X-Rays/Conventional radiographs/Plain films

Conventional radiographs or X-rays are the most common studies conducted in radiology (e.g. chest X-ray, abdominal X-ray, hand, wrist or foot X-ray).

An X-ray is a picture taken of the inside of the body by a machine that sends out beams of radiation energy. When these beams or rays pass through skin and muscle they are blocked by the bones and teeth, creating shadow effects. These shadows are captured on photographic film.

The different parts of your child's body have different body tissues, which vary in their absorption of the X-rays. This means bones, soft tissues and other internal features can be seen on the film in varying shades of grey. X-rays sometimes involve the injection of substances to highlight soft tissues.

All radiographs involve radiation, so before exposing your child to its effects, the request for an X-ray must be clinically justified. We use dedicated paediatric equipment and techniques to minimise the radiation dose. Most radiographs require the child to stay still at least momentarily during the exposure.

For all examinations a family member or carer is encouraged to stay with the child for their comfort. However, other children or pregnant mothers are not allowed to stay with the child during the actual radiation exposure.

Chest XR

A chest XR will generally involve a single picture. A young child has the X-ray taken while lying on a bed. An older child would be imaged sitting or standing if possible.

Abdominal XR

This generally involves a single picture with the child lying on an X-ray bed.

X-rays of Extremities (Forearm, Elbow, Knee, Ankle, etc)

This may require pictures of the relevant area in two or more positions, depending on the external indications of the problem.

Skull X-rays

These are taken while the child lies on the X-ray bed. Three different views are usually taken.

Ultrasound

Ultrasound is high frequency sound (much higher than humans can hear). Sound passes into the body from an ultrasound probe (transducer) that is passed over the relevant area of the body. The sound "bounces" off the organs inside the body. Visible images of the sound waves created by this bouncing effect are displayed on a television-like screen.

Ultrasound scans are used to look at internal structures beneath the skin surface, particularly organs like the bladder, kidneys and spleen. Radiation is not involved.

Generally, if your child's organs such as the liver or gall bladder are to be examined, your child should fast for a few hours before their appointment. If the test is for your child's kidneys or bladder your child will need to drink plenty of fluids to fill their bladder. Ultrasound scanning of extremity areas such as limbs or neck generally does not require any formal preparation.

You will be asked to stay with your child during the ultrasound, which usually takes approximately 30 minutes. Scanning rarely involves discomfort, although the gel used on the probe can feel peculiar in a cool and slippery way.

Fluoroscopy Procedures

Your child may be referred for a special procedure which involves fluoroscopy e.g. an MCU or barium meal to observe internal movement relating to various organs like kidneys or parts of the digestive tract. It is sometimes used to guide catheters through the body. Fluoroscopy is like making an internal movie because the X-rays beams are continuous.

Fluoroscopy studies involve radiation, but unlike a simple X-rays the radiologist needs to see the X-ray picture on the screen as it is happening and store some selected images during the examination for later study.

If your child is referred for such a study and you have any questions or concerns about the procedure, you are welcome to phone to discuss the study with a paediatric radiology nurse or radiologist should you have specific concerns. The study will be explained to you and your child more fully at the appointment.

Micturating Cystogram

A micturating cystogram is an X-ray that examines the bladder as it fills and empties (this is called "micturition"). The examination allows the doctor to see whether urine goes the “wrong way” from bladder up towards the kidneys—a condition termed “reflux”. The examination is also helpful in showing any obstruction as the bladder empties. No special preparation is necessary for the test.

Your child will be given a gown to change into and asked to lie on the X-ray table. You will be asked to stay with your child during the study and every effort will be taken to make your child as comfortable as possible. A small tube will be gently inserted into the bladder and a special liquid (which can be seen on X-ray) will be run through the tube to fill the bladder. When the bladder is full your child will be encouraged to empty their bladder while lying down so that X-rays can be taken during micturition. The tube is removed during the study. The examination usually takes approximately 30 minutes.

Barium swallow / meal / upper GI contrast study

This is a special procedure for watching what happens as your child drinks fluid. Your child must fast for a few hours before the examination to ensure their stomach is empty and they are hungry. The exact duration of the fast will vary, depending on your child’s age. You will be advised of the fasting details when you make the appointment. Generally, babies need to fast for three hours and older children for four to six hours. Any regular medicines should still be taken, with a small amount of water if necessary. If your child is diabetic or you have any questions, please phone the Department before the appointment on +61 7 3163 8311.

Your child will be asked to change into a gown and given barium liquid to drink. This is a thin, white liquid which looks like milk but tastes chalkier. Whenever possible, the barium will be flavoured to make it more palatable. If your child prefers a particular feeding cup or bottle you may wish to bring this with you.

You will be asked to stay with your child throughout the study. The doctor will watch the image on a TV screen as your child swallows and take X-ray pictures at different stages during the study. The examination generally takes approximately 30 minutes.

Barium Follow-through

This is a special procedure focussed on the small bowel (intestine), which lies beyond the stomach. Your child will be given a gown to change into and given barium liquid to drink. This is a thin, white liquid which looks like milk but tastes chalkier. Whenever possible the barium will be flavoured to make it more palatable. If your child prefers a particular cup or feeding bottle, please bring it with you. You will be encouraged to stay with your child during the study. The doctor will watch the image of the barium moving through your child's system on a TV screen and take pictures at different stages. This first part of the examination usually takes about 30 minutes. More X-rays may then be taken at intervals as the barium moves through the bowel. It is not possible to say how long the entire study will take, as the liquid moves through at very different rates from one child to another—it can take two to four hours.

