INTRODUCTION TO

DIAGNOSTIC IMAGING

DR. HJH. SALWAH BT HJ. HASHIM, KMN, DJN

PAKAR PERUNDING RADIOLOGI & KETUA
JABATAN PENGIMEJAN DIAGNOSTIK
HOSPITAL PULAU PINANG

25 JULY 2012
 INTRODUCTION.cont

Brief history of Radiology

Brief history of Radiology in

Malaysia
 Discoverer of X-Rays
Professor Wilhelm Conrad
Roentgen
( 08.11.1895 )
Mrs. Roentgens
hand the very
first X-Ray of a
human
 Brief History of Radiology in
Malaysia
Feb 1897 Introduced in the Malay
Peninsular with installation of the
first X-Ray machine in Taiping, Perak
Oct 1897 machine donated to
Government Hospital in Ipoh
Feb 1910 General Hospital in Kuala
Lumpur received its X-Ray machine
followed by Penang General Hospital
Brief History of Radiology in
Malaysia..cont
1924 first dark room built in KLGH
1927 first fluoroscopy machine in KLGH
1957 Dr Omar Din, the first Malaysian to
be appointed Consultant Radiologist of
Selangor & the Federated Malay States
1963 first Cerebral angiography done in
KLGH
Brief history of Radiology in
Malaysia.cont
1966 first peripheral angiography
done in Penang GH
1967 first Cardiac angiography done
in UHKL
1972 mammographic services started
in KLGH
1974 first ultrasound machine in
HUKM
Brief history of Radiology in
Malaysiacont
1977 first CT scanner installed in
KLGH
1983 Master of Radiology training
programme started in HUKM
1992 first MRI scanner installed in
KLGH
2005 first CT-PET scanner installed
in Penang Hospital
WHOS WHO IN RADIOLOGY

Radiologist

Medical Physicist

Radiographer
 Radiologist
Specialist doctor undergone further
3 to 4 years of training in radiology

Interpret X-Rays, ultrasound, CT,

MRI and other special radiological
examinations

Perform interventional procedures

 Medical Physicist
Specialist in the application of
physics to medical diagnosis and
therapy
Assist in the specification and
selection of imaging or therapy
equipment
Development and supervision of
quality assurance programme
Radiation safety programme-
monitoring radiation doses
 Radiographer
At least SPM, undergone 3 years
training programme

Trained technologist in performing

radiography

Operates the X-Ray equipments

Assistant to the radiologist

 Tips to maximise services
Before coming to the dept
Kindly ensure form has been filled
completely
Provide adequate history and clinical
findings
State indication of examination
Provide provisional clinical diagnosis
Tips to maximise services.. cont
Know the complete medical history of
the pt even if not in charge of the pt
Excuses:
My MO ask me
My specialist ask me
I am helping my colleague
I just took over this case
I just came back from holiday
Tips to maximise services.. cont

-/+ BUSE and Se Cr, written consent

form, allergy form
For interventional procedure kindly
provide bleeding profile, Hb, platelet
count
Tips to maximise services ..cont
Coming to the dept
Look at the roster. Determine the
Radiologist/MO in charge of the respective
modality. The roster is available at the notice
board outside the reporting room.
For Urgent appt-approach the
Radiologist/MO in charge of the appropriate
modality
For Normal appt-approach the
Radiologist/MO in charge of reporting
 Tips to maximise services.cont
Coming to the dept
Kindly bring along all previous films and
reports
To get a film reported on the spot, look for
the MO/Radiologist in charge of the
reporting room
CT scans done after office hours will be
reported the next day ( Radiologist/MO in
charge of CT scan room ). Report is usually
available by late morning
 Tips to maximise services.cont
Coming to the dept
Kindly trace these reports at the
dispatch counter and if not available,
trace at the CT scan room
Any films taken from the depart have to
be checked out at the dispatch counter
Please do not remove any film from the
Radiologists table without informing the
Radiologist concerned
Request Form
NOT
Order Form!!!
GENERAL RADIOLOGY
Orthopantomogram ( OPG )
 RADIOLOGICAL
CONTRAST STUDIES
 BARIUM STUDIES

Barium swallow

Barium Follow through

Small bowel enema/ Enteroclysis

Barium enema etc

Ba Swallow evaluates the oesophagus
BARIUM MEAL evaluates the
stomach and duodenum
Small Bowel Enema: evaluates the
small bowel
BARIUM ENEMA evaluates
the colon
 INTRAVENOUS UROGRAM
evaluates the kidneys, ureters
and bladder

R
R
 MICTURATING
CYSTOURETHROGRAM evaluates
the bladder and posterior urethra,
look for VUR
HYSTEROSALPHINGOGRAM
evaluates the uterus and the
fallopian tubes
MYELOGRAM evaluates
the spinal cord and nerve
roots
DACROCYSTOGRAM evaluate any
blockage of the duct which normally
drain tears
 SUBMANDIBULAR
SIALOGRAM evaluates the
ducts within the salivary gland
 INTERNAL CAROTID
ANGIOGRAM- radiological
examination of arteries
AORTOGRAM
Superior Mesenteric Angiogram
 Coronary Angiogram

Left coronary arteriogram : Lateral view

VENOGRAM radiological
examination of the veins
BRONCHOGRAM evaluates the
bronchial tree for
bronchiectasis/obstruction
 LYMPHANGIOGRAM staging
lymphomas, to look for metastatic
deposit, primary lymphoedema
MAMMOGRAPHY
CC

MLO
R
CC L R L
CC MLO MLO
COMPUTED TOMOGRAPHY
Intracranial Hematoma
CTA Coronary
CT Pulmonary Angiography is
now considered the gold
standard to examine patients
with suspected pulmonary
embolism in patients with D-
dimer positive
 NEWER IMAGING
TECHNIQUES
Ultrasound

Magnetic Resonance Imaging ( MRI )

ULTRASONOGRAPHY
Normal Right &
Left Kidney-
sagittal view
Normal Study : Color Doppler sonogram of
the popliteal artery
MAGNETIC RESONANCE
IMAGING ( MRI )
MRCP
THANK YOU
FOR YOUR ATTENTION

drsalwah@moh.gov.my