Sierra Imaging patients

Latest Technology



TeraRecon brings real-time 3D visualization technology to diagnostic imaging. An advanced radiology workstation enables real-time diagnostic review of 2D, 3D, and 4D images for CT and MRI.



Sierra Imaging Associates has the capability of computer-guided implantology for dental implant surgery. The system is an interactive 3D implant planning system using Simplant software for predictable treatment planning of dental implants. It allows the implant surgeon to determine the bone density of the jaw, and find the ideal position of the implants for both clinical and esthetic considerations. A CT scan provides comprehensive, non-distorted data describing the patient’s bone quantity and quality. SimPlant interactive CT software allows an accurate evaluation of the patient’s anatomy and simulates implant placement and bone augmentation procedures. Implant placement is guided by a surgical template fabricated with a 3D printer according to the original treatment plan. This new treatment modality assures precise and predictable implant placement for better treatment outcome. For more information about our Simplant sytem contact us, and we will be happy to answer any questions you may have.

Cardiac Calcium Scoring

Cardiac Calcium Scoring

Cardiac Calcium Scoring uses a CT scan to find the build-up of calcium on the walls of the arteries of the heart (coronary arteries). This test is used to check for heart disease in an early stage and to determine how severe it is.

Cardiac Calcium Scoring is also called Coronary Artery Calcium Scoring. The coronary arteries supply blood to the heart. Normally, the coronary arteries do not contain calcium. Calcium in the coronary arteries is a sign of CAD.

A CT scan generates an x-ray beam that rotates around your body, and a powerful computer creates cross-sectional images, like slices of the inside of your body. These images are recorded in a computer and can be saved for more study, or printed out as photographs.

Why It Is Done

Cardiac Calcium Scoring is done:

  • To check for early heart disease.
  • Find out how severe heart disease is.

Imaging Exams

The following is to provide you with general information regarding a specific exam we might offer. Click on the exam in question from the menu below and the link will take you to a description of that exam.

Diagnostic X-Ray

Diagnostic x-rays are a type of radiation called electromagnetic waves. x-ray imaging creates pictures of the inside of your body. The images show the parts of your body in different shades of black and white. This is because different tissues absorb different amounts of radiation. Calcium in bones absorbs x-rays the most, so bones look white. Fat and other soft tissues absorb less, and look gray. Air absorbs the least, so lungs look black.

The most familiar use of x-ray is checking for broken bones. X-rays are also used in other ways. For example, chest x-rays can spot pneumonia, and Mammograms use x-rays to look for breast cancer.

When you have an x-ray, you may wear a lead apron to protect certain parts of your body. The amount of radiation you get from an x-ray is minimal. For example, a chest x-ray gives out a radiation dose similar to the amount of radiation you're naturally exposed to from the everyday environment over 10 days.



CT (computed tomography) or CAT (computed axial tomography) is a highly advanced computerized x-ray machine used to obtain images of the body in the axial plane much like slices of bread. This sophisticated computer emits a thin x-ray beam that will continuously rotate 360 degrees while the exam table moves during your procedure. Our highly skilled technologists can use this technology to painlessly and safely obtain images from inside your body. These images provide crucial information to your doctor that helps him or her make accurate diagnoses and treatment plans for you. Occasionally, intravenous and/or oral contrast may be given for various clinical indications to help improve visualization of certain structures.

Sierra Imaging CT Machine


CTA stands for Computed Tomography Angiography (angiography is the study of blood vessels), and is very similar to a CT scan. However, for a CTA, the technologist will use computer techniques along with an IV contrast injection to visualize desired vessel(s). From the patient's perspective, while on the table during the exam, there is no difference from a CT. Similar to a CT scan, the images will provide important information to your doctor to help him or her in your care.



MRI stands for Magnetic Resonance Imaging, and utilizes a strong magnet as the basis for visualizing normal and abnormal structures in the body. With sophisticated computer technology, our highly skilled technologists use the magnetic field and radio waves to painlessly and safely obtain images from inside the body.

