Diagnostic Imaging
Non-Invasive Echocardiogram Ultrasound
Transthoracic echocardiography (TTE) is a noninvasive ultrasound test that creates moving pictures of the heart to evaluate its structure and function, including the heart chambers, valves, major vessels, and pericardium.
The test uses sound waves to provide real-time images of cardiac anatomy and blood flow patterns. A comprehensive TTE examination includes two-dimensional imaging, color flow Doppler, and spectral Doppler to assess chamber sizes, wall thickness, valve function, and blood flow velocities. The procedure is completely noninvasive and does not involve radiation, needles, or contrast dye for standard examinations.
Conditions Diagnosed
Echocardiography is used to diagnose a wide range of cardiovascular conditions, including:
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Coronary artery disease and heart attack complications
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Heart failure and cardiomyopathy
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Valvular heart disease (stenosis or regurgitation)
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​Congenital heart defects
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Pericardial disease
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Cardiac tumors or masses
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Hypertensive heart disease
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Pulmonary hypertension
What to Expect During the Test
The examination typically takes 30-45 minutes and is performed in an echocardiography laboratory. Patients lie on their left side on an examination table while a sonographer applies gel to the chest and uses a handheld transducer to obtain images from multiple positions.
The test is painless, though some pressure may be felt as the transducer is moved across the chest. Patients can resume normal activities immediately afterward.
Clothing and Preparation
Patients should wear comfortable, loose-fitting clothing that allows easy access to the chest. A hospital gown is typically provided, and patients will need to undress from the waist up. Women should wear a two-piece outfit rather than a dress for convenience. No special preparation is required—patients may eat and drink normally before the test and should continue taking their regular medications unless specifically instructed otherwise.
This imaging technique uses high-frequency sound waves to create detailed, digitized images of your heart’s movement, structure, and size.
Non-Invasive Arterial Ultrasound
What is Non-Invasive Arterial Imaging?
Non-invasive arterial imaging uses specialized technology to create detailed pictures of the blood vessels in your legs—without the need for surgery, needles, or catheters. What sets our facility apart is our commitment to a truly comprehensive evaluation. While many providers stop at the calf, we go the extra step by imaging all the way below the ankle and into the foot. By capturing these final pathways of blood flow, we ensure a more precise diagnosis and a higher standard of care for our patients.
What Does It Diagnose?
These imaging tests help diagnose peripheral artery disease (PAD), which happens when the arteries in your legs become narrowed or blocked. The tests show:
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Which arteries in your legs have blockages or narrowing, flows better
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How severe the blockages are
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Whether treatment might help improve blood flow
Your doctor may order these tests if you have leg pain when walking, if simpler tests were unclear, or if you might need a procedure to improve blood flow to your legs.
Typical Preparation
Your doctor will give you specific instructions, but general preparation includes:
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Clothing: Wear comfortable, loose-fitting clothes. For ultrasound, you may be able to keep your clothes on if they allow access to your legs. For CTA and MRA, you will likely need to change into a hospital gown and remove your shirt and pants.
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Eating and drinking: For ultrasound, you can usually eat and drink normally. For CTA and MRA, you may need to avoid eating for a few hours before the test.
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Medications: Continue taking your regular medications unless your doctor tells you otherwise.
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Metal objects: For MRA, you must remove all metal objects including jewelry, watches, hearing aids, and dentures. Tell your doctor if you have any metal implants in your body.
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Allergies: Tell your doctor if you have allergies to contrast dye or if you have kidney problems.
After the Test
Most people can return to normal activities right away. If you received contrast dye, you may be asked to drink extra water to help flush it from your body. Your doctor will discuss the results with you and explain what they mean for your treatment plan.
it is typically obtained for more focused evaluation of the lower extremity arterial system such as localization of stenosis, assessment of stent or bypass graft patency, and detection of pseudoaneurysms or arteriovenous fistulas.
Non-Invasive Venous Ultrasound
What is Non-Invasive Venous Imaging?
Non-invasive venous imaging is a safe, painless test that uses sound waves to create pictures of the veins in your legs or arms. The most common type is called duplex ultrasound or venous ultrasound. This test does not use needles, radiation, or contrast dye. The ultrasound machine uses a small handheld device called a transducer that is gently pressed against your skin. It sends sound waves into your body that bounce off your veins and create images on a screen. This allows your doctor to see inside your veins without making any cuts or injections.
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What Does This Test Diagnose?
Venous imaging helps diagnose several conditions affecting your veins, including:
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Blood clots (also called deep vein thrombosis or DVT) - These are clots that form in the deep veins of your legs or arms
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Chronic venous insufficiency - This occurs when the valves in your veins don't work properly, causing blood to pool in your legs
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Varicose veins - These are enlarged, twisted veins that you can often see under the skin
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Post-thrombotic syndrome - This is damage to veins that can occur after a blood clot
The test can show whether your veins are blocked, if blood is flowing in the wrong direction (called reflux), and whether the valves in your veins are working properly.
