Medical Imaging / Radiology

WinnMed is home to one of the area’s most comprehensive and advanced diagnostic imaging departments. State-of-the-art diagnostic radiology services include:

  • X-ray
  • Bone Density Analysis
  • CT scanning
  • Fluoroscopy
  • Magnetic Resonance Imaging (MRI)
  • 3D Mammography
  • Nuclear Medicine
  • Ultrasound

At WinnMed, patients benefit from the expertise of a full-time, board-certified radiologist, as well as skilled and compassionate registered technologists.

If your doctor orders a radiology examination, request a referral to WinnMed. We gladly provide radiology services to patients of all area health care providers.

Patient receives an MRI.

X-Rays

An X-ray is a quick, painless exam that produces images of the solid structures inside your body,  including bones and internal organs such as your lungs, heart and abdomen.  A radiologic technologist takes the X-rays. You may experience discomfort during the exam depending on the position the technologist asks you to maintain. They will do their best to make it as painless as possible, while also ensuring they obtain quality images.  Please tell your technologist if you experiencing any pain. Please inform the technologist if you are pregnant or could be pregnant prior to the test.

The examination is usually completed within 15-20 minutes. The X-rays are read by a radiologist and your doctor will discuss the results of the X-ray with you.

Commonly asked questions

Are X-rays dangerous?

  • The amount of radiation you are exposed to during an X-ray is so small that the risk of any damage to cells in you body is extremely low. The machine produces a tiny burst of radiation at a safe level. You cannot feel the radiation passing through your body.

Why do you place a “shield” over me?

  • While you are exposed to a low dose of radiation, it is still best to shield you from unnecessary exposure.

How do I find out my results?

  • Results will be available as soon as they are ready through MyChart.  Your provider will also contact you to discuss the results and answer any questions you may have.

My pain is on the right side. Why are taking an X-ray of my left side?

  • As radiation passes through your body, it collects information of both sides. There are specific views taken of each body part in order to obtain the best diagnosis.

Will my cell phone be OK in the X-ray room?

  • Radiation will not affect a cell phone. You may need to remove it from you pocket if it will interfere with the x-rays.

Can I get an X-ray if I am pregnant?

  • In the event the benefit of an X-ray outweighs the risk, the technologist will take all necessary measures to protect your unborn child.

Fluoroscopy

Fluoroscopy is a method of testing that uses real-time X-rays in order to assist the radiologist in viewing the digestive tract or joints.  A special X-ray machine, called a fluoroscopy machine,  is used. A radiologist performs the test with the assistance of a radiologic technologist. WinnMed offers the following tests:

Upper GI Series

GI stands for gastrointestinal, more commonly known as the digestive system. An Upper GI Series is an exam of the upper portion of your digestive system, including the esophagus, stomach and small intestine. Please inform the technologist if you are pregnant or could be pregnant prior to the exam. Expectant mothers, or women who think they may be pregnant, should not have an Upper GI Series.

What to expect

An Upper GI Series is performed as an outpatient procedure. A radiologic technologist will position you next to the fluoroscope. You will be asked to swallow a small cup of liquid barium or similar substance. The radiologist, using the fluoroscope, will capture images of the liquid as it flows into your digestive system. You may be asked to change positions throughout the exam.

The examination is usually completed within 20-30 minutes and you can resume normal activity and diet directly following the exam. Your doctor will discuss the results with you.

Commonly asked questions

Will I be under a form of anesthesia for an Upper GI Series?

  • No anesthesia is given. You will be asked to drink a liquid substance called barium, which highlights your organs on the X-ray.

Do you put a tube down my throat to look at my esophagus?

  • No.

How long will the test take?

  • An Upper GI Series will take about 20-30 minutes. If your doctor has ordered a Small Bowel Follow Through (SBFT) of your small intestine as well, that test can vary by person and may take several hours to complete.  The average time is 30 minutes to four hours.

Barium Enema

A barium enema is a special X-ray of the lower digestive tract, colon or large intestine. Since standard X-ray does not highlight soft tissue, a liquid barium solution is given by enema to make the colon and rectum visible to X-ray. A radiologist performs the test with the assistance of a radiologic technologist.  Your doctor will discuss the results with you.

Please inform the technologist if you are pregnant or could be pregnant prior to the exam.