These images provide crucial information to your doctor that helps him or her make accurate diagnoses and treatment plans for you. Occasionally, intravenous contrast may be given under certain indications to help improve visualization of certain structures.

Sierra Imaging Associates MRI


MRA stands for Magnetic Resonance Angiography (angiography is the study of blood vessels), and is very similar to MRI. However, for an MRA, the technologist will use computer techniques designed specifically to visualize arteries and/or veins. From the patient's perspective while on the table during the exam, there is no difference from an MRI. As with MRI, occasionally contrast may be given. And similar to an MRI, the images will provide important information to your doctor to help him or her in your care.


After registration, you will be brought to a changing room and asked to change into MRI-safe clothing, which we will provide. You will also be asked to remove all loose metal, including jewelry. While a small locker will be provided for your clothing and personal items, it is recommended that you leave valuables at home.

After you have changed into MRI compatible clothing, you will be brought to a small pre-exam room near the MRI room. If intravenous contrast is to be given for your exam, an intravenous line will be placed at this time.

When the technologist is ready for you, a member of our staff will bring you into the room and position you on a special table. Ear plugs can be provided for your comfort, and headphones may be provided at times to help the exam pass more quickly. As the exam begins, the table will be moved into the magnet, and you will hear a series of noises while the magnet is acquiring images. It is not unusual for the table to move slightly for each new set of images. The key to obtaining the clearest images is for you to remain as still as possible for the duration of the exam. The length of the exam depends on the type of study being performed, but generally averages 20 to 30 minutes.  Very few exams exceed 40 minutes.  Our staff will remain in contact with you for the entire length of the exam.

Preparation for Procedures

Each procedure requires specific preparation. Please locate the type of exam you are scheduled to have from the options below. Carefully review the preparations needed for your exam and apply the instructions accordingly.

If you are new to Sierra Imaging, we offer our printable Patient Registration Form online for your convienience.

CT Non-contrast

CT PREPARATIONS (No oral or I.V. contrast)

For those exams NOT requiring oral or I.V.
This is a very simple prep.

  • The only thing we ask is to not eat or drink 4 hours
    prior to your exam.

For those exams requiring oral contrast only

  • Do not eat or drink 4 hours prior to your exam
  • You will be asked to drink 1 bottle of oral contrast 1 hour prior to the examination time. This bottle may be given to you by your doctor’s office, or may be picked up at our facility. This bottle may be refrigerated until time for dosing. Once in the exam room, the technologist may ask you to drink a cup of water before the scanning begins. The purpose of this oral barium is to coat your entire bowel tract. If you are unable to tolerate the oral contrast, please notify our office so that alternatives may be attempted.



For those exams requiring oral and IV contrast:

  • Do not eat or drink anything 4 hours prior to your scheduled exam time. This examination includes an injection of intravenous (IV) non-ionic iodine contrast to define the blood flow into the area of interest or in question. Without the presence of food or liquids in your stomach, the possibility of nausea from the contrast injection will be reduced.
  • You may be required to drink 1 bottle of oral contrast 1 hour prior to the examination time. This bottle may be given to you by your doctor’s office, or may be picked up at our facility. This bottle may be refrigerated until time for dosing. Once in the exam room, the technologist may ask you to drink a cup of water before the scanning begins. The purpose of this oral barium is to coat your entire bowel tract. If you are unable to tolerate the oral contrast, please notify our office so that alternatives may be attempted.
  • If you have a colostomy bag, please inform our staff before beginning the oral contrast dosing. Also, it is necessary to bring an additional colostomy bag with you on the day of your exam.
  • There are certain medical conditions that may restrict you from receiving the IV contrast for your CT examination. Other conditions require further testing. These include:
    • A previous allergic reaction to IV contrast
    • An allergy to Iodine
    • Medication controlled diabetes
    • Kidney Disease (Solitary kidney, Kidney failure, Kidney transplant, Kidney cancer, or Kidney surgery)
  • All conditions listed above except for those regarding allergies, require a serum creatinine blood test (to check kidney function) within 6 weeks prior to your examination date.
  • There are no restrictions regarding medications that you may take except for diabetes medication. It is important not to take your diabetic medication during the fasting period. You may take all non-diabetic medicines as you normally do with a small amount of water, even if it occurs during the 4 hours you are required to not eat or drink. Also, if you are diabetic and are taking the drug Metformin HCL (Glucophage, Glucovance, Avandemet, or Metaglip) you may be required to cease the use of these medications for a period of 48 hours after your CT examination by order of your diabetes physician. You will be required to have another blood test to determine if it is safe for you to resume your medication.