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What to Expect During the Procedure
The ultrasound examination is performed by a specially trained technologist and typically takes 10 to 30 minutes depending on which veins need to be examined.
During the test:
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You will lie on an examination table, usually on your back
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The technologist will apply a clear gel to your skin where the veins will be examined
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A small handheld device will be pressed gently against your skin and moved along your leg or arm
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The technologist will press down on your veins to check if they compress normally - this is an important part of the test
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You may be asked to hold your breath, take a deep breath, or bear down (like you're having a bowel movement) to check how blood flows through your veins
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The test does not hurt, though you may feel some pressure when the technologist presses on your skin.
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Preparation and Clothing
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You will need to remove clothing from the area being examined so the ultrasound device can be placed directly on your skin.
For leg vein examinations:
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You will need to remove pants, stockings, or tights
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You may be given a gown to wear or asked to wear shorts
For arm vein examinations:
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You will need to remove long sleeves or roll them up completely
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Short-sleeved or sleeveless clothing works best
Other preparation:
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No fasting or special diet is required before the test
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You can take your regular medications
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Bring a list of your current medications if this is your first visit
The gel used during the test washes off easily and will not stain your clothes, but you may want to bring a tissue or small towel to wipe off any excess gel after the examination.
A non-invasive evaluation of blood flow. This test provides information to help your vascular specialist make a sound diagnosis and outline a treatment plan.
Non-Invasive Renal Ultrasound
What is Non-Invasive Renal Imaging?
Non-invasive renal imaging refers to tests that create pictures of your kidneys and urinary system without surgery or inserting instruments into your body. These imaging tests help your doctor see the structure and function of your kidneys to diagnose various conditions.
Types of Non-Invasive Kidney Imaging
Ultrasound
Ultrasound is often the first imaging test used to look at your kidneys. It uses sound waves (not radiation) to create pictures of your kidneys. Ultrasound can show the size and shape of your kidneys, detect blockages in the urinary system, identify kidney stones, and find cysts or other abnormalities. A special type called Doppler ultrasound can also measure blood flow to your kidneys.
CT Scan (Computed Tomography)
A CT scan uses X-rays to create detailed cross-sectional images of your kidneys and urinary tract. This test provides more detailed pictures than ultrasound and is particularly useful for evaluating kidney masses, stones, and complex kidney problems. Sometimes a contrast dye is injected into your vein to make certain structures show up better on the images.
MRI (Magnetic Resonance Imaging)
MRI uses powerful magnets and radio waves (not radiation) to create detailed images of your kidneys. This test can provide information about kidney structure, blood flow, and function. A special type called MR urography (MRU) is designed specifically to image the entire urinary system, including the kidneys, ureters (tubes that carry urine), and bladder.
What These Tests Diagnose
Non-invasive kidney imaging can help diagnose many conditions, including:
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Chronic kidney disease and acute kidney injury
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Kidney stones and urinary blockages
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Kidney cysts and masses
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Kidney infections or inflammation
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Blood vessel problems affecting the kidneys
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Congenital (present from birth) kidney abnormalities
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Kidney size and structural changes
What to Expect During the Procedure
For Ultrasound:
You will lie on an examination table. A technologist will apply a clear gel to your skin over the kidney area and move a handheld device called a transducer across your skin. The test is painless and typically takes 20-30 minutes. You may be asked to change positions during the exam.
Typical Preparation
Clothing:
For all kidney imaging tests, you will typically be asked to change into a hospital gown. You should remove jewelry, watches, and any metal objects before the test, especially for MRI.
Before Ultrasound:
Usually no special preparation is needed. You may be asked to drink water before the test to fill your bladder, depending on what your doctor wants to examine.
A non-invasive exam that uses high-frequency sound waves to assess the kidneys, ureters, and bladder. The scan provides information about bladder draining, post-void residual, the position of the kidneys, and urine flow through the ureters.
Non-Invasive Inferior Vena Cava Ultrasound
What is the Inferior Vena Cava Imaging?
The inferior vena cava (IVC) is a large vein in your abdomen that carries blood from the lower half of your body back to your heart. Doctors sometimes need to take pictures of this vein to check for problems.
What Does This Test Do?
Non-invasive imaging of the IVC uses special cameras to take pictures of this vein without needing surgery or inserting tubes into your body. The most common methods are:
Ultrasound - Uses sound waves to create pictures of the vein in real-time
CT scan (computed tomography) - Uses X-rays to create detailed images
What Conditions Can This Test Find?