What to expect

Barium enema is performed as an outpatient procedure. You will be asked to lie down on a table and a radiologic technologist will position you next to the fluoroscope. The technologist will insert a tube into your rectum. A liquid barium solution will be gently given by enema and x-rays will be captured as the solution outlines your colon. While the liquid barium solution fills your colon, you may experience mild cramping and/or abdominal discomfort. You may be asked to change positions during the exam.  Following the exam, you will be asked to use the restroom to empty the barium from your colon.

Commonly asked questions

Will I be under a form of anesthesia for a barium enema?

  • No anesthesia is given.

How long will the test take?

  • A barium enema will take about 30-45 minutes.

Ultrasound

Ultrasound is an examination technique used to make still and live video pictures of the soft tissue structures of the body, such as the heart, digestive, reproductive or urinary tracts. Ultrasound is used to detect changes in appearance of organs, tissues and vessels or detect abnormal masses, such as tumors. Ultrasound is also used to monitor fetal growth and determine the age, weight and position of the fetus in the uterus.

What to expect

Ultrasound is performed as an outpatient procedure. An ultrasound technologist (called a sonographer) will apply a clear, water-based gel to the area of your body to be examined. The sonogapher will guide a hand-held instrument, called a transducer, across the area being examined. Throughout the examination, the sonographer will capture images of the area for a radiologist to interpret. Your doctor will discuss the results of the ultrasound with you.

In some ultrasound studies, the transducer is attached to a probe and inserted into a natural opening in the body. Winneshiek Medical Center offers the:

  • Transvaginal ultrasound – The transducer is inserted into a woman’s vagina to view the uterus and ovaries.

Depending on the area to be examined, your doctor may provide special instructions to prepare for the exam. The procedure is painless with no short- or long-term side effects. Depending on the exam, an ultrasound will typically last 30-60 minutes; some up to 120 minutes.

Commonly asked questions

When will I receive my results?

  • Results will be available as soon as they are ready through MyChart.  Your provider will also contact you to discuss the results and answer any questions you may have.

Is radiation used during an ultrasound?

  • No, ultrasound uses sound waves to obtain images.

Breast Imaging

WinnMed Radiology offers advanced breast cancer screening and diagnostic services, including 3D mammography (including mammograms for women with implants), ultrasound, ultrasound-guided breast biopsies and surgical biopsies in a convenient, comforting environment.

The American Cancer Society suggests:

  • A screening mammogram every year starting at age 40. If you have a family history of breast cancer, you should consult with your doctor for advice on when to begin a baseline mammogram.
  • Women should be familiar with how their breasts normally look and feel, and should report any changes to a health care provider right away.

Mammography

What is a mammogram?

A mammogram is an X-ray of the breast that can help identify any abnormalities. There are two types of mammograms: screening and diagnostic.

A yearly screening mammogram is recommended beginning at age 40 or earlier if recommended by your doctor. A screening mammogram documents changes to your breast tissue over time and can alert the radiologist to abnormalities early in the disease process.

Diagnostic mammograms are performed after a woman or her doctor has found a lump or has an abnormality in the breast tissue, or if a screening mammogram highlighted an area of concern.

Breast cancer can be treated most successfully when it is found early, many times before a lump can even be felt. Mammography is the most effective method of screening for breast cancer and can lead to early detection, which is the key to higher survival rates, better prognosis and lower treatment costs.

3D Mammograms

As your most trusted partner for breast care, WinnMed is pleased to offer 3D mammography for patients.

3D mammography is a relatively new screening and diagnostic breast imaging tool to improve the early detection of breast cancer.  Low-dose images from different angles around the breast create the 3D picture.  The detailed images allow for a better evaluation of the breast tissue, layer by layer. 3D mammography also can provide better images of dense breast tissue than conventional mammography, and is now covered by most insurance plans.

Patients benefit from softer, warmer mammograms through the use of special breast cushions during each mammogram, as they have come to expect from their experience at WinnMed.

WinnMed provides a full-time, on-site Mayo Clinic Health System radiologist who specializes in breast health and breast disease diagnosis. Our mammography suite is staffed with skilled, compassionate and certified mammography technologists, including technologists trained in mammography for women with breast implants.

Patients who need further testing after a mammogram screening can often have same day diagnostic workup appointments at WMC. WinnMed offers biopsy options and surgical options, including ultrasound-guided breast biopsies and sentinel node mapping – all in a private, comfortable environment, conveniently available at the medical center in Decorah.

Mammography screenings are available at WinnMed for any patient, regardless of provider.  Patients can self-request screening mammograms so long as they are able to identify the provider they want to receive their results. WinnMed mammography offers daily appointments, Monday through Friday.

