Imaging

Perry County Memorial Hospital (PCMH) offers Missouri residents bone densitometry testing using the established standard for measuring bone mineral density. The test, sometimes called a DEXA scan, is an enhanced form of x-ray technology. It is painless and noninvasive and involves minimal radiation exposure.

The test can be used to:

• Diagnose osteoporosis.
• Track the effectiveness of treatment for osteoporosis and other conditions that can cause bone loss.
• Determine a person's risk for developing a fracture.

After the exam, the images will be interpreted by the radiologist at PCMH. A report will be sent to your physician, who will go over the results with you. Your test results will be in the form of two scores:

• T score. This number compares the amount of bone you have to a young adult of the same gender with peak bone mass. The T score is used to estimate your risk of developing a fracture.
• Z score. This number reflects the amount of bone you have compared with other people in your age group and of the same size and gender. If this score is unusually high or low, it may indicate a need for further medical tests.

Preparing for a Bone Density Test

Do not take calcium supplements for at least 24 hours prior to the exam. On the day of the exam, you may eat normally.

Contact Us

PCMH Radiology Department
573.768.3295

Computed tomography (CT) is a noninvasive medical test that helps physicians diagnose and treat medical conditions using cross-sectional images.

CT scans use x-rays generated from a source that is rotated around the body to create 3-D pictures of the body. CT scans of internal organs, bones, soft tissue and blood vessels provide greater clarity and show more details than routine x-ray exams.

CT scans help diagnose problems such as cancers, cardiovascular disease, infectious disease, trauma and musculoskeletal disorders. For instance, a CT scan is often the preferred method for diagnosing different types of cancer because the image allows a physician to confirm the presence of a tumor, measure its size and exact location, and determine the extent of the tumor's involvement with other nearby tissue.

Physicians often use CT imaging to assess for:

• Stroke.
• Appendicitis.
• Kidney stones.
• Aortic aneurysms.
• Pulmonary embolism (a blood clot in the lung vessels).
• Injuries to the liver, spleen, kidneys, bowel or other internal organs, in cases of trauma.

At Perry County Memorial Hospital (PCMH), patient safety is a top priority of ours. So, it makes sense that our new CT scanner, SOMATOM Definition Edge, is the top of the line in areas of safety, image clarity and speed.

One of the top features of our CT scanner includes radiation dose reduction of up to 75% to the patients. The radiation dose reduction technology, X-CARE, allows us to reduce radiation exposure without compromising image quality. This technique can be used for CT scanning of the neck, chest, abdomen and pelvis for all patients, including children. The illustration below shows the benefit X-CARE provides to our patients.

Additionally, over the past couple of years, PCMH has been voluntarily participating in the American College of Radiology’s (ACR) Dose Index Registry to proactively monitor and minimize the amount of radiation our patients receive. This forum receives and compiles radiation dose comparisons from CT scanners across the country, and our new CT scanner has improved our CT dose ranking, enabling us to score better than some of the nation’s largest healthcare systems.

Another feature of the SOMATOM Definition Edge is superior image quality. The scanner can generate ultra-thin slices to deliver an extremely high image resolution without any increase in radiation dose. The increased image detail benefits critical cases such as emergency diagnostics and cardiovascular examinations, where every additional visible micrometer can be beneficial. Here are a few images for you to see the sharpness for yourself.

The Definition Edge CT scanner allows patients to experience a shorter scan time as well. With patients who are unable to remain still for long periods, or with scans involving fast moving organs such as the heart, the shortest possible scanning time may reduce image motion pieces. With our new scanner, a typical thorax or abdomen examination can be performed in about two seconds, potentially minimizing the need for patient breath-holding during scanning. A 6-foot patient can potentially be scanned in 8.3 seconds at full speed using the system. At PCMH, our new CT scanner can reduce patient scan times by up to 90% and minimize breath holds to 8 seconds or less.

For more information regarding what parents should know about CT scans for children, please visit CT scans for children.

An electroencephalogram (EEG) is a test that measures and records the electrical activity of your brain. Special sensors or electrodes are attached to your head and connected to a computer to be monitored. The computer records your brain's electrical activity. An EEG is safe and painless. The electrical activity of your brain is recorded, but no electrical current is put into your body.