  • As a rule there are no special preparations before your MRI examination. You are allowed to follow your daily routine in regards to medicines and food.
  • You will be asked to remove all metal from your body and given the appropriate clothing from the MRI staff.
  • You will be asked to remove all makeup, lotions, and deodorants that may contain metallic particles which may cause skin irritation during the procedure.

    You may have an injection of contrast during your MRI examination, through an IV or into a joint (intra-articular). The contrast used for the MRI examination is called Gadolinium, and is different from the contrast used in a CT exam. The two are unrelated, so it is of no concern if you have a history of an allergy to Iodine, or other non-ionic CT contrast material. Please notify the staff if you know that you are receiving MRI contrast and have the following condition:

    • Allergy to Gadolinium contrast

  • There will be a thorough screening completed at least once regarding your surgical history before your MRI examination.

Radiology FAQ

Billing / Insurance

Is Sierra Imaging Associates contracted with my Insurance?

In attempts to keep out of pocket costs down for our patients, Sierra Imaging is constantly working with local, and national insurance carriers to accept agreed contract rates for our patients. We have compiled a list of current insurance carriers that we have completed contracts with. If you do not see your insurance carrier on the list, please call our scheduling department at (559) 322-4271 for an update. Please check our Contracted insurances Link or Click Here to be taken to the page. We also accecpt credit cards, and Care Credit. You can learn more by clicking on the Care Credit link at the bottom of the page. We also have have a competetive cash pay program as an alternative option.

What should I bring to my appointment?

Please bring a current copy of our medical insurance card. At the time of admitting, please review all of your patient registration information for correctness so we can correctly bill your insurance carrier for your exam.

Will Sierra Imaging Associates bill both my primary and secondary insurance:

Yes, we will bill both your primary and secondary insurance carriers as long as we have your correct billing information on file.

What if my exam needs a prior authorization?

Sierra Imaging will work directly with your referring physician’s office and your medical insurance carrier to obtain a prior authorization for your exam.


What patient information is needed to schedule an exam at Sierra Imaging?

The following information should be provided at the time of scheduling a patient at Sierra Imaging:

  • Patient name
  • Patient’s date of birth
  • Referring physician
  • Social Security number
  • Patient’s telephone number
  • Patient’s insurance information
  • Procedure requested Diagnosis or ICD-9 code
  • Prior studies and prior facilities (if known)

My patient works during the day; can Sierra Imaging accommodate early morning, evening, and Saturday appointment times?

Sierra Imaging will be glad to schedule your patient for an early morning, extended evening, or Saturday appointment time. (Currently MRI appoinments only on Saturday). It is important to note that children cannot be left unattended during your patient's appointment.

How can my office obtain Sierra Imaging Associates referral pads?

Please contact Irene Royal, Marketing Coordinator at (559) 322-4285, or email Irene at She will be glad to bring by any referral information you may need to your office.

What procedures are done at Sierra Imaging?

Sierra Imaging currently has state of the art imaging equipment for the following modalities: CT, MRI, Digital X-ray and Ultrasound (Ultrasounds are performed through our partnership with W.I.S.H.)

Who do I speak with concerning scheduling an appointment?

