Institute of Clinical Radiology

We are proud to say that the Department of radiology, Clinical Center of Banja Luka, is one of the leaders in the wider region by the quality of service and sophistication of technology used. Patients are the reason why there is a Department of radiology, and they must occupy a central role in our professional activities. Our main task is to provide a complete diagnostic and therapeutic services saving the principles of clinical excellence. Clinical responsibility for a particular patient must be before all other requests.

The mission of the Department of radiology is multiple and it includes:

• the provision of high quality diagnostic and therapeutic services to patients,
• education of medical and nonmedical staff
• Development of new technologies and new approaches to providing medical care to patients.

The vision of the department is about to become and remain the best radiology department in Bosnia and Herzegovina, and to become the best residual Serbian radiology department
The Institute is located at 2 locations in 3 objects:

• Paprikovac
• The new diagnostic center (ground floor of Central medical block)
• Building of gynecology (in basement)
• Downtown • the surgery building (ground floor).

With the reconstruction of the old and with building new premises on the site of gynecology, it is able to improve the quality of medical services and it is made a prerequisite for the introduction of new diagnostic modalities.

In addition to the classic X-ray-device and device for radioskopiju, mammogram and ultrasound, the Department has two KT-scanner (16-layer and one layer), magnetic resonance imaging of 1.5 T and Angio-device. Annually we do about 51,000 views, of which nearly 7 500 16-layer KT-4 000 scanner and MRI. The above mentioned two diagnostics are fully digital. With the system of computed radiography (CR), images obtained on the classic X-ray machine is put into digital form, which greatly facilitates its reading and reduces the number of repeated recording.

The introduction of a system for transferring and storing images (PACS) and digital recording of patients (RIS) is increased efficiency of labor and there is an access to some of the earlier recordings / findings. Presence of these two information systems has only 1 clinical center in former Yugoslavia. Recently, it is set up a system of teleradiology, that is a possibility of internet consulting of radiologists from the Institute with the colleagues from the eminent centers abroad.
From 2006, the Department of radiology is one of seven pilot SIEMENS centers in the world.

Multidisciplinary, which is characterized by the work of the Department, requires quality cooperation and continuous improvement of the employees through staff lectures, seminars and practical training.
Great attention is paid to the constant raising of the level of quality improvement of diagnostic procedures and radiation protection for patients and staff. For this purpose, in 2008, the commission was established internal quality control. At the end of 2008, an international team of experts visited the Department and got detailed insight into its activities and recommended more world quality standards, which we will try to follow in the future.
The Department of radiology is also the center of research in the field of medicine and related branches.

Prospects for future work are complete digitalization by integrating the clinical information system, as well as the introduction of additional highly diagnostic modalities (CB and MR) and new quality control procedures.

Department of radiology consists of two departments:

1. Department of general radiology and
2. Department for emergency radiology

Information for patients 

Computerized tomography – KT / CT computerized tomography (abbreviated Kt) is a special type of X-ray device that creates a special photo inside the body. KT scanner is able to, using X-rays, make the pictures of layers of certain body images of interest. CT is a radiological method that can perform testing of almost all organs: the skull and brain, chest, abdomen, pelvic and extremities.
During the medical examination, the patient usually lies on his back. During the scan, it is important to keep the breath of default command that is heard from the speakers. Also you should know that, during the examination, the patient is alone in a room, but the radiologist and technician continuously monitor the patient through the window and patient can discuss with them by intercom. CT examination usually takes 5 – 10 minutes and exposure to radiation takes 10-30 seconds. Sometimes, for satisfactory images are needed contrast medicines that are given to the patient in the vein, the rectum or on drinks. It is recommended to avoid foods and beverages immediately prior to the examination.

Magnetic resonance
A device for magnetic resonance imaging uses strong magnetic fields and radio waves instead of x-rays to obtain a clear and detailed images of various internal organs and tissues. Device for magnetic resonance imaging is a cylindrical magnet in which the patient must lie very quietly for few minutes. Examination is painless but some people can feel the fear of enclosed spaces – claustrophobia. During the inspection, the patient was alone in the room, but the radiologist and technician continuously monitor the patient through the window and patient can discuss with them using intercom. Depending on the results, review may last 15 to 45 minutes and some more studies can take even more time. Sometimes, intravenous contrast medicines are given in order to get a better search results.

Due to the implementation of a strong magnetic field that attracts metal objects, patients will be asked if they have: a pacemaker or artificial heart valvula, a geller, projectiles from firearms, metal surgical bone splints, such as screws, plates, pins, etc.. These metals can disable view.
When recording on the MR, it is not recommended to wear makeup that often contain metal oxides. Patients will be asked to remove all metal objects from their body and clothing: jewelry, glasses, watch, earrings, etc.. Before theexamination, the patient will be asked to fill out a questionnaire on all issues that are importantfor the examination..
Ultrasound
Ultrasound is a quick and painless method of examination. Ultrasound is a sound of a frequency more than what human ear can hear (above 20 kHz). In medical diagnostics, it is used ultrasound frequencies between 2-10 MHz.

Ultrasound sources broadcast certain frequencies of ultrasound waves that are reflected from the tissue and then detected by the detector. They are mathematical processed in the computer later and re-converted information that we receive in the form of image. Ultrasound is more known as ultrasonography or otherwise echosonography.
During the examination of the abdomen, it is necessary that the patient come to the ultrasound starving, it will thus be easier and clearer view of gallbladder and pancreas. During the examination of the pelvis, patients must have full uric bladder, because of allowing a better view of the bladder, prostate, vesicules seminalis, and women and girls of the uterus and ovaries. Also, the doctor should be noted if the patient back from four days made some contrast method (such as irrigography).

