Abdominal Radiography

Lateral abdominal radiograph

1. Position the sedated patient in lateral recumbency (right side to the plate for right lateral, left side to the plate for left lateral).

Figure 1 — A sedated patient lying in right-lateral recumbency
Figure 1 — A sedated patient lying in right-lateral recumbency

2. Measure the deepest part of the patient. Select exposure settings on the x-ray machine, and place the grid on the plate if the depth is over 10cm. Some x-ray machines have the plate fixed in position under the table (as in the pictures), so this won’t need to be done.

Figure 2 — Patient depth is measured in a model patient.
Figure 2 — Patient depth is measured in a model patient.

3. In the sedated patient, place a foam wedge under the patient’s sternum to minimise rotation, and ensure the patient’s ribs are in line with their spine. In conscious patients, the restrainers may adjust the patient and hold the limbs in place to minimise rotation. This is not ideal, though, as the clinicians will be exposed to harmful scatter radiation.

Figure 3 — A foam wedge placed under the sedated patient’s sternum minimises rotation.
Figure 3 — A foam wedge placed under the sedated patient’s sternum minimises rotation.

4. In the sedated animal, secure the patient’s neck in place by placing a sandbag over it, making sure breathing is not obstructed.

Figure 4 — A sandbag has been placed over the patient’s neck.
Figure 4 — A sandbag has been placed over the patient’s neck.

5. Pull the forelimbs cranially to remove them from the X-ray field. Secure them in place with rope ties or sandbags. Very rarely and in exceptional circumstances (if sedation is too risky for a severely compromised dog), the limbs may be manually held in place, as long as proper shielding equipment (lead gloves, apron, thyroid protector) is worn.

Figure 5 — Forelimbs have been pulled cranially and sandbags have been added to hold them in position.
Figure 5 — Forelimbs have been pulled cranially and sandbags have been added to hold them in position.

6. Pull the hindlimbs caudally and secure in place with sandbags, placing a foam block or wedge between the patient’s stifles to prevent rotation of hindlimbs, and thus hips.

Figure 6 — Hindlimbs have been pulled caudally and held in position with a sandbag, and foam wedge between the stifles to prevent rotation.
Figure 6 — Hindlimbs have been pulled caudally and held in position with a sandbag, and foam wedge between the stifles to prevent rotation.

7. Place right/left marker within collimation of the beam, using the right marker when the patient is in the right lateral position, and the left marker when they are in the left lateral position. This may also be added digitally after the radiograph is taken.

8. Centre the primary beam on the patient’s mid abdomen at the level of the last rib and collimate to include the sternum, pelvis, and both dorsal and ventral skin edges.

Figure 7
Figure 8

9. Once staff are behind the lead shield, take the radiograph.

Figure 9 — A foot-operated x-ray button used at the WVS International Training Centre in Thailand; other buttons may be hand-operated.
Figure 9 — A foot-operated x-ray button used at the WVS International Training Centre in Thailand; other buttons may be hand-operated.

In the case of bladder studies, the beam is centred further caudally, and for male dogs, hindlimbs are drawn cranially.

General considerations for abdominal radiographyVentrodorsal abdominal radiograph

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