Please contact our scheduling department directly at (559) 322-4271. One of our scheduling specialists will be happy to assist you with any of your scheduling needs.

Medical Records

Can I obtain a copy of my medical records from Sierra?

Sierra Imaging will provide to our patients, a copy of the final Radiologist report after five (5) business days.  A copy of a CD of their studies can be released the same day, with a signed medical records release. A copy of the release form can be found on this website, or please contact our Medical Records Department at (559) 322-4269.

How soon can I obtain my records with a signed release?

Please allow the Sierra Imaging Medical Records staff (48) hours to complete your request for medical records.

I have had prior studies at other facilities; do I have to request my prior studies?

No, our staff will be happy to assist our patients in contacting the previous facilities and request a copy of your prior exams to be forwarded to Sierra. Please let your referring physician’s office know that you have had prior studies at other facilities at the time of scheduling.



What is a CT or CAT scan?

CT scans reveal both bone and soft tissues, including organs, muscles, and tumors. Image tones can be adjusted to highlight tissues of similar density, and, through graphics software, the data from multiple cross-sections can be assembled into 3-D images. CT aids diagnosis and surgery or other treatment, including radiation therapy, in which effective dosage is highly dependent on the precise density, size, and location of a tumor

What is the difference between CT and MRI?

CT uses a combination of x-rays and computer technology. MRI uses a combination of a strong magnetic field, radiofrequency, and computer technology.

Does the examination hurt?

Generally the procedure is painless. If your procedure is ordered with intravenous (IV) contrast, a minor needle stick will be involved.

What will it feel like when I get the intravenous (IV) contrast?

Some patients may note a metallic taste, and/or a warm sensation throughout the body. However, most patients do not feel any different.

What is the difference between MRI and CT intravenous (IV) contrast?

MRI IV contrast is a gadolinium based solution which will show blood vessels/blood flow. CT IV contrast is an iodine based solution that will show areas of blood vessels/blood flow.

What does the oral contrast agent taste like? Why do I have to drink it and why so much?

It tastes similar to a Berry smoothie. The oral contrast agent coats your stomach, small bowel, large bowel, and lower colon so it is more easily identified on the images. The bowel tract is approximately 20 feet long and it takes a generous amount of contrast to coat it adequately – the more, the better.

Why would I have a CT as opposed to a MRI?

Because the indication, your medical condition, and the area of interest can be better imaged and diagnosed in CT.

If I’m pregnant, can I have a CT scan?

Generally not, however, your ordering doctor and the radiologist may think the benefits of having the test outweigh any risks. Be sure to notify staff personnel if you are pregnant or possibly pregnant and have a procedure scheduled.

Does a CT scan involve a lot of radiation?

A combination of taking thin slices and technology reduces radiation to the patient. Recent updates to equipment and software have significantly reduced radiation.


When will I know the results?

Your doctor will generally receive the results within 24-48 hours after your exam, and you can obtain the results from him or her.

Can I get the results directly from Sierra Imaging staff?

Technologists are not trained to intrepert the procedures and therefore, cannot give any information to the patient. Once your procedure has been intreperted by the radiologist, you may request a copy of the report after 48 hours of the exam.

What about my medications?

Generally, there are no restrictions, however, there are for some procedures. Please refer to CT Preparation A for more information.

Will I need a driver?

No, unless you receive medications which will restrict your judgment, reactions or make you tired.

When can I go back to work?

Immediately after the procedure unless you have received medications which will restrict your judgment, reactions, or make you tired.

Do I need to bring anything with me to the test?

Your doctor’s order/referral slip. Any previous examinations which are pertinent to the procedure (films/reports) and a list of medications you are currently taking. If you are going to receive an intravenous (IV) injection, you may fill out and print the IV assessment form online and bring it as well. You may do the same with an online, pre-registration form.

Does my examination need to be scheduled?

Most procedures require advance scheduling, however some may be done on a walk-in basis. Please contact us if you have questions whether your procedure needs to be scheduled. It is important to note that children cannot be left unattended during your exam.

