What effect does a low kilovolt peak (kVp) have during a fluoroscopic examination?

A low kilovolt peak (kVp) during a fluoroscopic examination can indeed cause the image to appear grainy. This is due to the fact that lower kVp settings reduce the penetrating power of the X-rays, which results in an increase in the amount of scattered radiation compared to the transmitted radiation. As a consequence, the image can demonstrate a higher level of noise or graininess, making details harder to discern.

Conversely, a higher kVp increases penetration and improves the overall quality and clarity of the image, enhancing visualization of structures within the body. Low kVp settings are typically associated with images that lack sufficient detail and clarity, which can detract from diagnostic effectiveness. This grainy appearance can compromise the ability to accurately assess the area of interest during clinical evaluations.