Intubated Small Bowel Enema

This is an alternative technique to study the small bowel (small intestine) lying beyond the stomach and provides better detail than a Barium Follow Through.

Your child will be given a gown to wear and asked to lie on the bed. At the start of the study a thin tube will be passed through their nose. The X-ray machine will be used to guide the tube beyond the stomach into the start of the small bowel. A special liquid (contrast), which can be seen on X-ray, will then be given through the tube to outline the small bowel.

With this technique a large volume of contrast may be given to achieve detailed images. Although this method means your child avoids having to drink the contrast liquid, your child may feel uncomfortable initially with the tube and later due to the volume of liquid passing through the tube. We will do our best to minimise any discomfort. The test generally takes 30 to 45 minutes, during which the radiologist will observe the small bowel on a screen and take selected images. The tube will be removed on completion of the study.

Barium Enema / Contrast Enema

This is a special procedure for viewing the large bowel (colon), which lies beyond the small bowel. Depending on your child's circumstances, you may need to give your child a type of laxative to ensure the colon is empty prior to the study. You will be advised of what this involves when you call to make the appointment. You will be encouraged to stay with your child throughout the study and every effort will be made to keep your child comfortable.

Your child will be given a gown to change into and asked to lie on a bed. A small, soft tube will be gently inserted into their bottom. Special contrast liquid, which can be seen on X-ray, will be run through the tube and as the bowel fills the doctor will watch the image on a TV screen and take pictures at different stages. Your child will probably be asked to turn on the table for some of the pictures. The examination usually takes about 30 minutes and when it is finished the tube will be removed and your child will be allowed to go to the toilet.

IVP / Urogram

This is a special procedure to obtain an X-ray of the kidneys and bladder, which do not show up on an ordinary X-ray. No special preparation is necessary for the test. You will be encouraged to stay with your child throughout the study.

Your child will be given a gown to change into, then asked to lie down on the X-ray table. A special fluid containing iodine will be injected into a vein, which will travel via the blood to the kidneys. If possible, a local anaesthetic cream is used to numb the skin before the injection, however, this is not routinely given to babies less than one year old.

A series of X-rays will be taken so that the doctor can see the kidneys and bladder. The examination usually takes 30 to 60 minutes. There is no discomfort associated with the test, except for the injection. If your child has an allergy to seafood, please advise us when you call to make the appointment.

Computed Tomography

CT scans involve radiation. The scanner is shaped like a large doughnut and contains a rotating camera which allows a thin X-ray beam to encircle part of the body requiring examination. CT scans provide a detailed cross sectional view of the body's internal structures, like a 3D picture.

Your child will generally lie flat on the bed for the study and must keep still for five to 10 minutes. Young children (six months to four years) may need sedation/general anaesthetic to help them lie still for the duration of the CT scan. This will be arranged in discussion with your referring doctor. Babies can generally be scanned while asleep after a feed. Children older than four years generally lie still without sedation. In this situation, you will be encouraged to stay with your child during the study.

The CT bed is  moved so that the relevant area of your child's body lies within "the doughnut". The machine will not touch your child. The radiographer will watch through an observation window and an intercom may be used for communication with your child.

Sometimes, a contrast liquid is used during the study to highlight certain structures. This may be given as a drink by mouth to outline the bowel or may require an intravenous injection. If an injection is required, a local anaesthetic cream will be applied in advance to minimise any discomfort to your child.

The contrast agents are generally very safe but, as with all medications, side effects may very occasionally occur. Allergic reactions are usually mild (itching or wheeze) and very rarely severe. If your family has a history of severe allergy, in particular to iodine or seafood, your child may be at increased risk of a reaction. Please advise if this is relevant when you call to make the appointment.

You should allow 30 minutes for the study, although often the scan will take less time. Mater's CT scanner is situated within Mater Adult Hospital Radiology Department, but your child's examination will be performed by paediatric trained radiographers, and supervised and reported on by paediatric trained radiologists.

Magnetic Resonance Imaging

An MRI scan does not involve X-rays. Instead, the technique uses a strong magnetic field, radio waves and sophisticated computer processing to create images of internal structures. MRI can be used to extract images of various different parts of the body. It is especially useful for testing the head, spine and musculoskeletal system.

The strong magnetic field causes the millions of atoms within the body to act as tiny magnets and these align themselves within the magnetic field. Radio waves are used to change the alignment of the atoms. The release of energy this causes is transferred into an image. A series of pictures is taken through the relevant area of your child's body. The information the scan collects from the different directions and alignments can be reconstructed as electronic images. These provide detailed information of problem internal areas.

Currently, Mater Children's patients are scanned at the Mater Adult Hospital on Level 4 in the Adult Radiology Department. MRI requests for our inpatients or outpatients are generally reviewed by a paediatric radiologist, and if considered clinically justified, the study will be arranged. Out-patients are bulk-billed. MRI requests from GPs should be arranged directly with a medical imaging department convenient for the patient.