An EEG helps to evaluate patients with seizure activity. It also is used as a screening tool for patients experiencing frequent headaches, dizzy spells, fainting, loss of consciousness or changes in a person's mental status, such as confusion.

EEGs are performed at the Diagnostic Sleep Institute on the PCMH campus for patients 15 and older. This test is performed in a quiet, comfortable atmosphere. Appointments are required. This can be set up by a nurse or the patient.

Contact the Diagnostic Sleep Institute at 573.547.2536, ext. 3355.

PCMH's mammography department is accredited by the American College of Radiology and offers technologically-advanced diagnostic imaging and radiology services.

The care you receive involves state-of-the-art technology for screening and evaluation of breast cancer, including digital mammography for faster, more accurate exams. Our hospital utilizes Hologic Genius™ 3-D Mammography™

3-D mammography offers a number of advantages and patient conveniences:

• Reduced callbacks by up to 40% compared to 2-D.
• Exam results are more accurate than 2-D alone, detecting 20% to 65% more invasive breast cancers.
• Provide better, earlier breast cancer detection.
• Greater accuracy for women across a variety of ages and breast densities.
• U.S. Food and Drug Administration-approved as superior for women with dense breasts.
• 3.7 second scan time.

A good analogy for 3-D mammography is like thinking of the pages in a book. If you look down at the cover, you cannot see all of the pages. But when you open it up, you can go through the entire book page-by-page to see everything between the covers.

We know a mammogram may not be the most comfortable experience, so we continue to use MammoPads during mammograms to ensure the most comfortable mammographic experience for our patients. MammoPads reduce discomfort during an exam by providing a soft foam pad to cushion the breast while also providing a warmer surface.

Preparing for a Mammogram

Do not wear deodorant, talcum powder or lotion under your arms or on your breasts on the day of the exam. These items can appear as calcium spots on a mammogram.

Mammograms for the Uninsured

The East Missouri Action Agency (EMMA) offers mammograms to the uninsured. To take advantage of this program, contact the EMAA at 573.431.5191 or toll-free at 800.392.8663.

MRI uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues, bone and nearly all other internal body structures.

At PCMH, we offer the most advanced MRI technology clinically available. PCMH is the first critical access hospital in the state of Missouri and in the Southeast region to offer a 3 Tesla MRI.

Here's an overview of the benefits of the 3 Tesla MRI machine:

• Superb quality. The 3 Tesla MRI boasts the strongest magnet field strength used today. The higher the strength, the more clarity and detail is provided in the image, helping physicians in diagnosis.
• A wide range of uses. It can be used for many applications, including neurology; "functional neurology;" orthopedic cartilage assessment; and breast, vascular and cardiac imaging.
• Comfort. With one foot of headroom, you won't feel like you are nose to nose with the top of the magnet. We also offer Pandora radio.
• Speed. Our MRI uses Total Imaging Matrix (TIM™) technology to scan multiple areas of the body at one time, which means the test is over faster than a traditional MRI.

The MRI Difference

As you may have noticed, we boast that we offer the most advanced MRI technology clinically available, and we feel we have every reason to. However, we want you to see what all the excitement is about as well as show you exactly why you should have an MRI completed by us. Our studies offer physicians the most detailed view of your body so they can accurately diagnose and treat your conditions. Just see for yourself!

Key Technical Differences

Local competitor: Slice thickness is 4mm with a 4.5mm gap between images.
PCMH: Slice thickness is 1mm with a .2mm gap between images.

Slice thickness is important for detail and structure resolution so the doctor can clearly see the anatomy that he or she is looking at. Thinner slices provide greater detail, but require a larger, more efficient magnet (what PCMH has). Less efficient scanners have to image at larger slice thicknesses to help produce an image with fewer artifacts and in a reasonable time period. Also, a larger gap between images is required to avoid image-image artifact. The trade-off of a larger slice (what the competitor produces) is less detail. The trade-off of a larger slice gap is missed anatomy as well. You can clearly see the difference in the anatomy and clarity PCMH's MRI provides the doctors versus the local competitor's.

Preparing for an MRI

Some pacemakers are now MRI-compatible. Check before your appointment.

