Strange Socket In Hospital

[JBR]

Except, I don't remember the US head being used, nor any of that lub they use. I was quite curious at the time, and since, about the viewing method, so I was paying attention to that.

This is quite strange. It occurred to me that it could have been MRI, but a couple of things just don't work. You said a tiny room, but an MRI is a large piece of equipment. Also, they could hardly work on you because in order to image what they were doing they'd have to be doing it inside a narrow tube within the machine, which sounds impossible. No magnetic metals allowed either, so does not compute! I can't think with any certainty what it could have been.
I suppose they could have done it under screening (X-rays and fluoroscopy), but there should have been lead-rubber aprons, unless they were really taking a chance... and I wouldn't!

 

[Harry Bloomfield]

I suppose they could have done it under screening (X-rays and fluoroscopy), but there should have been lead-rubber aprons, unless they were really taking a chance... and I wouldn't!

As said, I wasn't sure of anything much. If I'd been able to see the screen, I would have had a better idea, though I have heard of others, undergoing similar OPs and watching the progress of the stent on a screen.

Just a thought - is there a type of US, which perhaps doesn't need the head to be in such close contact with the body?

 

[JohnW2]

This is quite strange. It occurred to me that it could have been MRI, but a couple of things just don't work. You said a tiny room, but an MRI is a large piece of equipment. Also, they could hardly work on you because in order to image what they were doing they'd have to be doing it inside a narrow tube within the machine, which sounds impossible.

Exactly. It would be impractical to undertake many procedures on a patient who was 'inside a narrow tube - although, in your case,I suppose it may be just about possible to have a patients groin outside the tube but there kidney area with in in.

However, more to the point, although it might just be because I'm out-of-touch, I haven't heard of MRI being used for real-time 'video' screening - all I've ever seen are 'stills', and I'm not sure how frequently they could be captured (as 'frames of a video'). Again, our present0-day radiography friend may be able to enlighten us about that.

I suppose they could have done it under screening (X-rays and fluoroscopy), but there should have been lead-rubber aprons, unless they were really taking a chance... and I wouldn't!

Quite - as I keep saying

 

[JohnW2]

Just a thought - is there a type of US, which perhaps doesn't need the head to be in such close contact with the body?

Not that I've ever seen or heard of - and if it were possible, I'm sure that's what we would be using. Not only does the head have to be in good contact with the body but, as has been said,one even needs to use the messy gel to get decent images. Although US has no problem travelling through air, to actually get a 'US image' to remain usable after passage through air might be a problem - the 'image' might have degenerated into just a 'general US illumination' by the time it got through air to the sensor.

 

[darreng1983]

Hmmm - all a bit of a mystery,then. I'm very much out of touch, but radiation certainly hasn't got any safer (so I doubt that the aprons can have got thinner and lighter), but I'm not aware of any real options other than X-rays or US - and if the stent was being put in your renal artery (was it?) I would really have expected the former.. as I recently wrote (albeit I was then writing to the wrong person ), maybe @darreng1983 may have some thoughts, in relation to modern kit and practices ?

What's your background @JohnW2 ?

The newer aprons are definitely lighter and less bulky than previous, i don't think they're made entirely of lead these days but can't remember what it's called!

It sounds like the kind of procedure that would be performed in an interventional radiology suite with a fixed c-arm? Like you say, ultrasound requires the probe to be up against "mass", the waves don't like going through air, which is why gel is used.

Going back a page or so, the mobile c-arms are just plugged into any free 13a socket and they have an inbuilt timer. We tend to alert the surgeon if it reaches 5 mins of fluoroscopy time, and then every 5 mins thereafter. The screening times in conventional theatre procedures, such as orthopaedic or urology, are usually a lot less than the 5 mins. Cardiology cath lab and interventional can accumulate pretty high durations though!

As someone said, we all wear dose monitoring badges whenever we're at work, worn under any protective garments, and it is very unusual for anyone to record a dose. Some surgeons wear dose monitoring rings on a finger, and they're the ones that do receive a dose as they're so close to the radiation beam. The second best method of radiation protection is to utilise the inverse square law and stand as far back as possible!

 

[JohnW2]

What's your background @JohnW2 ?

Complex I'll PM you.

The newer aprons are definitely lighter and less bulky than previous,

I suppose that doesn't surprise me, but ...

i don't think they're made entirely of lead these days but can't remember what it's called!