Your doctor may order this test to check for:
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Blood clots in the vein
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Blockages or narrowing of the vein
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Tumors or masses affecting the vein
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Abnormal vein structure present from birth
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Fluid status in your body (especially with ultrasound)
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Problems before placing a filter in the vein
What to Wear and Clothing Instructions
For Ultrasound:
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Wear comfortable, loose-fitting clothing
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You may be asked to change into a hospital gown so the technician can easily access your abdomen
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You may need to remove your shirt or pull it up to expose your belly area
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Remove any jewelry or metal objects from the area being examined
The Inferior vena cava pictured in the cine-loop demonstrates respirophasic changes in a spontaneously breathing patient
Non-Invasive Imaging Carotid
What is Non-Invasive Carotid Imaging?
Non-invasive carotid imaging is a safe way to take pictures of the carotid arteries in your neck. These arteries carry blood from your heart to your brain. The test helps doctors see if these arteries have become narrow or blocked, which could increase your risk of stroke.
What Does This Test Diagnose?
This imaging looks for carotid artery stenosis, which means narrowing of the arteries in your neck. The narrowing happens when fatty deposits (called plaque) build up on the artery walls. Finding this narrowing is important because it can help predict and prevent strokes.
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Your doctor may order this test if you have had symptoms like:
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Weakness or numbness on one side of your face, arm, or leg
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Temporary vision loss in one eye
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Difficulty speaking or understanding speech
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A mini-stroke (also called a TIA or transient ischemic attack)
The test may also be ordered if you have had a stroke or if your doctor hears an abnormal sound (called a bruit) when listening to your neck with a stethoscope.
When is This Test Typically Performed?
Carotid imaging is most commonly performed when you have had symptoms of a stroke or mini-stroke. According to medical guidelines, patients with stroke symptoms should have carotid imaging done quickly—often within 24 to 48 hours of symptom onset.
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What to Expect During the Procedure
For Carotid Duplex Ultrasound:
The test is performed in an ultrasound laboratory and typically takes 30-45 minutes. You will lie on your back on an examination table. The technologist will apply a clear gel to your neck and use a small handheld device (called a transducer) to take pictures of your carotid arteries. You may hear whooshing sounds during the test—this is normal and represents blood flow through your arteries.
The test is painless and safe. There are no needles, no radiation, and no side effects. You can return to your normal activities immediately after the test.
Clothing and Preparation
What to wear: Wear comfortable clothing with a loose-fitting collar or a shirt that opens in the front. You may be asked to remove jewelry, necklaces, or scarves from around your neck.
Before the test:
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You can eat and drink normally before a carotid ultrasound
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Take your regular medications as prescribed
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If you are having an MRA or CTA, your doctor may give you additional instructions about eating, drinking, or medications
No special preparation is needed for a standard carotid ultrasound.
This painless, noninvasive test is used to see and measure the rate at which blood flows through your carotid arteries and look for possible blockages. No radiation, dye or needles are used.
Nuclear Stress Testing and PET Myocardial Perfusion Imaging: Patient Information
Nuclear stress tests evaluate heart blood flow and function during rest and stress (exercise or medication-induced) to detect coronary artery disease and assess ischemia risk. These tests use radioactive tracers that distribute in the heart muscle proportionally to blood flow, creating images that reveal areas of reduced perfusion.
Nuclear Stress Testing Overview
Nuclear stress tests can be performed using two main technologies:
SPECT (Single-Photon Emission Computed Tomography) is the most widely available nuclear imaging technique, using technetium-99m labeled tracers (sestamibi or tetrofosmin). The test involves injecting a radiotracer at peak stress, with imaging performed to detect perfusion defects indicating ischemia. SPECT has a sensitivity of approximately 86% and specificity of 74% for detecting significant coronary stenosis. The radiation exposure is approximately 10 mSv for technetium-99m SPECT.
PET (Positron Emission Tomography) uses tracers like rubidium-82 (generator-produced) or N-13 ammonia (cyclotron-produced). PET offers several advantages over SPECT, including higher spatial and temporal resolution, lower radiation exposure (approximately 3-3.7 mSv), and superior diagnostic accuracy with sensitivity of 90% and specificity of 88-89%.
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Unique Advantages of PET
PET can quantify absolute myocardial blood flow and calculate myocardial flow reserve (the ratio of peak stress to resting blood flow), which provides incremental diagnostic and prognostic information beyond standard perfusion imaging. This capability is particularly valuable for detecting multivessel disease (which may appear falsely normal on SPECT due to balanced ischemia) and for identifying coronary microvascular disease, especially in women who often have nonobstructive coronary disease.
Both tests can be performed with exercise or pharmacological stress (vasodilators like adenosine or dipyridamole, or dobutamine). The tests provide information on perfusion abnormalities, left ventricular function, and high-risk features such as transient ischemic dilation. Normal stress test results carry excellent prognosis, with negative predictive values of 96-100% and low annual event rates.
Sample photo | PET images provide similar visual information but with higher spatial resolution and can include color-coded displays of quantitative myocardial blood flow measurements. The images may also show indirect signs of ischemia such as transient left ventricular dilation or increased lung uptake of the tracer.
