(b) The patient is placed in the supine position on the x-ray table, and
adjusted so that the sagittal plane located 1 1/2 to 2 inches medial to the midclavicular
line is aligned to the midline of the x-ray table. A 10 x 12-inch or a 14 x 17-inch cassette
is placed in the Bucky tray, positioned crosswise in relation to the midline of the patient,
and centered to the level of the xiphoid process.
(c) A preliminary film is exposed and immediately processed. The film
is used to check the adequacy of intra-abdominal preparation and the correctness of the
(d) The anesthetist then induces general anesthesia and performs
endotracheal intubation. In the meantime, the site of injection is made aseptic and
sterile drapes are placed.
(e) The examiner inserts the injection needle in the midaxillary line (left
side) in the 9th and 10th intercostal space. As the examiner advances the needle into
the bulb of the spleen, he instructs the anesthetist to induce apnea.
Injection of contrast medium and radiography (figure 3-13).
(a) A 50 cc syringe is filled with a contrast solution and then attached
to the injection needle.
(b) With all participants of the medical team alerted and the x-ray
apparatus adjusted and energized, the examiner again instructs the anesthetist to
induce apnea and gives the "Ready," signal to the specialist.
(c) The examiner will now inject the contrast solution at a rate of 10 to
15 cc per second. Immediately upon completion of the injection, the injection needle is
withdrawn and the first exposure is made.
(d) Subsequent exposures are made at predetermined intervals. In the
event that rapid-serial radiography is used, the exposures are generally made at a
continuous rate of one per second for 10 to 15 seconds.
3-24. CEREBRAL ARTERIOGRAPHY
a. Patient Preparation. This has already been discussed in this section (para
b. Preliminary Procedure.
(1) The patient is placed in the supine position and centered to the midline
of the x-ray table.