Diagnostic Services

Radiography

The Radiology department is equipped with a number of Advanced Radiography machines incorporated with CR system and Digital Radiography unit. Portable radiography units are kept on each floor of the hospital, in the intensive care units, hospital wards and operation theatres.

Fluoroscopy Procedures

A state of the art Remote Controlled Image Intensifier Fluoroscopy unit with High frequency x-ray generator is available to carry out all the contrast procedures.

Gastro Intestinal (GI) Tract

• Oesophagogram
• Barium Meal
• Barium meal follow through
• Barium Enema
• Enteroclysis
• Loopogram

Urinary Tract

• Intravenous Urogram (IVU)
• Cystogram
• Voiding Cystourethrogram (VCU)
• Ascending Urethrogram (AUG)
• Opposing Urethrogram
• Nephrostogram

Ultrasound

The ultrasound facility of the department consists of the latest state of the art ultrasound scanners and Has individualized scan room for female / male / pediatric / special investigation patients.

2 Dimensional (2D) Ultrasound

• Abdomen
• KUB
• Pelvis

3 Dimensional (3D) Ultrasound

• 3D Angiography
• Tomographic Ultrasound Imaging (TUI)
• Volume Calculation on 3D Ultrasound

4 Dimensional (4D) Ultrasound

• 3D Ultrasound in real time
• Contrast ultrasound
• Elastography

Small Parts Ultrasound

• Thyroid
• Breast (Sonomammogram)
• Superficial Swelling
• Scrotum & Eye (Ocular)
• Thorax (chest) Ultrasound
• Transcranial (Pediatric Neurosonogram) Ultrasound
• Transvaginal (3D) Ultrasound
• Neonatal and Paediatric Ultrasound
• Musculoskeletal Ultrasound

• Peripheral Nerve and Joint Ultrasound
• Dental ultrasound
• Ophthalmic ultrasound

Doppler Studies

• Carotid and Vertebral Studies
• Portal Venous System
• Aorta and IVC Flow
• Arterial-Venous Systems
• Renal Doppler
• Transplant Kidney , Liver Doppler
• Iliac Vessels Doppler
• Foetal Doppler
• Specific Organ Doppler
• Transcranial Doppler
• Scrotal Doppler
• Penile Doppler
• Musculoskeletal Doppler
• AV Fistula and graft Doppler

Ultrasound Guided Aspirations

• Pleural
• Ascitis
• Pseudocyst
• Abscess
• Pelvis Collection
• Retroperitoneal
• Specific Areas
• Ultrasound guided pigtail insertion

Biopsies

• Liver
• Kidney
• Breast
• Musculoskeletal

FNAC

• Breast
• Thyroid
• Mass lesion

Computed Tomography (CT)

The Department has three CT scanners. 16-slice Multidetector CT (Philips Brilliance 16) – 2 Nos  and  a state of the art 128-slice CT (GE Revolution EVO).

Procedures done using CT unit include

• Whole body Imaging and Angiography
• Cardiac CT with Calcium Scoring
• CT Angiography (Aorta, peripheral and cerebral)
• Bowel Imaging
• High Resolution Computed Tomography
• CT Perfusion Imaging including stroke and tumor
• CT guided procedures
• Fine needle aspiration and biopsy
• CT guided drainage procedures
• Virtual colonoscopy
• 3D Imaging
  The volume data of the CT images are processed in ADW 4.4 and centralised server based workstations to produce excellent 3D reconstruction images.

Magnetic Resonance Imaging (MRI)

The Department is equipped with three MRI scanners - State of the art 3T (128 channel GEArchitect with Air coil Technology) besides 1.5 T MRI (GE SignaHDxt) with 16 channel system and Siemens MagnetomAvanto 32 channel 1.5 T MRI. Around 50 – 60  MRI examinations are carried out every day.  The services using MRI include 

• Whole body MRI
• Whole body MR Angiography
• Functional MRI, Fiber trackiing
• MR Spectroscopy
• Perfusion and Diffusion Imaging
• Whole Spine Imaging
• Cardiac MRI
• MR Mammography
• Advanced abdominal imaging
• High Resolution Imaging of Joints
• Whole Body Metastasis screening
• Fetal MRI
• MR elastography
• High resolution MR imaging for Epilepsy

Breast Imaging & Interventions :

We habitat state of the art latest x ray mammography integrated with  3D Tomosynthesis machine which is unique from other routine machines in providing more precise , high definition & sharp images helping us to detect pathologies in their budding stage (less than 1 cm). High resolution ultrasound is used in our department for diagnosis as well as for the interventions of breast lesions. Dedicated breast MR coil is used for patients refereed for Breast MRI to provide the patients with complete solution.

