diagnostic imaging

diagnostic imaging, the use of electromagnetic radiation and certain other technologies to produce images of internal structures of the body for the purpose of accurate diagnosis. Diagnostic imaging is roughly equivalent to radiology, the branch of medicine that uses radiation to diagnose and treat diseases. However, other technologies—including ultrasound, which employs sound waves to visualize tissues, and endoscopy and similar methods in which a flexible optical instrument is equipped with a camera for imaging—may also be used.

X-ray imaging

X-rays, used since 1895, were the first type of radiation to provide images of the interior of the body. X-rays pass through bodily tissues and also have the property of darkening photographic film when they strike it. As they penetrate tissues, the X-rays are absorbed differentially, with denser objects such as bones absorbing more of the rays and thus preventing them from reaching the film. Soft tissues, on the other hand, absorb fewer rays; the result is that in an X-ray photograph of the interior of the body, bones show up as lighter areas and soft tissues show up as darker ones on the exposed film.

A limiting factor in X-rays when used alone is the inability to distinguish between adjacent, differentiated soft tissues of roughly the same density (i.e., it is not possible to produce contrasting tones between such objects on the exposed film). To obtain this contrast, a contrast medium—a liquid or gaseous substance that is comparatively opaque to X-rays (radiopaque) or comparatively transparent to them—is injected into the body. Contrast-medium fluids can be injected into naturally occurring body cavities, injected into the bloodstream and lymphatic vessels, swallowed or introduced by enema for study of the digestive tract, or injected around organs to show their external contour. Different contrast media thus allow the X-ray imaging of particular types of soft internal structures, such as the arteries and veins in angiography, the passage of blood through the heart in angiocardiography, the gallbladder and biliary channels in cholecystography, the spinal cord in myelography, and the urinary tract in urography. Virtually any part of the body can be examined for physiological disturbances of the normal structures by X-ray analysis. X-ray motion-picture films can record the body processes as the contrast media enter and leave parts of the body.

Other imaging techniques have been developed using X-rays. In tomography, X-ray images of deep internal structures can be obtained by focusing the rays on a specific plane within the body. A more complex variation of this technique is computed tomography, known as a CT scan.

Nuclear medicine

The scanning of radioactive isotopes that have been injected into the tissues is a medical specialty called nuclear medicine. Both isotope scanning and X-ray photography are used in brain scanning. An imaging technique related to isotope scanning is positron emission tomography. Another type of diagnostic imaging is nuclear magnetic resonance, which creates images of thin slices of the body using very-high-frequency radio waves. Ultrasound is a technique in which high-frequency sound waves are used for detecting abnormalities in internal organs. The varieties of radiation that are used in diagnostic imaging continues to expand, along with the techniques for using them.

Endoscopy and related procedures

Procedures such as endoscopy, laparoscopy, and colposcopy make use of generally flexible optical instruments that can be inserted through openings, either natural or surgical in origin, in the body. Many scope instruments are fitted with small video cameras that enable the physician or surgeon to view the tissues being examined on a large monitor. A number of scopes also are designed to enable tissue biopsy, in which a small sample of tissue is collected for histological study, to be performed in conjunction with visual analysis.