What to expect during your mammogram

Before your exam, a mammographic technologist will ask you to change into a gown and remove any jewelry. The technologist will guide you to the mammography unit and position each breast, one at a time, on a special platform within the unit. When you are ready, the technologist will lower a compression paddle, which will compress your breast for a short time. Images will be taken from a top-to-bottom view and an angled side view. The process will be repeated for the other breast.

Breast compression is necessary in order to:

  • Even out the breast thickness so all of the tissue can be visualized.
  • Spread out the tissue so that small abnormalities are less likely to be covered by overlying breast tissue.
  • Allow the use of a lower X-ray dose since a thinner amount of breast tissue is being imaged.
  • Hold the breast still in order to minimize blurring of the image caused by motion.
  • Increase the image clarity.

Special note about mammograms: Do not use deodorant, powder or perfume in your underarm or breast area on the day of your exam. These products may contain a metallic base that can look like an early breast cancer in the images. Winneshiek Medical Center supplies products for you to use following your mammogram.

Although it is non-invasive, a mammogram may cause some discomfort, especially if you have sensitive breasts. Try to schedule your mammogram when you are not menstruating to reduce breast sensitivity. The exam takes about 20 minutes to perform. A radiologist will interpret the mammogram and your doctor will receive the results of the images. A letter with the results will also be mailed to you.

Common Questions

Why does the compression have to be so tight?

  • Tight compression is necessary to separate the layers of breast tissue and reduce the amount of radiation you receive.

Do I still need a mammogram past the age of 80?

  • You and your doctor should discuss your need for a mammogram after age 80.

How often should I have a mammogram?

  • Yearly, after age 40.

Doesn’t compression cause breast cancer?

  • No, compression improves detail in the image and decreases your exposure to radiation.

Why do I need extra pictures taken?

  • Additional images may be needed to distinguish normal from abnormal tissue.

Free Mammogram Program

Winneshiek County Celebration of Life, a local non-profit organization, raises funds throughout the year to provide mammogram screenings free of charge to area women in need.

WinnMed actively participates in this program.

Women who are uninsured can qualify for a free screening at WinnMed. The application is a simple one-page form that is based on insurance deductibles, income, and number of persons in the household to name a few.

Fuel for the Fight

Winneshiek County Celebration of Life provides gasoline and grocery grants to support people with cancer on their journey to recovery.

Grants are awarded to those actively pursuing treatment for any form of cancer. The nominee must be 18 years or older, in active treatment for any form of cancer, and be either a resident or have a family doctor in Winneshiek County, Iowa. Nominations are accepted year round.

Nomination forms are reviewed monthly.  Recipients may receive a one-time $300 gas card and a one-time $100 grocery card per calendar year to help offset the expense for traveling to appointments and additional care required.  Grants are awarded on a first-come, first-served basis.

To apply, nominate, or for more information on Celebration of Life programs, visit www.winneshiekcol.com.

Breast Biopsies

WinnMed performs ultrasound-guided breast biopsies and surgical biopsies when a mammogram or ultrasound suggests further testing.

Ultrasound-Guided Breast Biopsies

An ultrasound-guided breast biopsy is an outpatient procedure that is performed by a radiologist. You are awake during this procedure. During an ultrasound-guided breast biopsy, you will be asked to lie on your back on an exam table, with your arm on the affected side raised above your head. The radiologist will inject local anesthesia into the affected breast, numbing the area for the procedure. Using an ultrasound probe to guide him or her, the radiologist will make a small incision (about 1/8 inch in length) to insert a special biopsy needle. The needle will remove a small amount of breast tissue; the radiologist will take several samples to ensure adequate sampling.

Following the procedure, the breast tissue samples will be evaluated by a pathologist and the results will be sent to your doctor. Your doctor will share the results with you and, together, you will determine the next steps of your care.

An ultrasound-guided breast biopsy takes between 30-60 minutes to complete.

Surgical Biopsies

Surgical biopsies are performed by general surgeons at WinnMed. They are done as an outpatient procedure in the operating room.  Talk to your doctor to determine the right plan of care for you.

Following the procedure, the breast tissue samples will be evaluated by a pathologist and the results will be sent to your doctor.  Your doctor will share the results with you and, together, you will determine the next steps of your care.

Bone Densitometry

Bone Densitometry, also known as bone density or DEXA, is a non-invasive scan of your bone mineral density or bone mass. It is a simple, painless exam that delivers approximately one-quarter to one-tenth the radiation that occurs during an ordinary chest X-ray.