Our department provides following services:

• Full field digital mammography
• 3 D tomosynthesis
• High resolution breast ultrasound
• MR Mammography
• Stereotactic Biopsies & wire localization
• Ultrasound guided biopsies, wire localizations & clip placements
• Ultrasound guided ablation procedures - like microwave ablation.
• Galactography

UROLOGY PROCEDURES

Cystoscopy

Cystoscopy is a endoscopic procedure that examines the inner lining of your urinary bladder and the tube that carries urine out of your body (urethra). A hollow tube (cystoscope) equipped with a lens is inserted into your urethra and advanced into your bladder. Cystoscopy is done as an outpatient procedure under local anaesthesia. Another option is to have cystoscopy in the operation theatre under regional or general anaesthesia. It is carried out with a semirigid or flexible cystoscope. Cystoscopy may be recommended for any of the following conditions:

• Unexplained urinary symptoms, not resolving with conservative measures.
• Recurrent urinary tract infections
• Blood in the urine (hematuria)
• Bladder stones and Bladder cancer
• Benign prostate hyperplasia (BPH)
• Urinary incontinence
• Difficulty in storage and/or emptying of urine

Double J Stent Removal

Double J stenting is usually done for renal stones, ureteric stones, hydroureteronephrosis, pyelonephritis and ureteric strictures. Stent removals can be done as outpatient setting, where the patients walk into the OPD chamber and get the cystoscopy and stent removal done under local anaesthesia. The main
advantage is that it can be done with a small slender scope and bearable discomfort. Patients can go back home the same day.

Note: Please bring one attendant with you when you come for this procedure.

Urethral Dilatation

Urethral dilatation is a procedure done under local anaesthesia, where Teflon dilators or metal dilators are used for dilating the urethral passage. An abnormal narrowing of the urethra, called a stricture, may restrict the flow of urine, and cause voiding difficulties making this procedure necessary. Though urethral dilatation is normally performed by a urologist, with proper training and precautions, it can also be performed by a patient (self calibration).

Urodynamic Study

Urodynamic study (UDS) or Urodynamic evaluation (UDE) is a study which refers to tests which are used to investigate lower urinary tract symptoms (LUTS), by measurements of bladder and urethral function. It comprises of invasive or non-invasive tests. Non-invasive tests include uroflowmetry and ultrasound estimation of post-void residual urine volumes. Invasive tests involve placement of pressure catheters inside bladder and vagina (females) or rectum (males) to determine bladder pressure, detrusor pressure and abdominal pressure. UDE is indicated in conditions like overactive bladder, voiding dysfunction, and urinary incontinence.

Suprapubic Cystostomy (SPC)

It is a form of urinary diversion, in which a self retaining catheter is placed into the bladder via the abdominal wall (suprapubic region) for purpose of draining urine. Most of the times, it is done as an emergency procedure in out patient department or emergency room under ultrasound guidance. It is indicated in retention of urine, ruptured urethra, urethero-cutaneous fistula, periurethral abscess and urinary extravasation.

Ultrasound guided Percutaneous Nephrostomy (PCN)

Percutaneous nephrostomy (PCN) is done as a minimally invasive, ultrasound guided procedure in patients with hydronephrosis (dilatation of pelvicalyceal system (PCS) in kidney), where a PCN drain or a pigtail catheter is placed via abdominal wall into the kidney.

GASTROENTEROLOGY PROCEDURES

Endoscopy

It is an invasive procedure to rule out the problems or defects if any in the upper gastrointestinal tract which includes esophagus, stomach and duodenum. You have to report in a fasting state at 8:00 a.m. (fasting from 10:00 p.m. the previous day should be adhered) to F1 - Procedural Area with all relevant medical documents. The actual procedure will take 5 - 10 minutes in normal situations. Appointment can be booked by contacting 044-24768403.

Colonoscopy

Colonoscopy is an invasive procedure to examine the lining of your colon (large intestine) advancing into rectum and colon. The preparation for this procedures in to be on fasting after 11:00 p.m. and take the medicine advised by the consultant for the procedure as per the instructions given. In case patient is a non-diabetic he / she can have clear liquids like coconut water / glucose / soft drinks. You have to report in a fasting state at 10:00 a.m.to F1 - Procedural Area with all relevant medical documents. After prior Consultation and appointment. The actual procedure will take 20 - 30 minutes in normal situations.

ERCP

Is a procedure which enables the physician to examine the duct and pancreatic ducts an endoscope is passed through the mouth to the intestine and a small plastic tube is passed through the endoscope and dye is injected into the bile duct passage to enable accurate visualization with help of X-rays. It is usually performed in cases with obstruction of Bile ducts, due to stones or other causes. Procedure will be done after consultation with Medical Gastroenterologist

Dilatation

It is an invasive procedure which is performed by gastroenterology specialist in order to stretch a narrowed area of food pipe. It is used to treat patients with swallowing difficult. You have to report in a fasting state at 8:00 a.m. (fasting from 10:00 p.m. the previous day should be adhered) to F1 - Procedural Area with all relevant medical documents. The actual procedure will take 20 - 30 minutes in normal situations. Prior consultation with treating physician is mandatory. Procedure will be done after prior
appointment and assessment by Gastroenterology specialist.

