facilities will set up a special locker room next to the computer room to provide necessary convenience for female patients, or change into a hospital gown and then undergo examination. Otherwise, no inspection will be granted.
After saying that the X-ray is under the CT examination, the principle is the same. Which part to photograph, that part can not have metal things. For example, if the lumbar disc CT scan, the metal buttons and belts of the outer pants need to be removed, otherwise there will be metal artifacts that affect the observation of the adjacent image.
For MR inspection, it is a completely different concept. The magnetic resonance machine room is a magnetic field formed by a huge magnet, and as the name suggests, all items with magnetism and metal cannot be brought into the machine room. Special attention is paid to patients with metal implants in the body, which can be estimated and judged according to specific situations, and try not to do it if there is a risk! Therefore, magnetic resonance examination is much more stringent than X-ray and CT, and I will not elaborate on it today.
Touched by a doctor? Accurate positioning, positioning, and assistance in diagnosis
For example, during mammography, the camera technician will push the breast to reduce the thickness of the muscle layer and better display the gland; when the diagnostic doctor observes the image, he will look at and palpate the breast. For example, when taking pelvic, hip and lumbosacral spine photography, private parts such as the pubic bone and sternum may be touched, which is a reasonable requirement for accurate positioning, body surface positioning, and assistance in diagnosis. Of course, medical staff should wear gloves as much as possible when performing these operations, and if necessary palpation is required, they must be performed with bare hands so as not to affect judgment.
Medical staff refuse to accompany family members to accompany the patient when performing imaging examinations? Try to avoid exposure to unrelated personnel
In practice, when male technicians irradiate female patients for examination, they will ask the accompanying personnel to leave the examination room to avoid irradiating the accompanying personnel without necessary irradiation, but some accompanying personnel will feel confused and even have doctor-patient disputes. The author believes that it is necessary to explain to the patient and the accompanying personnel before the examination: "X-ray is harmful to the human body, in order to avoid unnecessary radiation, please leave the examination room, and please rest assured, we will seriously examine the patient." "If the accompanying person strongly requests to enter the escort, as a medical staff, you should also show understanding and take out protective equipment for the accompanying person to wear before you can carry out relevant examinations."
Effective and timely communication is the best way to resolve embarrassment
For only one male doctor on duty alone, encountering embarrassing things, at this time try to explain to the patient, should be effective and timely communication, remove the metal items that may affect the image, less risk of misdiagnosis.
For female patients of childbearing age, before the examination, they will ask whether they are pregnant; there is also a female medical staff present when the male doctor conducts a private part examination, such as hysterosalpingogram, breast examination and other examinations, which is a mandatory rule.
Summary, remove the foreign body in the position, reduce artifacts, and strive to optimize each image, all for better diagnosis, good communication with patients, and patient cooperation, can avoid a lot of unnecessary trouble in the examination process.