Radiological – RTG RTG EGD EGD (Examination of esophagus, gaster, duodenum) is a radiological method by which we test esophagus and stomach, and the initial part of the small intestine. In the beginning of the examination, the patient will be asked to drink barium sulfate solution, which coats digestive organs and thus allows us to view the X-ray film. A radiologist observes the movement of barium on a television monitor by placing the patient in different positions. The examination takes 30 minutes up to 2 hours, depending on whether it is looked only esophagus and stomach, or we follow and observe intestines too. Viewing is painless.
It is essential that the patient comes for review starving (it is not allowed to eat or drink anything after midnight).

Irrigography
Irrigography a radiological method that examines large intestine. During the examination, the solution of barium sulfate is injected by clizma in the rectum of the patient. The very procedure may be uncomfortable but not painful. After giving clisma, radiologist observes and occasionally shoots course of bari. After clisma of bari, a certain amount of air is needed to be injected into the rectum in order to obtain a better view of the large intestine. During the examination, the patient will occupy different positions on the radiological table, based on the instructions given by the radiologist.
The patient must come to view with an empty stomach, and at the day before the examination he must take a device to clean the bowel in order to obtain a clearer view of the bowel and surrounding tissues.

Intravenous urography or pyelography – IVP or IVP (intravenous urography or pyelography) is a radiological method that examines the urinary system – kidneys, ureter and bladder. With the search, we have access to kidney function, presence of stones in the urinary system as well as insight into the flow of urine from the kidneys through the bladder ureter.
In order to have a better view in the structures of the urotract, the patient should be adequately prepared with diet to cleanse the bowel as the content and gas collection. Preparation starts 3 days before the appointment, as follows: The first 2 days take 2 x 1 tablet DULKOLAKS, beside a diet feeding.
DO NOT take the following FOOD: beans, cabbage, roast and smoked meat, milk and milk products, fruits and vegetables that contain cellulose and make you puff. The day before the examination in the morning drink 2 Dulkolaks tablets, and for dinner, you should eat polenta on the water without additives. You must bring the following with you: urea, UZV and the urologist’s find.

To examine the urinary system, it is necessary to inject contrast medicine in the vein. During the exemination, the recordings are periodically made. Search itself takes on average 45 minutes and, if necessary, can be extended by several hours. Sometimes the standard clips do not always provide the optimal view of kidney or patients come unprepared, so that the intestinal content or gas collection cover the kidneys and the review must be supplemented with tomography recordings.

Cholangiography
Cholangiography is a radiological method that examines the gallbladder and bile ducts. It means the use of contrast medicines, which are injected into a vein. After injection, the patient usually lies on the right side while the gall bladder does not meet the contrast medicine. At the command of radiologists, the patient will take a certain position and the gallbladder will be filmed. To make the results better viewed of possible pathological changes, the patient should be specially prepared. On the day before the examination, you sholud eat some greasy meal, without having a dinner. In the morning come with an empty stomach.

Myelography
Myelography is a radiological method that observes spinal cord and nerve roots and allows accurate diagnosis and localization of intraspinal pathological process. The method includes the use of contrast medicines that are injected in the area of spinal with special needles. The needle is placed between the vertebrae in the lower (lumbar) part of the spinal column in the amount of L3-L4, L4-L5 or L5-S1 vertebrae, in an area where there is no spinal cord and spinal nerve roots. Into the spinal space is injected a contrast medicine, through the needle, and then record shows spinal cord and nerve roots. At the request of the radiologist, a patient takes certain positions on the x- ray table. Surgery is painless.

Mammography Mammography is an X-ray technique for breast examination. The breast is placed on the film and it is carefully compressed because it is extremely important to do a powerful compression of the breast during mammography in order to get satisfactory image quality. Compression, although unpleasant, considerably improves the visibility of different pathological processes. Mammography as a screening method (rapid method of verification) is irreplaceable in the early detection of breast cancer.

Angiography
Angiography is a radiological method by which blood vessels are tested. Examination is done only on hospital patients. The very method includes the use of contrast means that are injected with special needles and catheters into the appropriate blood vessel. Seldinger’s technique is applied- a catheterization of a blood vessel. Femoral artery or vein in inguinal zone is punctured with a needle, after local anesthesia. Then, through the needle is introduced a special flexible wire that is introduced to the appropriate vessel. The needle is then out of the vessel over the wire, which remains in the blood court. Place of the sting is extended with the help of the short catheter – dilator, which is introduced into the blood vessel over the wire. If we observe blood vessels of a leg, the wire is out and a contrast medicine is injected through the dilator. Contrast flow funds are monitored on the monitor and are serial recorded.

If is needed to show more distant blood vessels, after the spread of the place of sting, the dilator is pulled out, and a special flexible catheter vessel is pulled into the blood over the wire. The catheter is introduced to the appropriate vessel and the wire is pulled out. Through the catheter is then injected a contrast mean and blood vessels, which are seen on the monitor, are serial recorded. After the examination, the wire and catheter are pulled out, and the radiologist strongly compresses the place of the sting for ten minutes. The examination is painless and well tolerated by patients and, depending on the type of results and the status of blood vessels, takes 15 minutes to 1 hour. The exposure to the radiation lasts for a few minutes, maximum. Radiologist and technician are always with the patient.

Classical Radiography

In he Institute, the classical radiological results can be done, too ( X- ray of lung, sinus, skull, spine and other bones, …) that do not require special preparation. When doing X- ray, it is necessary to follow the instructions of the technician that is on duty.