People with porous bones, or osteoporosis, have higher risk for bone fracture. Bone densitometry provides information about your bones that, when compared to people whose age, sex and ethic background are similar to yours, can predict your potential for bone fractures. The most common risk factors for osteoporosis are:

  • Postmenopausal
  • Early menopause (before age 45)
  • Surgical menopause
  • Age
  • Previous fracture
  • Family history of osteoporosis
  • Certain medications (including steroids and thyroid hormones)
  • Race
  • Bone frame size
  • Tobacco use
  • Excessive alcohol consumption
  • Sedentary lifestyle
  • Low calcium intake
  • Certain medial conditions
  • Eating disorders
  • Gastrointestinal surgery

What to expect

Before your exam, a radiologic technologist may ask you to change into a gown. You will be asked to lie on your back on the examining table. The technologist will guide an imaging camera above your body that will move and take pictures. It is very important that you lie still while images are being taken so that the images are clear.

Please inform the technologist if you are pregnant or could be pregnant prior to the exam.

The exam takes approximately 15 minutes to perform. A radiologist will interpret the bone densitometry images and your doctor will discuss the results of the scan with you.

Commonly asked questions

How often do I need a bone density test?

  • Each patient has a unique history. Your doctor will work with you to establish when you should have your baseline exam and when to repeat.

Why do you only scan my back and hips?

  • The most accurate data is obtained from the lower back and hips.

Is this radiation?

  • Yes, but about 1/10th the dose of a chest X-ray.

How can technologists be in the room without protection?

  • The radiation level is so low that the technologist is not in any danger.

CT Scan

CT scan is short for Computed Tomography Scan, and is sometimes called CAT scanning. It is a noninvasive medical test that helps a radiologist study the inner workings of your body. CT scans of internal organs, bones, soft tissue and blood vessels reveal more details than regular X-ray exams. CT scans are particularly helpful in diagnosing and monitoring diseases of the central nervous system (brain and spine), as well as the chest and abdomen.

128-slice CT scanner

At WinnMed, we provide state-of-the-art technology with a 128-slice CT scanner. This means your doctor will have more images with more details to diagnose your illness or injury. The CT technology means our patients have shorter exam times, low dose exposure to radiation, and the larger machine helps to reduce anxiety for patients with claustrophobia and improves comfort for patients up to 676 pound.

What to expect

Before your exam, a radiologic technologist will ask you to change into a gown and remove any jewelry. You will be asked to lie on the examining table, usually on your back. Depending on the area of the body to be examined, you may need a contrast agent to help produce clear images. Most contrast agents are injected into your body through a small IV needle. During the injection you may experience a metallic taste in your mouth and a hot, flushed feeling throughout your body. Please inform the technologist if you are allergic to iodine or have had a previous contrast reaction during a CT scan.

Once the exam begins, the table will move in and out of the CT machine opening, which is shaped like a donut. While the machine is running and images are being taken, you will hear a variety of whirring and clicking noises. Only the area of your body being examined will remain inside the scanner. It is very important that you lie still while images are being taken, so that images are clear. You may be asked to hold your breath during parts of the exam.

The technologist will monitor the machine from a computer in an adjacent room. He or she will be able to see, hear and communicate with you at all times. You will be able to talk with the technologist through an intercom system.

Please inform the technologist if you are pregnant or could be pregnant prior to the exam.

The exam is painless and can take from 10 minutes to one hour to perform. A radiologist will interpret the CT scan and your doctor will discuss the results of the scan with you.

Commonly asked questions

When will I get my test results?

  • Results will be available as soon as they are ready through MyChart.  Your provider will also contact you to discuss the results and answer any questions you may have.

Does a CT scan hurt?

  • If an IV is required, there will be minor discomfort when the IV is started. The CT scan itself is painless.

How long does a CT scan take?

  • A CT scan takes 30–60 minutes to complete, on average.

MRI

If your doctor recommends an MRI, request a referral to WinnMed Radiology.  We provide MRI exams daily using the latest in MRI technology.  We serve everyone in our region, and will send the results to the doctor of your choosing.

What is MRI?

Magnetic Resonance Imaging is more commonly referred to as MRI. MRI is a non-invasive procedure used to gather information about your body without involving radiation.

The MRI machine is a large magnet with a round opening. Using the magnet and radio waves, signals are sent to a computer that makes an image of the inside of the body appear on a screen.