Esophageal Manometry

It is an Invasive test to check whether the muscles in the esophagus are functioning normally and to diagnose motility disorders of the esophagus. A thin tube will be placed through the nose into the esophagus and responses to swallows of water will be analysed . You have to report in a fasting state to F1. The procedure will take 15-20 minutes.

Anorectal Manometry

It is an Invasive test to evaluate the function of the anorectal sphincter in patients with fecal incontinence or chronic constipation. A small balloon attached to a thin tube is placed into the rectum and the pressures are analysed. You have to report to F1 after bowel preparation. Procedure will take 15-20 minutes. Prior consultation with treating physician is mandatory.

PH Impedence Study

It is an Invasive procedure to assess acid reflux, A Catheter inserted via the nose into the esophagus and this is connected to a small portable device, which records the pH at regular intervals over a 24 hour period during routine activities, for appointment and instructions contact 044-24768403.

Endoscopic Ultrasound (EUS):

It is a minimally invasive procedure where an endoscope with an in-built ultrasound device is used to look for abnormalities in the upper gastrointestinal tract. USG guided biopsy and related procedures can be done. Prior consultation with treating physician is mandatory.

Intra Gastric Balloon - Placement for Obesity:

The Intra Gastric Balloon is a new minimally invasive bariatric treatment for people with Obesity. A fluid filled balloon is placed inside the stomach via endoscopy to restrict the capacity of the stomach for a limited period of time.

PULMONOLOGY PROCEDURES

Bronchosopy

Bronchoscopy is an invasive procedure to visualize the airways for any obstructions, abnormal growth or mass, for diagnosis and further treatment. You have to report in a 12 hours fasting state at the appointment time, F1 - Procedural Area with all relevant medical documents. The actual procedure will take 30 minutes approximately in normal situations.

Thoracoscopy

It is a procedure done by the pulmonologist in the chest (Thorax) of a patient, who has fluid in chest cavity. Both diagnostic and therapeutic procedure can be performed with the Thoracosope. One can look inside the chest and also around the lungs to find out why fluid has collected in the chest cavity, to remove fluid which may have collected between the lung and the chest wall (pleural effusion), and try to prevent this from happening again. Biopsy of the pleura can be taken from the suspected area of infection.

Endo Bronchial Ultrasound Bronchoscopy

EBUS is done in F1 Bronchoscopy suite. This is a procedure that combines a Flexible bronchoscope with Ultrasound to visualize airway wall and lymph nodes in the chest and allows the Pulmonologist to do aspiration and take biopsy without making an incision. It is minimally invasive but highly effective procedure that is used commonly to diagnose lung cancer  (stage the lung cancer for management )
infections and other diseases causing abnormal enlarged lymphnode in the chest.
Rose ( Rapid Onset insite evaluation ) of the aspirated material will be performed by the pathologist and in    5 – 10 mts a diagnosis will be available. This will help the bronchoscopist proceed further in the case.

Ultrasound guided pleural aspiration

This procedure begins with a Pulmonologist, after clinical examination and chest x-ray, using an Ultrasound to check the chest cavity (pleura) for fluid. Using the ultrasound, the presence of fluid is confirmed and the quantity of fluid is also assessed. Then marking is done to choose the ideal site for removal of fluid -diagnostic or therapeutic. Following marking, a local anesthesia injection is given to
the marked site, and then a dedicated needle is inserted into the pleural cavity for fluid removal. The procedure takes between 10-30 minutes based on the amount of fluid removal. Post procedure, patient is observed for 1 hour and then shifted to ward or discharged home with medications by the Pulmonology team.

Ultrasound guided Intercostal drain / Pigtail insertion

Pulmonologist, after getting a consent from patient, screens the patient with ultrasound for evaluation of the chest cavity. Site is marked. Local anaesthetia is injected. Then Intercostal drain insertion or pigtail is inserted after incision and dilatation. This procedure is done for fluid (pleural effusion), pus (empyema) ,
blood(hemothorax), air (pneumothorax). The procedure is done as in-patient.

RIGID BRONCHOSCOPY

Rigid bronchoscopy is an advanced interventional procedure where a mettalic long tube is inserted via mouth to the patients breathing tubes under general anesthesia in an operation theatre/ bronchoscope suite. Diagnostic procedure like tumour biopsy or more commonly therapeutic procedures like tumour debulking, stent insertion and removal, foreign body removal, dilatation of airway narrowing (tracheobronchial stenosis), cryotherapy etc., could be done using this interventional procedure. A
Pulmonologist, after patient consultation, would plan the procedure, with the involvement of anesthesia team.