Fair enough Isn't the degree of blockage of radiation fairly directly related to the atomic mass of the element concerned, which, in turn determines it's density, hence weight? If so, I wouldn't have expected that an alternative material would probably have to have at leastthe same weight as lead to achieve the same degree of protection - or have I got that wrong?

It sounds like the kind of procedure that would be performed in an interventional radiology suite with a fixed c-arm?

I would have thought so. I can't honestly imagine that any intra-vascular procedure would be undertaken using anything iother that X-ray screening.

Like you say, ultrasound requires the probe to be up against "mass", the waves don't like going through air, which is why gel is used.

Quite. Although I think US is (was) used for some procedures like putting stents into bile ducts or 'aiming' biopsy needles, as above, I really can't imagine anyone trying to use it for intravascular procedures.

Going back a page or so, the mobile c-arms are just plugged into any free 13a socket and they have an inbuilt timer. We tend to alert the surgeon if it reaches 5 mins of fluoroscopy time, and then every 5 mins thereafter. The screening times in conventional theatre procedures, such as orthopaedic or urology, are usually a lot less than the 5 mins. Cardiology cath lab and interventional can accumulate pretty high durations though!

As you will see, I was talking about the latter (cardiac caths and pacemakers) when, as you say, screening times can get quite long. However, as the discussion was about mobile image intensifiers, as I said, I was thinking/talking primarily about ('emergency') insertion of temporary pacing wires, since any other invasive cardiological investigation or intervensuion would normally be domne in a cath lab with 'fixed' equipment (as you say, a C-arm).

However, as I also said, the radiographers seemed much more nervous back then (maybe because the gear was more 'leaky'?) and used to start 'alerting us' long before 5 mins - probably more like 2 mins

... but what about the other question I asked. Was I right in suspecting that more modern technologies like MRI cannot be used for 'continuous real-time screening'?

Kind Regards, John

 

[darreng1983]

Complex I'll PM you.

I suppose that doesn't surprise me, but ...

Fair enough Isn't the degree of blockage of radiation fairly directly related to the atomic mass of the element concerned, which, in turn determines it's density, hence weight? If so, I wouldn't have expected that an alternative material would probably have to have at leastthe same weight as lead to achieve the same degree of protection - or have I got that wrong?

I would have thought so. I can't honestly imagine that any intra-vascular procedure would be undertaken using anything iother that X-ray screening.

Quite. Although I think US is (was) used for some procedures like putting stents into bile ducts or 'aiming' biopsy needles, as above, I really can't imagine anyone trying to use it for intravascular procedures.

As you will see, I was talking about the latter (cardiac caths and pacemakers) when, as you say, screening times can get quite long. However, as the discussion was about mobile image intensifiers, as I said, I was thinking/talking primarily about ('emergency') insertion of temporary pacing wires, since any other invasive cardiological investigation or intervensuion would normally be domne in a cath lab with 'fixed' equipment (as you say, a C-arm).

However, as I also said, the radiographers seemed much more nervous back then (maybe because the gear was more 'leaky'?) and used to start 'alerting us' long before 5 mins - probably more like 2 mins

... but what about the other question I asked. Was I right in suspecting that more modern technologies like MRI cannot be used for 'continuous real-time screening'?

Kind Regards, John

Sorry i forgot about this convo.

MRI screening.... we don't do it, i don't know if our scanners have that capability (we don't rotate through MRI). I know that it is possible for "real time" scanning, but I think it's used to examine a particular system, eg digestive. I don't think it's feasible to use this imaging perform actual procedures due to the massive lack of space, with the patient being in the middle of the scanner, plus the fact you wouldn't be able to have anything metallic in the scanning room. It's a shame really as the images are absolutely amazingly detailed

 

[JohnW2]

MRI screening.... we don't do it, i don't know if our scanners have that capability (we don't rotate through MRI). I know that it is possible for "real time" scanning, but I think it's used to examine a particular system, eg digestive. I don't think it's feasible to use this imaging perform actual procedures due to the massive lack of space, with the patient being in the middle of the scanner, plus the fact you wouldn't be able to have anything metallic in the scanning room. It's a shame really as the images are absolutely amazingly detailed

Thanks. That all makes sense. As I said, I've never seen or heard of MRI being used for imaging during a procedure and, for all the reasons you mention, I can't really see how it could. As you say, iut's a pity since MRI images are so good, but it seems that, at least unless/until someone comes up with a completely new idea/concept, we're probably stuck with either X-rays or US for procedures?

Kind Regards, John