(3) The patient's lower bowels should be cleared of gas and fecal material,
as ordered by the responsible medical authority.
(4)
The patient is requested to void just prior to the examination.
c. Procedure.
(1) The patient is placed in the supine position with the median plane of the
body aligned to the midline of the combination radiographic-fluoroscopic table. If
fluoroscopy is not to be done, the standard radiographic-urological table unit may be
preferred.
(2) A 10 x 12-inch film is placed lengthwise in the Potter-Bucky film tray with
the mid-length of the film aligned to the level of the ASIS. The CR is projected
perpendicularly and directed to the center of the film. Collimation should be used to
confirm the field of irradiation to the most practical limits.
(3) A preliminary film is exposed as ordered. Routine pelvic factors will
serve for basic exposure technique.
(4)
The gynecologist or the radiologist introduces a vaginal speculum.
(5)
A cannula is inserted into the cervical canal of the uterus.
(6) The gynecologist injects from 3 to 10 cc radiopaque contrast material
(usually Salpix) containing from 35 to 40 percent iodine compound. In some instances,
the course of the contrast medium is observed fluoroscopically. Spot-filming is done by
the radiologist, when necessary.
(7) Hysterosalpingograms are exposed by the specialist in a given signal
from the gynecologist. Respiration is suspended for the exposure.
(8) Additional films are taken as ordered. For example, these may include
one or more of the following:
(a)
AP projection with or without caudal angulation of the CR.
(b)
PA projections with or without cephalad angulation of the CR.
(c)
Obliques, anterior or posterior (right and/or left).
(d)
(e)
Video taping the fluoroscopy during injection.
MD0959
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