Apparatus for Serial Radiography and the Demonstration of the Mucosal Relief in Gastro-Intestinal Examinations

Abstract

AT THE present time there seems to be considerable controversy as to the best type of roentgen examination to use in gastro-intestinal work. Many American radiologists depend largely upon the fluoroscopic examination. Dr. Lewis Gregory Cole is the great proponent of serial radiography. The so-called mucosal relief examinations have undoubtedly been employed to some extent by many examiners for years; however, recently Berg, Akerlund and others have written extensively on this phase of the subject and have described various types of apparatus for this kind of examination. It is not the purpose of this paper to enter into a discussion of the place of each of the above-mentioned examinations in gastro-intestinal work, but it is my own opinion that all should play a part in most cases. I believe that serial radiography and the so-called examination of the mucosal relief have not come into general use because of the lack of suitable apparatus that can be adapted to that now in use. I have developed such apparatus in my own work and I thought that it might be of interest to describe it. I make no claim for originality in the principles involved, for many, if not all, of them have been used in equipment which has been described in this country or abroad. I shall include only sufficient illustrations of the films that I am making in order to show some possible applications of equipment of this type. Apparatus for Serial Radiography Figure 1 illustrates a serial tunnel and tube support in use in the Norton Memorial Infirmary, one of the hospitals with which I am connected. It was built by Mr. J. W. Fowler, the engineer in that institution, at a cost for materials not exceeding thirty-five dollars. As can be seen the tunnel is mounted with bearings in the tilting table, the bearings resting in the channel irons that ordinarily support a Bucky diaphragm. This particular tunnel is not counterbalanced but can be used upright by raising it and locking it in any position desired. This is not very convenient but is less expensive than one which is counterbalanced. I use the latter type in my office, however, and it has proven most satisfactory. The tunnel in my office was made by removing the bakelite top from a so-called polygraph and the metal back was cut out immediately beneath the opening in the lead diaphragm in order that fluoroscopic centering might be done. The polygraph was then mounted in the table with bearings similar to those used in the hospital, as above described. This polygraph has the advantage of having a track which permits films to be made in any position.