The only patient preps for MRIs are those listed below:

• Magnetic Resonance Angiography (MRA): Drink four to six glasses of clear liquids the day before the exam.
• Magnetic Resonance Cholangiopancreatography (MRCP): Do not eat or drink anything after midnight. If scanning is to be performed the same day as the test is ordered, do not have anything to eat or drink for at least four hours before the exam.
• MRI Prostate: Low fiber diet the day before. Fleets enema the day of test.

Nuclear medicine is a type of medical imaging that uses small amounts of radioactive material to diagnose a variety of diseases, such as many types of cancers; heart disease; gastrointestinal, endocrine and neurological disorders; and other abnormalities within the body. Nuclear medicine procedures are able to locate molecular activity within the body. Because of this, the exam can identify disease in its earliest stages and see a patient’s immediate response to treatment. This type of diagnostic imaging is used by physicians to visualize the structure and function of an organ, tissue, bone or system within the body.

Nuclear medicine or molecular imaging procedures are noninvasive and, with the exception of intravenous injections, are painless. These scans use radioactive materials called radiopharmaceuticals or radiotracers to help physicians diagnose and evaluate medical conditions.

Depending on the type of nuclear medicine exam, the radiotracer is either injected into the body, swallowed or inhaled as a gas. Eventually it accumulates in the organ or area of the body being examined. Radioactive emissions from the radiotracer are then detected by a gamma camera that produces images and detailed molecular information.

PCMH performs many nuclear medicine scans, including:

• Nuclear stress test (myocardial perfusion study or cardiolite stress test).
• Bone scan.
• HIDA scan (gallbladder).
• Renal scan.
• Thyroid scan.
• Lung scan.
• MUGA scan (heart function).
• Gastric emptying scan.
• Infection imaging.
• Breast cancer lymph node study.
• Liver/spleen study.

At PCMH, ultrasound imaging is performed with state-of-the-art equipment that produces clear images for the radiologist and patient. Ultrasound imaging, also called ultrasound scanning or sonography, is a noninvasive test that exposes part of the body to high-frequency sound waves, which produces a picture of the inside of the body.

Unlike x-rays, ultrasound exams do not use ionizing radiation. Because ultrasound images are captured in real-time, they can show the structure and movement of internal organs, as well as blood flowing through blood vessels.

Ultrasound imaging is a helpful way of examining many of the body's organ tissue. Some examinations are:

• Obstetrics—the unborn child (fetus) in women.
• Heart and blood vessels.
• Liver.
• Gallbladder.
• Spleen.
• Pancreas.
• Kidneys.
• Bladder.
• Breast.
• Thyroid.
• Uterus and ovaries.
• Scrotum (testicles).

At PCMH, a Doppler ultrasound study can be performed as part of an ultrasound examination. Doppler ultrasound is a special technique that evaluates flow through blood vessels, including the body's major arteries and veins in the abdomen, arms, legs and neck.

Doppler ultrasound images can help the physician see and evaluate:

• Blockages to blood flow, such as clots.
• Narrowing of vessels, which may be caused by plaque.
• Tumors and congenital malformation

When an ultrasound is performed, the patient often lies face-up on an examination table. The sonographer (ultrasound technologist) must use a clear, water-based gel on the area of the body being studied to help the transducer make secure contact with the body. The sonographer will then press the transducer firmly against the skin to see the area from many angles.

This form of diagnostic imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions. This type of radiology exam is the oldest and most frequently used form of medical imaging. Diagnostic imaging with x-rays involves exposing part of the body to a small dose of ionizing radiation to produce pictures of the inside of your body.

X-rays are commonly taken of the chest and bones. A chest x-ray is often used to evaluate the lungs, heart and chest wall. Some conditions this can help diagnose are:

• Pneumonia.
• Emphysema.
• Lung cancer.
• Heart failure and other heart-related problems.
• Line and tube placement.
• Other medical conditions.

Bone x-rays are often performed to help:

• Diagnose fractured bones or joint dislocation.
• Demonstrate proper alignment and stabilization of bony fragments following treatment of a fracture.
• Look for injury, infection, arthritis, abnormal bone growths and bony changes seen in metabolic conditions.
• Assist in the detection and diagnosis of bone cancer.
• Locate foreign objects in soft tissues in or around bones.
• Guide orthopedic surgery, such as spine repair/fusion, joint replacement and fracture reductions.

An x-ray usually requires no special preparation.