PRINTMedical tests: behind the scenes
What happens when you’re waiting for results
December 18, 2008 | 12:00 a.m. CST
Magnetic resonance imaging
What it tests: An MRI tests for any injuries, sources of unexplained physical problems and benign or malignant tumors as well as other specific abnormalities.
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How it’s done: The patient lies flat on a narrow table, which moves into an enclosure that produces a strong magnetic field. “The hydrogen atoms align in the patient in one direction, pulsing radio frequency into the patient,” says Bill Martin, technologist at Ellis Fischel Cancer Center. It sounds scary, we know, but Martin says it’s a completely painless procedure that takes about 30 minutes.
Step 1: Following the test, the digital images collected are transmitted electronically to a picture archiving and communication system, a computer program that helps radiologists view images in a clear, organized way.
Step 2: The radiologist reads the images using high-resolution monitors and looks for abnormalities and asymmetrical areas, such as tumors or strokes, in the brain, says James Aldridge, radiology director at Advanced Radiology in Columbia. In some cases, the radiologist will administer an intravenous contrast called Gadolinium, making tumors or other abnormalities show up as white cloud-like clusters amid dark tissue. Knees, shoulders, ligaments, menisci and cartilage are seen well with the use of an MRI, making it the best way to quickly diagnose sports-related and common joint injuries.
Step 3: The radiologist comments on the findings with a hand-held speaker that looks like a walkie-talkie. In a separate room, a medical transcriptionist listens to the results and transcribes them.
Step 4: The radiologist approves the final report, which is sent back to the physician, who can usually have the results the same day.
Lipid cholesterol test
What it tests: This test looks at the different types of cholesterol in the blood to determine whether a diet change is necessary. “The test also can detect any inborn or congenital abnormalities in lipid metabolism,” says Dr. John Yanos, an emergency medicine specialist at
University Hospital.
How it’s done: The patient shouldn’t eat for at least 12 hours before the test, which might be difficult, depending on appetite. This is to eliminate any recent fat in the blood stream. Blood is usually drawn from a vein in the arm into a test tube. This takes a few seconds.
Step 1: The lab technician receives the blood sample in a specifically labeled plastic bag. The blood is then dispersed into a serum separator test tube called an SST. There is a small amount of coagulate, a gel substance that speeds up the blood clotting for quicker reading of results, at the bottom of the tube.
Step 2: The technician waits half an hour for the blood to clot. “A rule of thumb is if you turn it upside down and it stays, it’s done clotting,” says Jillynda Adams, manager at AnyLabTestNow in Columbia.
Step 3: The SST is put into a centrifuge, a circular device that spins test tubes around at 3,300 rotations per minute, for 10 – 15 minutes. This draws the red plasma cells to the bottom of the tube while pushing the amber-colored serum up. Imagine oil and water in a test tube; except the oil is red.
Step 4: The serum is put in a plastic vial for transport and sent to a large testing company. In AnyLabTestNow’s case, it’s Quest Diagnostics in St. Louis or Kansas City. There, a computer reads the sample, and technicians send results back to the original testing company, which sends them to the physician.
Mammogram
What it tests: A mammogram detects any abnormalities in the breast tissue such as malignant and benign tumors.
How it’s done: Many women cringe at the thought of having this test done because the machine flattens the breasts in order to see the tissue more clearly. However, it only takes 10 – 15 minutes and causes no change to the original shape of the breast. “One of the emitter plates sends radiation through the breasts to the detector plate to detect how much of the radiation gets through,” Yanos says.
Step 1: The images are sent electronically to a radiologist.
Step 2: The radiologist reads and analyzes the images and looks for dense spots that appear brighter than the rest of the breast tissue.
Step 3: Like the MRI, a medical transcriptionist listens to the report and types out results, and the radiologist signs off on them and sends them back to the physician.
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