MRI has been useful in diagnosing disorders of the central nervous system, joints, abdominal and pelvic organs, and circulatory system.

Winneshiek Medical Center has an in-house MRI machine. With patient convenience in mind, we provide scheduled MRI exams Monday – Friday.

Special notes about MRI

Due to the magnetic properties of MRI, it is essential that we know about all metallic devices that may be present inside your body. They include pacemakers and/or pacewires, embedded shrapnel, aneurysm clips, cochlear stimulating devices, and artificial valves surgically affixed to your heart. You may be asked to have an X-ray of your eyes if you have a history of metal welding or grinding to ensure there is no metal present in your eyes.  A radiologic technologist will review an MRI safety screening questionnaire with you prior to your scan to ensure you are sae to enter the MRI suite.

You will be asked to remove all loose or foreign metal objects such as jewelry, watches, dentures, credit cards and hairpins.

What to expect

WinnMed’s MRI has a wide-bore magnet for added comfort during these studies.  If you have concerns about lying in a small, enclosed space, mild sedation can help you comfortably complete the exam. Please discuss these concerns with your doctor prior to the exam to obtain the necessary medications.

Before your exam, a radiologic technologist will ask you to change into a gown and remove all loose or foreign metal objects such as jewelry, watches, dentures, credit cards and hairpins. Prior to entering the exam room, the technologist will screen your body with a metal detector to ensure your safety. You will be asked to lie on the examining table, usually on your back.  You will be required to lie still during the MRI scan, and the technologist will do their best to get you as comfortable as possible. Depending on the area of the body to be examined, you may need a contrast agent to help enhance the images. Most contrast agents are injected into your body through a small IV needle.

Once the exam begins, the table will move inside a large circular opening that houses the magnet. The magnet is permanently open on both ends for patient comfort.  While the machine is running and images are being taken, you will hear a variety of knocking and buzzing noises, which may become quite loud. To help reduce the sounds you will be provided ear plugs or you can select the type of music you would like to listen to throughout the exam.

The technologist will monitor you and your images through a large window the entire time.  He or she will be able to see, hear and communicate with you at all times through a two-way intercom system. The technologist will also provide you with an alarm button to alert the technologist of any discomfort or concern you may experience at any point during the MRI exam.

If you are pregnant, MRI is not recommended. Please inform the radiologic technologist if you are pregnant or suspect you may be pregnant.

In general, most exams take between 45 minutes and 1 hour, but can take up to 2 hours to complete. A radiologist will interpret the MRI and your doctor will discuss the results of the scan with you.

Commonly asked questions

Can I see my images?

  • Your images will be available to your doctor in 24-48 hours in the event you would like to view the MRI images.

When will I get my results?

  • Results will be available as soon as they are ready through MyChart.  Your provider will also contact you to discuss the results and answer any questions you may have.

How long does the test take?

  • Most exams take between 45 minutes and 1 hour, but can take up to 2 hours to complete.

Nuclear Medicine

A nuclear medicine scan is a safe, painless exam to help diagnosis abnormalities of internal organs and systems, especially abnormalities of the bone, gallbladder, heart, liver or thyroid.

The scan requires the use of a small amount of radioactive material, which is introduced into your system orally or with an IV injection. As the radioactive material travels to the area to be examined, a machine called a gamma camera makes detailed images of the area.

WinnMed offers nuclear medicine scans through a mobile service provided by Mayo Clinic.

What to expect

A specialized technologist will provide an oral or IV injected dose of radioactive material. After the injection, you may be asked to leave and come back for the imaging in approximately 2.5–3.5 hours.

In most cases, you will not have to change into a gown for a nuclear medicine scan. You will be asked to lie on the examining table, usually on your back. You may be asked to change position as the technologist rotates the camera. It is very important that you lie still when asked by the technologist – sometimes up to 15 minutes at a time – so that images are clear.

Please inform the technologist if you are pregnant or could be pregnant prior to the exam.

The exam may take several hours to perform.  A nuclear medicine physician will interpret the images and your doctor will discuss the results of the scan with you.

Commonly asked questions

Is the radioactive material safe?

  • There is no evidence of danger caused by radiation used in this exam.  Complications and/or side effects are rare.

How long will the radioactive material stay in my body?

  • The radioactive material will disappear within 1-2 days.
Meet Our Team
Richard Remark, M.D. headshot
Medical Imaging / Radiology
Mayo Clinic Health System
563.382.2911

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