Radio graphic technique 3

1. Radiographic Technique 3
Prepared by:
Behzad Ommani
Bachelor of Radiology
Master of Medical Engineering
May, 2014

2. LATERAL PROJECTION
R or L position
Image receptor: 24 x 30 cm lengthwise.
Position of patient : Place the patient in the lateral
recumbent position on either the left or right side.
Position of part :
• Center the midcoronal plane to the center of the grid.
• Flex the patient's knees slightly for stability, and place a
support between the knees to keep the pelvis lateral.
• Adjust the patient's shoulders and hips to be
perpendicular.
• Adjust the center of the IR to the ASIS.
Large Bowel

3. Respiration: Suspend
Central ray : Perpendicular to the IR to enter the
midcoronal plane at the level of the ASIS.
Structures shown :
The lateral projection best demonstrates the rectum and
distal sigmoid portion of the colon.
Large Bowel

4. Large Bowel

5. AP PROJECTION
Image receptor: 35 x 43 cm lengthwise.
Position of patient : Place the patient in the supine position
Position of part :
• Center the midsagittal plane to the grid.
• Adjust the center of the IR at the level of the iliac crests.
Respiration: Suspend.
.
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6. Central ray : Perpendicular to the IR to enter the midline
of the body at the level of the iliac crests.
Structures shown :
The AP projection demonstrates the entire colon with the
patient supine.
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7. AP AXIAL PROJECTION
• Image receptor : 35 x 43 cm or 24 X 30 cm
lengthwise.
Position of patient : Place the patient in the supine position
Position of part :
• Center the midsagittal plane to the grid.
• Adjust the center of the IR at a level approximately 2
inches (5 cm) above the level of the iliac crests.
Respiration: Suspend.
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8. Central ray :
• Directed 30 to 40 degrees cephalad to enter the midline
of the body approximately 2 inches (5 cm) below the
level of the ASISs .
• Directed to enter the inferior margin of the pubic
symphysis when a collimated image is desired for
demonstration of the rectosigmoid region.
Structures shown :
The AP axial projection best demonstrates the rectosigmoid
area of the colon .A similar image is obtained when the
patient is prone .
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9. Large Bowel

10. AP OBLIQUE PROJECTION
LPO position
Image receptor : 35 x 43 cm or 24 X 30 cm lengthwise.
Position of patient : Place the patient in the supine position
Position of part :
• With the patient's left arm by the side of the body and the
right arm across the superior chest, have the patient roll
on to the left hip to obtain a 35 to 45 degree rotation
from the table.
• Use a positioning sponge and flex the patient's right
knee for stability, if needed.
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11. • Center the patient's body to the midline of the grid.
• Adjust the center of the IR at the level of the iliac crests.
Respiration: Suspend.
Central ray :
Perpendicular to the IR to enter approximately 1 to 2 inches
(2.5 to 5 cm) lateral to the midline of the body on the
elevated side at the level of the iliac crest.
Structures shown
• The LPO position best demonstrates the right colic
flexure and the ascending and sigmoid portions of the
colon. = RAO
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12. Large Bowel

13. AP OBLIQUE PROJECTION
RPO position
Image receptor : 35 x 43 cm or 24 X 30 cm lengthwise.
Position of patient : Place the patient in the supine position
Position of part :
Similar LPO Position of part.
Structures shown :
• The RPO position best demonstrates the left colic flexure
and the descending colon. = LAO
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14. Large Bowel

15. AP or PA PROJECTION
Right lateral decubitus position
Image receptor : 35 x 43 cm lengthwise.
Position of patient :
• Place the patient on the right side with the back or
abdomen in contact with thevertical grid device.
• Exercise care to ensure that the patient does not fall
from the cart of table; if a cart is used, lock all wheels
securely in position.
Position of part :
• With the patient lying on an elevated radiolucent
support, center the mid sagittal plane to the grid.
Large Bowel

16. • Adjust the center of the IR to the level of the iliac crests.
Respiration: Suspend
Central ray : Horizontal and perpendicular to the IR to
enter the midline of the body at the level of the iliac
crests.
Structures shown
• The right lateral decubitus position demonstrates an AP
or PA projection of the contrast-filled colon. This
position best demonstrates the "up" medial side of the
ascending colon and the lateral side of the descending
colon when the colon is inflated with air.
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17. Large Bowel

18. AP or PA PROJECTION
Left lateral decubitus position
Image receptor : 35 x 43 cm lengthwise.
Position of patient :
• Place the patient on the left side with the back or
abdomen in contact with thevertical grid device.
• Exercise care to ensure that the patient does not fall
from the cart of table; if a cart is used, lock all wheels
securely in position.
Position of part :
• With the patient lying on an elevated radiolucent
support, center the mid sagittal plane to the grid.
Large Bowel

19. • Adjust the center of the IR to the level of the iliac crests.
Respiration: Suspend
Central ray : Horizontal and perpendicular to the IR to
enter the midline of the body at the level of the iliac
crests.
Structures shown
• The left lateral decubitus positiondemonstrates a PA or
AP projection of the contrast-filled colon. This position
best demonstrates the "up" lateral side of the ascending
colon and the medial side of the descending colon when
the colon is inflated with air.
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20. Large Bowel

21. AXIAL PROJECTION
CHASSARD-LAPINE METHOD
• Structures shown
The Chassard-Lapine image demonstrates the rectum,
rectosigmoid junction, and sigmoid in the axial
projection
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22. DEFECOGRAPHY
Defecography, evacuation proctography, or dynamic rectal
examination is a relatively new radiologic procedure
performed on patients with defecational dysfunction.
• No preparation of the patient is necessary, and
cleansing enemas are not recommended because water
remaining in the rectum dilutes the contrast medium.
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23. Large Bowel