What is a creatinine laboratory test and why am I having one done?

This is applicable only to patients who are going to receive intravenous (IV) contrast. A creatinine laboratory test is an indication of kidney function. Some patients, due to certain medical conditions, medication regimens, and other factors may have less than normal kidney function. The intravenous (IV) contrast is eliminated by your kidneys, therefore, we need to know your kidney function before we give you the contrast.

Why am I repeatedly asked questions about a pacemaker, surgeries, and metal in my eyes, amongst other things?

Because the magnetic fields present in our scanners are so strong, these things can be adversely affected. We continually screen our patients for their safety. We want to avoid possibly damaging any implants and/or having them move or dislodge and potentially harming you.

Why do I have to have an x-ray of my eyes?

Any metallic objects when put in the magnetic field of the scanner have the potential to move. Any patient who has had an accident in which a metallic foreign object lodged in the eyes, will have an x-ray taken prior to the scan. The radiologist will then check the x-ray to see if the object is still embedded. Although you may have had this removed by a doctor, we will still check to ensure there is nothing left.

Are there any instructions or restrictions after the examination? Are there any restrictions on my medications? Do I need a driver?

The answer to all three questions is NO, unless you are going to be given medication for claustrophobia or pain.

What if I am claustrophobic?

You have a couple of options. We may be able to scan you in our open MRI scanner, or you may be given oral sedation to help you relax for the procedure.

What is contrast material?

Also referred to as contrast agent or contrast medium. Any internally administered substance that has a different opacity from soft tissue on radiography or computed tomography. Materials used include barium, used to make opaque parts of the gastrointestinal tract; water-soluble iodinated compounds, used to make opaque blood vessels or the genitourinary tract; may refer to air occurring naturally or introduced into the body; also, paramagnetic substances used in MRI.

What does it mean when contrast has to be used?

Contrast is used depending upon your symptoms, condition, or possible diagnosis. The use of contrast helps to better visualize areas where blood flow exists. If contrast is used for your study, it does not mean that your condition is serious or anything is wrong – it simply means that additional information gained from the injection will provide a more complete answer for your doctor. The contrast used for MRI studies is completely different and unrelated to other contrasts used for CT and radiology studies.

What is Neuroradiology?

The branch of medicine that uses radiant energy (x-rays, magnetic resonance imaging, etc.) to diagnose disorders or diseases of the central nervous system.


What is Radiology?

The branch of medicine concerned with the use of radiant energy (such as x-rays) in the diagnosis and treatment of disease.

What is a Radiologist?

A doctor who specializes in creating and interpreting images of areas inside the body. The pictures are produced with x-rays, sound waves, or other types of energy. A radiologist is trained in the diagnostic and/or therapeutic use of x-rays and radionuclides, and radiation physics; a diagnostic radiologist may also be trained in diagnostic ultrasound and magnetic resonance imaging and applicable physics.

Why is radiology important?

Radiology technology enables physicians to make accurate and early diagnoses, select the best treatment plans, and if the treatment involves surgery, even practice in advance. By using radiographic imaging and computers, surgeons can have a dress rehearsal. Three-dimensional images can be rotated; images can be manipulated to peel away organs and isolate a single structure - all on a computer screen. Today, 59% of the U.S. population receives radiology services each year. Some of the most important and recent advances in medicine are occurring in neuroradiology. In it's first 100 years, radiology turned medicine upside down. In the next hundred years, radiology will turn medicine inside out!

Are we exposed to radiation in our everyday life?

Radiation is a natural part of life. Radiation is light, short radio waves, ultraviolet or x-rays. It has existed since the beginning of time and is an integral part of the universe in which we live. Life on earth has evolved in the presence of radiation. Radiation comes to us from many sources both natural and man-made. These sources include cosmic radiation from outer space, radiation from the soil and buildings, and natural isotopes in our own bodies. Cosmic radiation and terrestrial radiation vary with location.