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Radiologists are specialists who report on the findings of imaging techniques such as X-rays, CT scans, ultrasounds and MRIs. These investigations are done to aid a physician in diagnosing and managing a specific disease or illness. Radiologists can also perform certain minimally invasive medical procedures under the guidance of imaging investigations, and the discipline that is involved here is called interventional radiology.
The medical images are obtained by radiographers, who are healthcare professionals who perform procedures such as taking X-rays and working the CT scanner and MRI machine. The radiologist will then look at the images taken by the radiographers, interpret these images and compiles a report of their findings, opinion or diagnosis. This report is then sent to the referring doctor who requested the imaging investigation via hard copy being delivered to them, telephonically or can be accessed on the picture archiving and communication system (PACS) where the images are stored digitally and can be accessed by the patient's treating physicians.
A doctor who wants to specialise in radiology needs to complete a 5 year residency programme at an institution that offers radiology as a postgraduate specialty, and that have consultants available to teach and mentor these clinical assistants. In order to be allowed to specialise, a medical student needs to complete their undergraduate medical degree, that takes 5-6 years to complete, to qualify as a medical doctor. Doctors then need to complete a 1-2 year internship phase where they are exposed to different medical and surgical specialties.
Sub-specialties in radiology are available for specialists to sub-specialise in by completing a 1-2 year fellowship training programme and they include the following:
- Interventional radiology
- Interventional neuroradiology
- Abdominal imaging
- Thoracic imaging
- Magnetic resonance imaging (MRI)
- Cross-sectional studies/ultrasound
- Musculoskeletal imaging
- Paediatric radiology
- Nuclear medicine
- Emergency radiology
- Breast and women's
Diagnostic imaging techniques in radiology
These images are produced by shooting X-rays through a patient. The X-rays are beamed through the body onto a detector, and an image is formed based on which rays pass through versus those that are scattered or absorbed in the patient.
Radiography is usually the first test of choice in diagnostic imaging and many diseases can be diagnosed with X-rays such as pneumonia, arthritis, fractures, bowel obstruction and congenital skeletal abnormalities.
This investigative method uses high-frequency sound waves to examine soft tissues and organs of the body in real time. The advantage of ultrasound is that it doesn't use ionizing radiation to produce an image which makes it a very safe procedure to perform. A disadvantage of ultrasound use is that the quality of the images seen is operator dependent, and is also affected by the size of the patient. Nowadays, ultrasound machines can produce 3D-reconstructions, especially of an unborn fetus.
Computerized tomography (CT) scan
In CT imaging, X-rays are used together with computing algorithms to scan the body. Here, an X-ray tube is situated opposite to X-ray detectors in a circular apparatus that rotates around a patient. A notable point is that CT exposes the patient to more ionizing radiation than a normal X-ray procedure does.
CT scans have become the investigation of choice in diagnosing urgent and emergent conditions such as diverticulitis, appendicitis, pulmonary embolism, cerebral hemorrhage and kidney stones causing obstruction in the ureters.
Magnetic resonance imaging (MRI)
MRI scans give the best soft tissue imaging of all the modalities used in radiology, and has become an important tool in neuroradiology and musculoskeletal radiology.